Advances in Regenerative Medicine for the Treatment of Osteonecrosis of the Jaw.

Osteonecrosis of the jaw (ONJ) is a debilitating condition characterized by progressive bone tissue necrosis, commonly linked to bisphosphonates, radiation therapy, or trauma. Traditional treatments, such as surgical debridement and conservative management, often fail to fully restore bone function, driving the need for alternative therapeutic strategies. Regenerative medicine, particularly cellular therapies and biomaterials, has emerged as a promising field in ONJ treatment. This review explores recent advancements in regenerative approaches for ONJ, with a focus on Mesenchymal stem cells (MSCs) and bioengineered scaffolds. MSCs, with their dual ability to differentiate into osteoblasts and modulate immune responses, play a crucial role in bone regeneration by both forming new bone tissue and reducing inflammation. Bioengineered scaffolds, such as hydrogels, bioactive ceramics, and nanomaterials, provide essential structural support and create a conducive environment for cellular growth and tissue repair. The combination of MSCs with these biomaterials has demonstrated a synergistic effect, significantly enhancing bone healing and regeneration. Additionally, emerging techniques such as platelet-rich plasma (PRP), platelet-rich fibrin (PRF), and bone morphogenetic proteins (BMPs) offer new avenues for improving clinical outcomes in ONJ patients. However, several challenges remain, including regulatory barriers, the need for standardized cell isolation and delivery protocols, and scalability issues for clinical application. This review further examines emerging technologies, such as 3D bioprinting and personalized medicine, which offer the potential to tailor regenerative treatments to individual patients, thereby improving both the efficacy and longevity of therapies. In conclusion, while significant progress has been made in the application of regenerative medicine for ONJ, continued research is essential to address current limitations, optimize treatment protocols, and ensure broader clinical adoption. Advances in cellular therapies and biomaterials hold transformative potential for improving therapeutic outcomes in patients with ONJ.