Past, Present, and Future of Regeneration Therapy in Oral and Periodontal Tissue: A Review

Abstract

Chronic periodontitis is the most common disease which induces oral tissue destruction. The goal of periodontal treatment is to reduce inflammation and regenerate the defects. As the structure of periodontium is composed of four types of different tissue (cementum, alveolar bone periodontal ligament, and gingiva), the regeneration should allow different cell proliferation in the separated spaces. Guided tissue regeneration (GTR) and guided bone regeneration (GBR) were introduced to prevent epithelial growth into the alveolar bone space. In the past, non-absorbable membranes with basic functions such as space maintenance were used with bone graft materials. Due to several limitations of the non-absorbable membranes, membranes of the second and third generation equipped with controlled absorbability, and a functional layer releasing growth factors or antimicrobials were introduced. Moreover, tissue engineering using biomaterials enabled faster and more stable tissue regeneration. The scaffold with three-dimensional structures manufactured by computer-aided design and manufacturing (CAD/CAM) showed high biocompatibility, and promoted cell infiltration and revascularization. In the future, using the cell sheath, pre-vascularizing and bioprinting techniques will be applied to the membrane to mimic the original tissue itself. The aim of the review was not only to understand the past and the present trends of GTR and GBR, but also to be used as a guide for a proper future of regeneration therapy in the oral region.

Poly(lactic acid/caprolactone) bilayer membrane blocks bacterial penetration

“…There are crucial limitations of both resorbable and non‐resorbable membranes. For instance, resorbable membranes often show inadequate mechanical properties or inconsistent degradation patterns 4 4,9 .…”

Effects of the Sintering Process on Nacre-Derived Hydroxyapatite Scaffolds for Bone Engineering

“…Xenograft which is bone graft harvested from different individuals and species are among the choices available. Bio-Oss ® is the most commonly used xenograft in the maxillofacial region [ 5 ]. Although it is an inexpensive option as compared with allograft, this graft exhibits poor vascularity and mechanical property for use in critical-sized defects [ 6 ].…”

Measurement of the Clinical Effects of a Marine Fish Extract on Periodontal Healing—A Preliminary Clinical Interventional Study

“…This is the reason why we used Alflutop ® infiltrations as an adjuvant for periodontal treatment. The elimination of pathogen microbiota from periodontal pockets is crucial, but the need for arresting bone loss mechanisms led to the use of different healing methods and the use of different compounds, such as marine-derived biomaterials, to provide healing [23][24][25].…”