An update on recent advances in bone regeneration.

SUMMARY: Bone loss from trauma, neoplasia, reconstructive surgery and congenital defects remains a major health problem, making the development of effective bone regeneration therapies a primary priority. The long-term clinical goal is to reconstruct bony tissue in an anatomically functional three-dimensional morphology. Today, the science of bone regeneration is in its infancy with current and emerging therapies still having significant limitations. In addition to bone grafting, current bone regeneration strategies include the application of different bioactive factors, cell types, biologic or artificial scaffolds, alone or in various combinations. Recently, efforts are focused more on understanding the normal bone regenerative process where multiple factors interact in a defined temporal and spatial cascade of events. Bone biology has benefited over the last decade from an explosion of information regarding the molecular mechanisms underlying bone formation and resorption, as well as the feedback signals controlling these complex homeostatic mechanisms. New insights in the complexity of the homeostatic mechanisms regulating bone remodeling have uncovered potential therapeutic strategies for bone repair.