Bone morphogenetic protein-assisted bone regeneration and applications in biofabrication

Bone morphogenetic proteins (BMPs) are osteogenic growth factors frequently incorporated into biomedical devices to encourage the formation and regeneration of bone. They have played an important role in the development of tissue engineering, regenerative medicine, and, more recently, biofabrication strategies for the treatment of bone loss as a result of disease, trauma, or congenital abnormality. Current metallic bone implants provide load-bearing mechanical properties but are not osteoinductive, failing to instigate bone formation and infiltration into the implant for effective regeneration. Following regulatory approval for spinal fusion products in the early 2000s, BMPs peaked in interest over the next decade for the treatment of a range of bone conditions. However, various concerns surrounding on- and off-label BMPs use in the early 2010s demonstrated a lack of translational understanding. We have now reached an era where the future of bone regeneration device development aims to minimize dosages, incorporate advanced controlled-release patterns, or potentially avoid the use of BMPs altogether. These advanced techniques aim to maintain the same, if not improved efficacy of devices without the costs and risks associated with BMP use. This chapter discusses BMPs past and future applications at a turning point in its use for osteoinductivity in biofabrication devices.