Osteoporosis, affecting the entire skeletal system, can cause bone mass to diminish, thereby reducing bone strength and elevating fracture risk. Fracture nonunion and bone defects are common in patients with fractures, and pain and loss of function may cause serious distress. The search for a new therapeutic strategy is essential because of the limited therapeutic options available. Bone marrow mesenchymal stem cells (BMSCs) are crucial for bone metabolism and development due to their high self-renewal capabilities. Wnt signaling is a key pathway that plays a significant role in bone formation by regulating the differentiation of BMSCs. Therefore, the osteogenic differentiation of BMSCs can be regulated by activating Wnt signaling as an idea for bone tissue repair. In this review, we systematically compile and analyze the roles of various drugs, biomolecules, exosomes, and biomaterials in influencing the Wnt/β-catenin signaling pathway during the osteogenic differentiation of BMSCs. It is also discussed how these factors impact on BMSCs and the Wnt/β-catenin pathway. Finally, we also present recent advances in combining bone regeneration materials through these factors, which will help subsequent clinical treatment and translation.
Keywords: Wnt/β-catenin signaling pathway; bone defects; bone marrow mesenchymal stem cells; bone tissue engineering; osteoporosis.