<![CDATA[Bone waste is a sustainable, calcium-rich resource for the production of hydroxyapatite (HA), a biomaterial widely used in dental and bone tissue engineering. This systematic review evaluates recent advances in the extraction, transformation, and biological performance of HA derived from bone waste. A total of 20 records were initially identified, of which 11 full-text articles met the eligibility criteria and were included in the qualitative synthesis. The reviewed studies demonstrate that bone waste can be effectively converted into HA through several routes, including thermal-based extraction (calcination, annealing, and sintering at 600–1000°C), alkaline hydrolysis, and hydrothermal or microwave-assisted methods, enabling the production of micro- and nano-sized HA with high purity. Post-extraction functionalization, such as ion doping (Mg²⁺, Na⁺, Co²⁺), drug loading, and composite formation, further enhances osteogenic, antimicrobial, and mechanical properties. Physicochemical characterization using XRD and FTIR consistently confirmed the formation of non-stoichiometric, ion-substituted HA with Ca/P ratios ranging from 1.6 to 1.9, closely resembling biogenic apatite. The presence of multiscale porosity (25–65%) and nano-scale features promotes protein adsorption, ion exchange, and cellular interactions. In vitro studies confirmed cytocompatibility, while ALP activity and mineralization assays demonstrated strong osteogenic potential. Overall, bone waste–derived HA offers biomimetic, functional, and environmentally sustainable alternatives for dental and maxillofacial applications.]]>
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