Eggshell sourced hydroxyapatite as a bone regenerative material in dentistry – a narrative review
DOI:
https://doi.org/10.2340/biid.v13.45750Keywords:
Bone, bone density, demineralised freeze-dried bone allograft, eggshell-derived hydroxyapatiteAbstract
Although bone is a dynamic connective tissue with inherent regenerating potential, grafting materials are frequently needed to recuperate shape and function in cases of bone defects. Eggshell-derived hydroxyapatite (EHA) and its nano-form (EnHA) have become viable alternatives because of their availability, affordability, osteoconductivity, biocompatibility, and environmental friendliness.
Human studies evaluating the clinical potential of EHA/EnHA in bone regeneration that were published between 2014 and 2024 were reviewed. A total of seven trials with 112 patients and 88 intervention locations were included in this narrative review. EHA showed promising results in improving bone density, volume, and healing time across a variety of motives including socket preservation, intrabony defects, apicoectomy, and cystic lesions. When paired with platelet-rich fibrin, EnHA consistently demonstrated better healing than ungrafted areas and equivalent outcomes to conventional grafts, such as demineralised freeze-dried bone allograft and synthetic hydroxyapatite. Significant improvements in bone density and the production of new trabecular bone were confirmed by radiographic and histomorphometric investigations.
The therapeutic viability of materials generated from eggshells is further supported by their high calcium content, non-cytotoxic profile, and efficient high-temperature sterilising. However, there are drawbacks, such as inconsistent resorption rates, a dearth of long-term randomised controlled studies, and a lack of established preparation procedures. Large multi-centre studies, long-term result validation, and manufacturing process optimisation should be the main areas of future study. However, with the existing literature, EHA and EnHA are found to be affordable, biocompatible, and sustainable substitutes for conventional graft materials in bone repair and regeneration in dentistry.
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References
Dimitriou R, Jones E, McGonagle D, Giannoudis PV. Bone regeneration: current concepts and future directions. BMC Med. 2011;9:66. DOI: https://doi.org/10.1186/1741-7015-9-66
Mkhize SC, Onwubu SC, Mokhothu TH, Mdluli PS, Mishra AK. Comparative assessment of the remineralization characteristics of nano-hydroxyapatite extracted from fish scales and eggshells. J Appl Biomater Funct Mater. 2023;21:22808000231180390. DOI: https://doi.org/10.1177/22808000231180390
Nainoor N, Shobha ES, Prashanth NT, Rangan V, Malick R, Shaju N. Comparison of clinical and radiographic assessment of efficacy of eggshell-derived nano-hydroxyapatite (EnHA) and demineralized freeze-dried bone allograft (DFDBA), both covered with platelet-rich fibrin (PRF) as a barrier membrane in socket preservation: a randomized controlled clinical trial. J Maxillofac Oral Surg. 2026;25:225–37. DOI: https://doi.org/10.1007/s12663-024-02187-4
Opris H, Bran S, Dinu C, Baciut M, Prodan DA, Mester A, et al. Clinical applications of avian eggshell-derived hydroxyapatite. Bosn J Basic Med Sci. 2020;20:430. DOI: https://doi.org/10.17305/bjbms.2020.4888
Lee SW, Balázsi C, Balázsi K, Seo DH, Kim HS, Kim CH, et al. Comparative Study of hydroxyapatite prepared from seashells and eggshells as a bone graft material. Tissue Eng Regen Med. 2014;11:113–20. DOI: https://doi.org/10.1007/s13770-014-0056-1
