From Basic Science to Clinical Practice: A Review of Current Periodontal/Mucogingival Regenerative Biomaterials

Abstract

Periodontitis is a dysbiosis‐driven inflammatory disease affecting the tooth‐supporting tissues, characterized by their progressive resorption, which can ultimately lead to tooth loss. A step‐wise therapeutic approach is employed for periodontitis. After an initial behavioral and non‐surgical phase, intra‐bony or furcation defects may be amenable to regenerative procedures. This review discusses the regenerative technologies employed for periodontal regeneration, highlighting the current limitations and future research areas. The search, performed on the MEDLINE database, has identified the available biomaterials, including biologicals (autologous platelet concentrates, hydrogels), bone grafts (pure or putty), and membranes. Biologicals and bone grafts have been critically analyzed in terms of composition, mechanism of action, and clinical applications. Although a certain degree of periodontal regeneration is predictable in intra‐bony and class II furcation defects, complete defect closure is hardly achieved. Moreover, treating class III furcation defects remains challenging. The key properties required for functional regeneration are discussed, and none of the commercially available biomaterials possess all the ideal characteristics. Therefore, research is needed to promote the advancement of more effective and targeted regenerative therapies for periodontitis. Lastly, improving the design and reporting of clinical studies is suggested by strictly adhering to the Consolidated Standards of Reporting Trials (CONSORT) 2010 statement.

A new direction in periodontitis treatment: biomaterial-mediated macrophage immunotherapy

“…Periodontitis is treated with a stepwise approach, and after the non-surgical phase, intraosseous or bifurcation defects may be amenable to regenerative surgery. Biomaterials available in treatment include biologics (autologous platelet concentrates, hydrogels, nanoparticles), bone grafts (pure bone grafts or ceramics), and membranes (polymers) involved in periodontal adjuvant therapy, bone tissue regenerative restoration, and guided tissue regeneration [ 13 ]. Ceramic materials, polymers, and nanoparticles are the main types of biomaterials that regulate periodontitis macrophages.…”