Advances of piezoelectric biomaterials in bone defect repair: The role of direct and inverse piezoelectric effect

Natural bone exhibits piezoelectric properties due to its collagen structure. Piezoelectric biomaterials, which can replicate the electromechanical behavior of bone, have thus become a key focus in the development of artificial biomaterials. Their piezoelectricity is expressed as the direct effect under mechanical stimulation and the inverse effect under electrical stimulation. Studies have shown that appropriate mechanical or electrical cues can enhance bone defect repair by activating the piezoelectric properties of these materials, influencing osteogenesis, angiogenesis, osteoclastogenesis, inflammatory responses, and neurogenesis. This review summarizes the mechanisms through which piezoelectric biomaterials facilitate bone defect repair via direct and inverse piezoelectric effects, and discusses the current challenges and future prospects for their application in accelerating bone healing. The Translational Potential of this Article. This review provides a comprehensive overview of the mechanisms by which direct and inverse piezoelectric effects in piezoelectric biomaterials facilitate bone defect repair. It highlights their roles in promoting osteogenesis, angiogenesis, and neurogenesis, inhibiting osteoclast differentiation, and modulating inflammatory responses. These insights are critical for the development of novel piezoelectric biomaterials and the advancement of their personalized clinical applications.