Piezoelectric materials for reconstruction of osteogenic microenvironment coupling: new advances and insights

Bone tissue relies on the intricate interplay between blood vessels, nerve fibers and immune system, which are all essential for physiological and pathological processes of the skeletal system. When the integrity of the bone is destroyed, various physiological responses are initiated, among which the electric signal is a promising intervention since it has been proved effectively modulate the vascular, neural and immune coupled osteogenesis. Among several electricity supplementary strategies, piezoelectric materials have gained significant traction in recent years. This review first elucidates the biological interplay among the vascular, neural, and immune systems, with a focus on their synergy with electrical signaling in osteogenesis. It then delineates the fundamental properties and design principles of piezoelectric biomaterials. Furthermore, the specific mechanisms by which these systems mediate bone regeneration are comprehensively discussed. By synthesizing recent advances, this review highlights key structure–function relationships to guide the rational design of next-generation piezoelectric platforms for enhanced bone repair.