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REVIEW

Carbonated hydroxyapatite: Mechanisms, properties, and therapeutic applications 

Mikhail A. Shlykov1* ,  Valery I. Putlayev2,3 ,  Elena S. Klimashina2,3 ,  Zhidao Xia4*
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1 Baikov Institute of Metallurgy and Materials Sciencen Academy of Sciences, Moscow, Russia
2 Department of Interdisciplinary Materials Science, Faculty of Materials Science, Lomonosov Moscow State University, Moscow, Russia
3 Department of Inorganic Chemistry, Faculty of Chemistry, Lomonosov Moscow State University, Moscow, Russia
4 Centre for Nanohealth, Swansea University Medical School, Faculty of Medicine, Health and Life Science, Swansea University, Swansea, Wales, United Kingdom
BMT, 175 https://doi.org/10.12336/bmt.25.00175
Submitted: 8 September 2025 | Revised: 1 December 2025 | Accepted: 17 December 2025 | Published: 21 January 2026
© 2026 by the Author(s). Licensee Biomaterials Translational, USA. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 (CC BY-NC-SA 4.0) (https://creativecommons.org/licenses/by-nc-sa/4.0/deed.en)
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Abstract

It is widely accepted that bone tissue consists of an organic and an inorganic matrix, with hydroxyapatite (HAp) conventionally considered the dominant inorganic component. However, growing evidence suggests that the mineral phase of bone is not pure HAp but carbonated hydroxyapatite (CHAp). CHAp is a class of apatite in which phosphate (PO43−) or hydroxyl (OH−) groups are partially substituted by carbonate (CO32−). Compared to HAp, CHAp exhibits greater biological and thermodynamic activity, resulting in higher biodegradability, osteogenicity, and osteoconductivity. This review discusses the crystal structure, synthesis methods, the role of sintering, analytical techniques, physicochemical properties, biological functions, and potential clinical applications of CHAp. In addition, it highlights the key differences between currently used bone graft substitutes (e.g., HAp ceramics and cements, β-tricalcium phosphate ceramics, and bioglass) and the natural mineral composition of bone. It is anticipated that a more biomimetic approach— particularly the incorporation of CHAp—will play an increasingly vital role in the future development of bone graft substitutes and osteogenic implants.

Keywords
Biomaterials
Bone graft substitutes
Bone minerals
Carbonated hydroxyapatite
Hydroxyapatite
Funding
None.
Conflict of interest
The authors declare no competing interests.
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