Current bone repair methods have limitations, prompting
the exploration
of innovative approaches. Tissue engineering emerges as a promising
solution, leveraging biomaterials to craft scaffolds replicating the
natural bone environment, facilitating cell growth and differentiation.
Among fabrication techniques, three-dimensional (3D) printing stands
out for its ability to tailor intricate scaffolds. Silk proteins (SPs),
known for their mechanical strength and biocompatibility, are an excellent
choice for engineering 3D-printed bone tissue engineering (BTE) scaffolds.
This article comprehensively reviews bone biology, 3D printing, and
the unique attributes of SPs, specifically detailing criteria for
scaffold fabrication such as composition, structure, mechanics, and
cellular responses. It examines the structural, mechanical, and biological
attributes of SPs, emphasizing their suitability for BTE. Recent studies
on diverse 3D printing approaches using SPs-based for BTE are highlighted,
alongside advancements in their 3D and four-dimensional (4D) printing
and their role in osteo-immunomodulation. Future directions in the
use of SPs for 3D printing in BTE are outlined.