Lee SW, Kim SG, Balázsi C, Chae WS, Lee HO. Comparative study of hydroxyapatite from eggshells and synthetic hydroxyapatite for bone regeneration. Oral Surg Oral Med Oral Pathol Oral Radiol. 2012;113:348–55. DOI: https://doi.org/10.1016/j.tripleo.2011.03.033
Kattimani V, Lingamaneni KP, Chakravarthi PS, Kumar TS, Siddharthan A. Eggshell-derived hydroxyapatite: a new era in bone regeneration. J Craniofac Surg.2016;27:112–7. DOI: https://doi.org/10.1097/SCS.0000000000002288
Wu SC, Tsou HK, Hsu HC, Hsu SK, Liou SP, Ho WF. A hydrothermal synthesis of eggshell and fruit waste extract to produce nanosized hydroxyapatite. Ceram Int. 2013;39:8183–8. DOI: https://doi.org/10.1016/j.ceramint.2013.03.094
Li-Chan EC, Kim HO. Structure and chemical composition of eggs. Egg bioscience and biotechnology. 2008;10:9780470181249. DOI: https://doi.org/10.1002/9780470181249.ch1
Rivera EM, Araiza M, Brostow W, Castano VM, Dıaz-Estrada JR, Hernández R, et al. Synthesis of hydroxyapatite from eggshells. Mater Lett. 1999;41:128–34. DOI: https://doi.org/10.1016/S0167-577X(99)00118-4
Sanosh KP, Chu MC, Balakrishnan A, Kim TN, Cho SJ. Utilization of biowaste eggshells to synthesize nanocrystalline hydroxyapatite powders. Mater Lett. 2009;63:2100–2. DOI: https://doi.org/10.1016/j.matlet.2009.06.062
Abdulrahman I, Tijani HI, Mohammed BA, Saidu H, Yusuf H, Ndejiko Jibrin M, et al. From garbage to biomaterials: an overview on egg shell based hydroxyapatite. J Mater. 2014;2014:802467. DOI: https://doi.org/10.1155/2014/802467
Siva Rama Krishna D, Siddharthan A, Seshadri SK, Sampath Kumar TS. A novel route for synthesis of nanocrystalline hydroxyapatite from eggshell waste. J Mater Sci. 2007;18:1735–43. DOI: https://doi.org/10.1007/s10856-007-3069-7
Han Y, Xu K, Montay G, Fu T, Lu J. Evaluation of nanostructured carbonated hydroxyapatite coatings formed by a hybrid process of plasma spraying and hydrothermal synthesis. J Biomed Mater Res. 2002;60:511–6. DOI: https://doi.org/10.1002/jbm.10097
Brostow W, Lobland HE. Materials: introduction and applications. John Wiley & Sons; 2016.
Wood RA, Mealey BL. Histologic comparison of healing after tooth extraction with ridge preservation using mineralized versus demineralized freeze-dried bone allograft. J Periodontol. 2012;83:329–36. DOI: https://doi.org/10.1902/jop.2011.110270
Ho-Shui-Ling A, Bolander J, Rustom LE, Johnson AW, Luyten FP, Picart C. Bone regeneration strategies: engineered scaffolds, bioactive molecules and stem cells current stage and future perspectives. Biomaterials. 2018;180:143–62. DOI: https://doi.org/10.1016/j.biomaterials.2018.07.017
Grover V, Malhotra R, Kapoor A, Sachdeva S. Bone allografts: a review of safety and efficacy. Indian J Dent Res. 2011;22:496. DOI: https://doi.org/10.4103/0970-9290.87084
Kattimani VS, Lingamaneni KP, Kreedapathi GE, Kattappagari KK. Socket preservation using eggshell-derived nano-hydroxyapatite with platelet-rich fibrin as a barrier membrane: a new technique. J Korean Assoc Oral Maxillofac Surg. 2019;45:332–42. DOI: https://doi.org/10.5125/jkaoms.2019.45.6.332
Kattimani V, Lingamaneni KP, Yalamanchili S, Mupparapu M. Use of eggshell-derived nano-hydroxyapatite as novel bone graft substitute – a randomized controlled clinical study. J Biomater Appl. 2019;34:597–614. DOI: https://doi.org/10.1177/0885328219863311
Rachna M, Nandita S, Rashmi KS, Vidya GB, Srikant N, Ananya J, et al. Eggshell membrane as a regenerative material in alveolar bone grafting in combination with advanced platelet rich fibrin. Clin Ter. 2024;175:219–25.
