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A biologic is a therapeutic agent with biological activity that is administered to achieve an enhanced regenerative or reparative effect. The use of biologics has progressively become a core component of contemporary periodontal practice. However, some questions remain about their safety, indications, and effectiveness in specific clinical scenarios. Given their availability for routine clinical use and the existing amount of related evidence, the goal of this American Academy of Periodontology (AAP) best evidence consensus (BEC) was to provide a state‐of‐the‐art, evidence‐based perspective on the therapeutic application of autologous blood‐derived products (ABPs), enamel matrix derivative (EMD), recombinant human platelet‐derived growth factor BB (rhPDGF‐BB), and recombinant human bone morphogenetic protein 2 (rhBMP‐2). A panel of experts with extensive knowledge on the science and clinical application of biologics was convened. Three systematic reviews covering the areas of periodontal plastic surgery, treatment of infrabony defects, and alveolar ridge preservation/reconstruction and implant site development were conducted a priori and provided the foundation for the deliberations. The expert panel debated the merits of published data and exchanged experiential information to formulate evidence‐based consensus statements and recommendations for clinical practice and future research. Based on an analysis of the current evidence and expert opinion, the panel concluded that the appropriate use of biologics in periodontal practice is generally safe and provides added benefits to conventional treatment approaches. However, therapeutic benefits and risks range based on the specific biologics used as well as patient‐related local and systemic factors. Given the limited evidence available for some indications (e.g., gingival augmentation therapy, alveolar ridge preservation/reconstruction, and implant site development), future clinical studies that can expand the knowledge base on the clinical use of biologics in periodontal practice are warranted.

This study was designed to investigate the healing of surgically induced, horizontal periodontal defects in dogs following placement of a biocompatible, porous polytetrafluorethylene membrane around the roots of the treated teeth and to compare the healing to that of control teeth without membrane. Mandibular premolar teeth of 5 beagle dogs were used for experimentation. Specimen blocks were removed 3 months postoperatively for histological evaluation of contralateral experimental and control teeth. Mean apical migration of junctional epithelium among the experimental surfaces amounted to 0.1 mm as compared to 1.3 mm for the control surfaces. Accordingly, the amount of connective tissue attachment, defined by the distance from the base of the junctional epithelium to the apical termination of root planing, was greater for experimental than for control surfaces. As this increased amount of connective tissue attachment was associated with more coronal bone apposition, a periodontal ligament space was more prevalent in experimental than in control surfaces. A limited amount of ankylosis was observed for both experimental and control surfaces. Root resorption was more prevalent in control than in experimental surfaces. Conceivable reasons for the differences in healing between experimental and control teeth are discussed.

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