Shital S. Shendage, Gokul P. Kamble, Rutuja A. Chavan, Namdeo R. Jadav, Ruey‐an Doong, Jia‐Yaw Chang, Anil V. Ghule
Bioactive glass (BG) has emerged as a promising material in bone tissue engineering due to its unique ability to actively participate in the healing process. The present review introduces human natural bone and its properties, and the challenges posed in artificial bone material development. While much of the existing literature emphasizes its structural and compositional design, this review offers a novel perspective by focusing exclusively on the biological properties of BG that drive tissue regeneration. Key mechanisms, including osteoconduction, osteoinduction, angiogenesis, antibacterial activity, and immunomodulation, are critically examined to highlight how BG influences cellular behavior and the healing microenvironment. The review further presents recent in vitro and in vivo findings, compares the biological efficacy of different glass compositions, and discusses current clinical applications. By concentrating on the biological interface rather than fabrication strategies, this work provides an updated and focused framework for understanding the regenerative potential of BG and identifies future directions for enhancing its therapeutic performance. However, challenges such as controlling ion release kinetics, improving mechanical reliability and porosity balance, aligning degradation rates with tissue healing, ensuring predictable in vivo performance across diverse patient conditions, and overcoming barriers to large-scale clinical translation remain to be addressed. Addressing these limitations will be critical to fully realize the clinical potential of BG in bone regeneration.