Magnesium-Based Resorbable Biomaterials: Biological Effects to Clinical Use

Magnesium (Mg) has emerged as a promising biomaterial, drawing significant attention for its potential in biomedical applications. As Mg-based products are in several clinical trials and in clinical use, it is timely to summarize the current knowledge of the biological effects and clinical potential with a special emphasis on oral and craniomaxillofacial applications. Mg-based biomaterials offer biocompatibility, biodegradability, and mechanical properties suitable for various clinical applications. These characteristics make them promising alternatives to polymers and permanent metals used in implantable devices, meshes, and fixation plates, effectively addressing challenges such as stress shielding, inflammation, and the need for removal surgeries. Their degradation enables gradual native tissue replacement while providing initial support, which is why most of the devices were developed for bone fixation applications. Clinically, Mg-based biomaterials such as resorbable membranes and bone grafts show potential in guided bone/tissue regeneration. In the United States, there is one FDA-approved Mg-based device for orthopedic applications compared with more regulatory approvals in Europe and Asia (at the time of writing). The main limitations that have delayed their widespread clinical use are the variable site-dependent degradation of Mg and Mg’s effect as a biological agent, which adds another layer to the regulatory process. Studies show Mg’s pro-osteogenic, anti-osteoclastic, and anti-inflammatory properties. Mg enhances bone regeneration by activating signaling pathways in mesenchymal stem cells and modulating the immune response. As research progresses, innovative Mg delivery systems leveraging its biological properties may utilize the potential of Mg-based biomaterials for advancing regenerative therapies. This review explores the following: (1) the current status of Mg-based biomaterials in clinical applications, (2) the corrosion properties of Mg metal devices and the biological interactions of degradation by-products, (3) the biological and immunomodulatory role of Mg in bone regeneration, and (4) the use of Mg-based biomaterials in oral and maxillofacial bone regeneration.