Spinning a new future: The resurgence of silk fibroin biomaterials in oral and maxillofacial surgery

Oral and maxillofacial surgery (OMFS) continuously seeks biomaterials capable of meeting the complex regenerative requirements of the craniomaxillofacial region, which includes both hard and soft tissue repair. Historically valued for its textile applications, silk—particularly the protein silk fibroin (SF) derived from the Bombyx mori silkworm—has emerged as a highly biocompatible polymer. Upon removal of the immunogenic sericin coating, SF demonstrates excellent mechanical strength, tunable biodegradation rates, and the capacity to support stem cell differentiation. This review highlights the current landscape of SF applications in OMFS and identifies existing gaps in its utilization. Specifically, it discusses SF-based bone tissue engineering scaffolds, barrier membranes for guided bone regeneration, vehicles for drug and growth factor delivery, and adjuncts for soft tissue and nerve repair. Finally, the review addresses translational challenges that must be overcome before SF can become a standard-of-care material in clinical practice. Overall, SF represents an economical and minimally invasive biomaterial that promotes facial and intraoral harmony and can be seamlessly integrated into advanced dental practice.