Abstract
Background/Objectives: Today, regenerative therapy is routinely utilized in both medical and dental practices. Its outstanding results are due to the continuous development of technology and the invention of modern, more advanced biomaterials. The overarching idea in current regenerative therapy has shifted in the direction of the materials applied being osseointegrative, bioactive, responsive to stimuli from the body and actively promoting the overall regeneration of natural bone tissue. The aim is to determine whether chitosan is a material capable of improving the biological properties of different types of bone regeneration materials and, if so, which biological properties are affected. Methods: After going through the eligibility criteria, twenty articles, with a total of seventeen in vitro studies and six in vivo studies (some articles consisting of both), were included in this study. Results: The results presented colorimetric assays as the most commonly used methods investigating biological properties in in vitro studies, while in in vivo studies, researchers mainly rely on radiological and histological evaluation. After analyzing the data in this systematic review, it is clear that in vitro studies found a clear advantage of the results of chitosan-modified bone grafts in terms of bioactivity, osteogenic potential, biomineralization potential, biodegradability and antibacterial activity. In in vivo studies, chitosan-modified bone grafts stood out with better results in biocompatibility, osteogenic ability and biodegradability. Conclusions: In conclusion, it can be noted that chitosan-modified bone grafts have proven efficacy and the influence of chitosan is evidently favorable in terms of biological properties.