Bio-scaffold for bone tissue engineering with focus on bacterial cellulose, biological materials for hydroxyapatite synthesis and growth factors

Bio-based biomaterials, are created using renewable biomass from sources such as plants, animals and microorganisms. Cellulose is a renewable biopolymer and its usage for bone tissue regeneration has advanced significantly. Bacterial cellulose (BC), which is derived from microorganisms is currently one of the most considered for bone tissue engineering (BTE). However, its performance is limited by lack of bioactivity to stimulate and guide cell differentiation. The introduction of bioceramics into the matrix of BC, enhances its mechanical properties and bioactivity. Hydroxyapatite (HA) is one of the most widely used bioceramics in BTE due to its bioactivity and similarity to the natural bone mineral. The use of growth factors (GFs) has proven to further improve the bioactivity of materials in BTE. This review summarizes the biosynthesis of BC, its modification and applications in BTE. Also, the use of biological products such as fish waste, shells, plants, animals and algae, which are rich in minerals for HA and BTE. GFs and immobilization strategies for their delivery to maintain their bioactivity, were discussed. The development in the application of modern additive manufacturing technology such as 3D bioprinting is paving the way toward the design of tailor-made materials for tissue engineering.