Advances in Bacterial Cellulose/Strontium Apatite Composites for Bone Applications

Bacterial cellulose (BC), associated with hydroxyapatite (HA), is a hybrid scaffold that shows promise for use in bone tissue engineering, owing to its osteoconductive, osteoinductive, and osteogenic properties. The hybrid material, constituted of organic and inorganic phases, can be produced by in situ or ex situ routes via three main processes: biomimetic, immersion cycles, and chemical precipitation. This composite has exceptional properties, such as biocompatibility, mechanical strength, conformability, and elasticity, due to the synergetic effect of both phases compared to the single phase. Recent studies have reported on the usefulness of this composite with regard to the adhesion, proliferation, and migration of bone cells for bone healing. The purpose of this review is to report on the state of the art of BC/HA as a hybrid membrane, presenting its synthesis process, the major properties of the single organic and inorganic phases, and their combination, as well as characterization methods, and pre-clinical and clinical studies of bone repair. We also highlight recent progress in the development of multiphasic systems (biopolymers, nanostructures, and factor growth), focusing on the addition of metal cations to improve functionality (particularly strontium).