Changes in lifestyle and the advent of knowledge and technology for health care increased the longevity of people and the risks to which they are exposed. In the present decade, the general life expectancy is in the eighth decade and in our country is over 70 years (1). Although these figures are encouraging, they lead to an increased risk of suffering pathologies related to the deterioration of the physical condition of individuals.

On the other hand, the greater access to private means of transport, the practice of sports with high risk of injuries, the sedentary lifestyle associated to the new productive models and the high frequency of obesity, originate scenarios in which the injuries increase their frequency and gravity. It is noteworthy to mention that these circumstances are not alien to our environment.

From a long time ago, the knowledge of the biological structures and their dynamics, together with the interest in maintaining a good quality of life, stimulated the research oriented to understand and eventually to take advantage of the principles of tissue regeneration. If we look at the number of scientific publications on the subject, we can see that from one in 1947² the respectable number of 668 reviews was reached in 2015, and in that year 3,514 articles related to the topic were published. It is particularly revealing that the PubMed database collects, by 2015, 1,000 records linked to tissue and bone regeneration, with notable emphasis on applications aimed at dental and craniofacial corrections.

The analysis of tissue regeneration, and particularly bone regeneration, is supported by the knowledge of the histological characteristics and the natural mechanisms of repair³. The following mechanisms were then added to that: the knowledge of the mineral bone structure chemistry, the biomechanical behavior of its components and, more recently, the identification of cellular signals that act in the process of formation and regeneration of bone structures, such as BMP (bone morphogenic proteins) and OGP (ostegenic growth peptides), recognized structurally and functionally in their ability to stimulate proliferation, differentiation and enzymatic production and mineralization capacity of osteoblastic cell lines⁴. Cell biology provides the knowledge to obtain, implant and differentiate cell lines for their effective incorporation in environments where their action is required ^5,6).

However, the cells are not sufficient in this process and there are very different research efforts regarding the construction of the scaffold capable of supporting them. The search for titanium metal matrices, materials of biological origin such as collagen derivatives, fibroin, alginates, hyaluronic acid and chitin derivatives (chitosans)^7-12, and extracellular bone matrix hybrids with polycaprolactone (DCB: PCL) capable of supporting cells at the appropriate site¹³, even those of different tissue origin, constitute an area of ​​strong experimental development.

No less important is to assure that all knowledge is translated into actual capacity to produce mass of material suitable for the desired repair. In this regard, cell cultures on various matrices, both natural and synthetic, 3-dimensional printing of support matrices for the proliferation of osteogenic cells and even the in vivo production of the repair biomaterial in the recipient subjects themselves were already explored.

The progress achieved is surprising, however, the vast majority of the evidence comes from in vitro studies, which further enhances animal testing. Clinical trials, although limited in the literature, are mostly focused on the regeneration of dental material or facial skull bones and the factors that may favor them^15,16, which indicates the need to deepen studies with translational orientation so that the solutions with the best profiles of effectiveness reach clinical applications in the medium term. In the meantime, medical practice has a high responsibility to influence the groups at greatest risk in order to reduce preventable factors, such as obesity, sedentary lifestyle and reckless driving, which are associated with pathologies and injuries whose treatment would require tissue regeneration.