Bone tissue engineering (BTE) is critical for addressing bone defects caused by aging populations, chronic diseases, and millions of annual road injuries, yet its potential is hampered by high costs, regulatory delays that deter investment, and healthcare's environmental footprint, which accounts for 8.5 % of the United States' emissions and continues to rise. BTE advancement must prioritize affordability, regulatory efficiency, and climate-conscious innovation to ensure equitable access and sustainability. This work conducts a comparative life cycle assessment (LCA), techno-economic analysis (TEA), and entropy-weighted sustainability indices (SI), a data-driven overall score that weighs economic and environmental metrics by their variability, of stereolithography (SLA) three-dimensional (3D) printing and electrospinning (ES) for polycaprolactone-based scaffold preparation. Results show SLA reduces energy demand per kilogram of scaffold compared to ES, attributed to ES's energy-intensive solvent evaporation and high-voltage fiber formation. When bioactive nanofillers were incorporated, SLA remained cost-competitive and environmentally favorable, whereas ES showed steep increases in energy use, solvent consumption, and ecotoxicity, largely attributed to chloroform. Entropy-weighted SI values reflected these trends: SLA led the ranking, its nanofiller variant remained viable, while ES (with and without nanofillers) performed poorest due to compounded environmental and economic burdens. Adopting solvent recovery systems, such as condensation and closed-loop recycling as well as green solvents and renewable energy, could trim the high energy demand and solvent-intensive processes.
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