Advances in Composite Bioactive Scaffolds for Alveolar Bone Repair: Implications for Oral Surgery.

Craniofacial bone defects present a unique challenge due to the complex anatomical and functional demands of the region. Composite bioactive scaffolds have emerged as promising strategies for bone regeneration, combining the structural support of inorganic materials with the biological responsiveness of natural or synthetic polymers. This review discusses recent advancements in composite scaffolds tailored for alveolar and maxillofacial bone repair, with an emphasis on material selection, scaffold architecture, bioactivity, and therapeutic delivery capabilities. Key features, including porosity, mechanical strength, degradation rate, and anatomical adaptability, are evaluated for their clinical relevance. Furthermore, the roles of ion release, surface topography, and incorporation of growth factors or stem cells in modulating osteogenesis, angiogenesis, and immune responses are highlighted. Recent innovations also include dual-functional scaffolds that can promote bone formation while delivering antimicrobial or anti-inflammatory agents. Although most remain in preclinical stages, some composite scaffolds, particularly those based on hydroxyapatite, β-tricalcium phosphate (β-TCP), and bioactive glass, have progressed to clinical applications in dental implantology. The integration of biomimetic cues, 3D printing, and controlled drug release marks a significant step forward in personalized bone tissue engineering.