Chen X, Chen Y, Fu B, Li K, Huang D, Zheng C, et al. Eggshell membrane-mimicking multifunctional nanofiber for in-situ skin wound healing. Int J Biol Macromol. 2022;210:139–51. DOI: https://doi.org/10.1016/j.ijbiomac.2022.04.212
Sah MK, Banerjee I, Pramanik K. Eggshell membrane protein modified silk fibroin-poly vinyl alcohol scaffold for bone tissue engineering: in vitro and in vivo study. JBBBE.2017;32:69–81. DOI: https://doi.org/10.4028/www.scientific.net/JBBBE.32.69
Ruff KJ, Morrison D, Duncan SA, Back M, Aydogan C, Theodosakis J. Beneficial effects of natural eggshell membrane versus placebo in exercise-induced joint pain, stiffness, and cartilage turnover in healthy, postmenopausal women. Clin Interv Aging. 2018;13:285–95. DOI: https://doi.org/10.2147/CIA.S153782
Kiers JL, Bult JH. Mildly processed natural eggshell membrane alleviates joint pain associated with osteoarthritis of the knee: a randomized double-blind placebo-controlled study. J Med Food. 2021;24:292–8. DOI: https://doi.org/10.1089/jmf.2020.0034
Mensah RA, Jo SB, Kim H, Park SM, Patel KD, Cho KJ, et al. The eggshell membrane: a potential biomaterial for corneal wound healing. J Biomater Appl. 2021;36:912–29. DOI: https://doi.org/10.1177/08853282211024040
Gokul MNR, Ramesh KS, Gautami PS, Sruthima NVS, Kumar PM, Anilkumar K, et al. A comparative evaluation of eggshell derived hydroxyapatite and demineralized freeze-dried bone allograft in alveolar ridge preservation – a randomized clinical trial. Biomater Investig Dent. 2025;12:44941. DOI: https://doi.org/10.2340/biid.v12.44941
Vani TMS, Paramashivaiah R, Prabhuji MLV, Peeran SW etal. Regeneration of intrabony defects with nano-hydroxyapatite graft, derived from eggshell along with periosteum as barrier membrane under magnification – an interventional study. Appl Sci. 2023;13:1693. DOI: https://doi.org/10.3390/app13031693
Wardana HA, Idulhaq M, Saputra RD, Ermawan R, Roshada MF. Potential use of eggshell as bone graft compared with bovine for bone defect: a systematic review study. Open-Access Maced J Med Sci. 2021;9:470–3. DOI: https://doi.org/10.3889/oamjms.2021.7103
Kattimani VS, Chakravarthi PS, Kanumuru NR, Subbarao VV, Sidharthan A, Kumar TS, et al. Eggshell derived hydroxyapatite as bone graft substitute in the healing of maxillary cystic bone defects: a preliminary report. J Int Oral Health. 2014;6:15–9.
Kattimani VS, Lingamaneni KP. Natural bioceramics: our experience with changing perspectives in the reconstruction of maxillofacial skeleton. J Korean Assoc Oral Maxillofac Surg. 2019;45:34–42. DOI: https://doi.org/10.5125/jkaoms.2019.45.1.34
Muñoz-Sanchez ER, Arrieta-Gonzalez CD, Quinto-Hernandez A, Garcia-Hernandez E, Porcayo-Calderon J. Synthesis of hydroxyapatite from eggshell and its electrochemical characterization as a coating on titanium. Int J Electrochem Sci. 2023;18:100204. DOI: https://doi.org/10.1016/j.ijoes.2023.100204
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Copyright (c) 2026 Konathala SV Ramesh, Mopati Nishanth Reddy Gokul, Penmetsa S Gautami, Naga Venkata SG Sruthima, Pasupuleti Mohan Kumar, Kanakamedala Anil Kumar, Mathala Venkata Lakshmi
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Biomaterial Investigations in Dentistry is a Diamond Open Access peer-reviewed journal, publishing research in oral biomaterials science. The publishing of articles is free for authors, thanks to the support of Acta Odontologica Scandinavica Society (AOSS), a not-for-profit society. 
