EGGSHELL-DERIVED HYDROXYAPATITE COMBINED WITH NANO CALCIUM SULFATE AND PRF AS AUTOLOGOUS BIOLOGICS AND SUSTAINABLE BIOMINERALS FOR MAXILLOFACIAL REGENERATION - A NARRATIVE REVIEW

Evelyn Nathania Prasetyo*, Rafael Gerrard, Audrey Goenharto, Kayla Puan Maharani, Naura Thifal Zayyani, Vanianda Eca Aishzada

Maxillofacial bone defects present a complex reconstructive challenge due to the intricate anatomy and aesthetic requirements of the craniofacial region. Conventional grafting methods, including autografts and allografts, are effective but constrained by donor site morbidity, immune responses, and limited availability. Recent advancements in biomaterials have led to the development of sustainable and bioactive alternatives such as eggshell-derived hydroxyapatite (EnHA), nano calcium sulfate (nCaSO₄), and platelet-rich fibrin (PRF). This narrative review synthesizes current evidence from 2019 to 2025 on the combined use of EnHA, nCaSO₄, and PRF in bone regeneration within the maxillofacial region. A systematic literature search of PubMed, ScienceDirect, and Google Scholar identified in vitro, in vivo, and clinical studies investigating these biomaterials. Findings indicate that EnHA acts as an osteoconductive scaffold supporting bone cell attachment and mineral deposition, while nCaSO₄ provides ionic calcium and a resorbable matrix that promotes early mineralization. PRF contributes autologous growth factors that enhance angiogenesis, osteoblast differentiation, and tissue maturation. The interaction among these components fosters balanced bone formation, resorption, and vascularization, leading to improved graft integration and accelerated healing. This combination represents a cost-effective, biocompatible, and environmentally sustainable alternative to conventional bone grafts. Further standardized preclinical and clinical studies are necessary to optimize formulation parameters and validate long-term outcomes for predictable maxillofacial bone regeneration.