Traditional bone healing approaches like casting and grafting often fail to restore complex fractures or address massive osteoporotic defects, leaving millions with permanent disability or chronic pain. The convergence of advanced bioprinting and responsive materials could fundamentally alter how medicine rebuilds damaged skeletal tissue.
This comprehensive analysis reveals how stereolithography, selective laser sintering, and bioplotter printing now enable creation of patient-specific bone scaffolds with precise architectural control. The integration of nanotechnology enhances scaffold biofunctionality, while emerging four-dimensional printing introduces stimuli-responsive properties that adapt to healing environments. Metal, ceramic, polymer, and composite biomaterials each offer distinct advantages for different anatomical sites and mechanical requirements.
The transition from static implants to dynamic scaffolds represents a paradigm shift in regenerative medicine. Unlike conventional grafts that simply fill voids, 4D-printed constructs can respond to biological cues, gradually releasing growth factors or changing porosity as new bone forms. This review consolidates evidence across multiple fabrication approaches but acknowledges critical limitations including vascularization challenges, immune compatibility concerns, and manufacturing scalability issues. The technology remains largely experimental, with most evidence from laboratory studies rather than clinical trials. However, the precision control over scaffold architecture and the potential for personalized, stimulus-responsive implants suggests bioprinting could eventually replace traditional bone grafting procedures. Success will depend on resolving current manufacturing limitations and demonstrating long-term safety in human subjects.