The use of bone adhesives in bone regeneration: a comprehensive review of clinical applications and outcome

Bone adhesives have emerged as a promising adjunct in regenerative medicine due to their potential to enhance fixation, improve osteointegration, and reduce operative time. Their application is particularly relevant in scenarios where traditional mechanical fixation is challenging or invasive, such as in cranial, orthopedic, and maxillofacial procedures. This narrative review explores the current landscape of bone adhesives, with a focus on synthetic and bioadhesive composites. A literature search was conducted across PubMed, Scopus, and Web of Science, including both preclinical and clinical studies published in the last two decades. Key parameters analyzed include adhesive composition, mechanical strength, biocompatibility, degradation behavior, and clinical outcomes. The reviewed evidence highlights that bone adhesives exhibit promising properties for use in bone regeneration. Synthetic adhesives, such as cyanoacrylates and polyurethane-based glues, offer high initial bond strength, while bioadhesives - often based on fibrin, collagen, or dopamine-functionalized polymers - demonstrate superior biocompatibility and osteoconductive potential. Clinical studies suggest their utility in bone graft stabilization, cranial defect repair, and minimally invasive maxillofacial surgery. Additionally, adhesives have been shown to reduce the need for hardware fixation, lower infection risks, and promote faster recovery. Bone adhesives represent a valuable complementary tool in regenerative bone procedures. While their integration into clinical practice is still evolving, current data support their safety and efficacy in selected surgical contexts. Further large-scale, long-term trials are warranted to validate their performance and optimize material formulations for specific applications.