Synthetic Biomaterials for Alveolar Bone Regeneration: A Systematic Review of Clinical Evidence

Background: Alveolar bone resorption remains a major challenge in implant and prosthetic rehabilitation. While autologous bone grafts are still considered the gold standard, their biological and surgical limitations have promoted the use of synthetic biomaterials such as biphasic calcium phosphate (BCP), β-tricalcium phosphate (β-TCP), nanocrystalline hydroxyapatite, and bioactive glass. Methods: This systematic review, conducted in accordance with PRISMA guidelines, was based on a comprehensive search performed in March 2025 across PubMed, MEDLINE, Embase, and Google Scholar. A total of 11 clinical studies—including both randomized and non-randomized comparative trials—were identified. Due to the marked heterogeneity of study designs and outcome measures, meta-analysis was not feasible. Reported outcomes focused on bone volume preservation, residual biomaterial, implant stability, histological integration, and postoperative complications. Results: Overall, synthetic biomaterials achieved satisfactory bone regeneration and implant stability, with mean bone preservation ranging between 85% and 95%, often comparable to xenografts and other grafting materials. Among the materials analyzed, β-TCP and BCP generally demonstrated superior resorption control and dimensional stability, while bioactive glass showed favorable integration and remodeling rates. The addition of bioactive agents such as rhBMP-2, rhPDGF-BB, or platelet-rich plasma further enhanced new bone formation. Conclusions: Within the limits of current evidence, synthetic biomaterials show clinical performance comparable to xenografts, particularly in socket preservation and ridge augmentation procedures. Their predictable handling, absence of donor-site morbidity, and potential for bioactive enhancement make them valuable tools for routine clinical use. Larger, standardized trials with long-term follow-up are needed to validate these findings and refine material selection in alveolar bone regeneration.