Biomaterials for Periodontal and Peri-Implant Regeneration

Abstract

Periodontal and peri-implant regeneration is the technique that aims to restore the damaged tissue around teeth and implants. They are surrounded by a different apparatus, and according to it, the regenerative procedure can differ for both sites. During the last century, several biomaterials and biological mediators were proposed to achieve a complete restoration of the damaged tissues with less invasiveness and a tailored approach. Based on relevant systematic reviews and articles searched on PubMed, Scopus, and Cochrane databases, data regarding different biomaterials were extracted and summarized. Bone grafts of different origin, membranes for guided tissue regeneration, growth factors, and stem cells are currently the foundation of the routinary clinical practice. Moreover, a tailored approach, according to the patient and specific to the involved tooth or implant, is mandatory to achieve a better result and a reduction in patient morbidity and discomfort. The aim of this review is to summarize clinical findings and future developments regarding grafts, membranes, molecules, and emerging therapies. In conclusion, tissue engineering is constantly evolving; moreover, a tailor-made approach for each patient is essential to obtain a reliable result and the combination of several biomaterials is the elective choice in several conditions.

Chitosan-Based Scaffold for Mineralized Tissues Regeneration

“…It consists of four components: gingiva, periodontal ligament, cementum, and alveolar bone. Severe inflammation of the periodontium is associated with progressively worsening periodontal bone defects resulting in tooth mobility or loss [64,65]. Several biomaterials have been developed as a 3D scaffold to provide an appropriate microenvironment and facilitate good periodontal regenerative outcomes [65,66].…”

Elements of 3D Bioprinting in Periodontal Regeneration: Frontiers and Prospects

“…Bioactive molecules can regulate the differentiation of seed cells into periodontal tissues, mobilize the resident stem cells to the defect sites and the recruitment of immune cells to regulate the inflammatory response of damaged sites, thereby promoting periodontal tissue regeneration [6,20,[80][81][82]. Platelet-derived growth factors (PDGFs), bone morphogenetic proteins (BMPs) and enamel matrix derivatives (EMD) are widely used [83]. PDGF is derived from autologous platelet concentrates.…”

The Outcomes of Enamel Matrix Derivative on Periodontal Regeneration under Diabetic Conditions

“…Other modifications induced by EMD are represented by increased production of PGE2 and OPG, proliferation and migration of T-lymphocytes, and a decreased production of IL-1b, IL-8 [11]. Besides influencing wound healing by downregulating inflammatory genes, while upregulating growth and repair-promoting genes, EMD has been demonstrated to encourage angiogenesis by the activation of endothelial cells [16][17][18][19], and it also stimulates microvascular cell differentiation [11]. There is evidence that EMD exerts a significant influence on the behavior of periodontal ligament cells, osteoblasts, cementoblasts, gene expression by regulating cell attachment, proliferation, and differentiation [13].…”

“…Enamel matrix derivate found its application in periodontology, being used for regenerative procedures, in order to stimulate wound healing, cementum and bone formation [17,18]. So far, EMD has been used in patients without systemic disease, showing great results.…”