Mechanistic Potentials of Natural Herbal Medicines (NHMs) in Promoting Bone Regeneration: A Comprehensive Review

Bone healing is a difficult clinical problem, particularly in cases of metabolic abnormalities such as osteoporosis, non-unions, or defects of crucial significance. The drawbacks of traditional therapy, including growth factor therapies and autografts, include immunological responses, donor site morbidity, and exorbitant expenditures. By utilizing the osteogenic, anti-inflammatory, and antioxidant qualities of substances derived from plants, phytomedicine has become a viable substitute. Flavonoids, polyphenols, saponins, and minerals that target important biochemical pathways, including BMP/Smad, Wnt/β-catenin, and RANK/RANKL/OPG, are among the distinctive phytochemical profiles of each medicinal plant. The function in restoring bone microarchitecture, preventing osteoclast activity, and promoting osteoblast genesis is confirmed by preclinical and clinical research. For targeted, long-term distribution, the synergistic potential of polyherbal formulations and integration with biomaterials or nano-based carriers is also covered. Despite compelling data, there are still problems with toxicity profiling, clinical translation, and standardization. All things considered, these medicinal plants are useful, reasonably priced, and biologically active means of encouraging bone repair and orthopedic regeneration. This review looks at the ability of five medicinal plants- Cissus quadrangularis, Dalbergia sissoo, Moringa oleifera, Withania somnifera, and Terminalia arjuna to aid in bone repair.