3 While the standard approaches generally result in successful defect repair, complications such as donor site morbidity or disease transmission often arise, which demands the investigation of suitable alternatives. 1, 2 The worldwide incidence of bone disorders and conditions is expected to double by 2020, especially in populations where aging is coupled with increased obesity and poor physical activity. Often additional materials such as pins, plates and bone fillers are needed to immobilize the grafts.īone grafts and their companion materials constitute a billion dollar industry as upwards of 1.5 million grafts are placed annually in the United States. The clinical standards for bone grafting are autografts, harvested from a secondary site in the patient, and allografts, harvested from cadavers and sterilized prior to use. This is often the case for segmental defects, fracture non-unions, and traumatic fractures where minimal tissue integrity remains in the defect site.
However, when bone defects are large enough or critical-sized, they cannot regenerate via normal physiological processes and require intervention in the form of bone grafts. In many cases, bone fractures can be immobilized to allow for spontaneous healing over time. Unlike many other tissues, bone has the remarkable ability to regenerate when damaged. Finally, we highlight recent advances in development of chitosan-based scaffolds with enhanced bone regeneration capability. We present the common methods for fabrication and characterization of chitosan scaffolds, and discuss the influence of material preparation and addition of polymeric or ceramic components or biomolecules on chitosan scaffold properties such as mechanical strength, structural integrity, and functional bone regeneration. In this review, we discuss the fundamentals of bone tissue engineering and the unique properties of chitosan as a scaffolding material to treat bone defects for hard tissue regeneration. Chitosan is especially attractive as a bone scaffold material because it supports the attachment and proliferation of osteoblast cells as well as formation of mineralized bone matrix. Chitosan, a biodegradable, naturally occurring polymer, has drawn considerable attention in recent years as scaffolding material in tissue engineering and regenerative medicine. Bone defects requiring grafts to promote healing are frequently occurring and costly problems in health care.
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