Periodontal regeneration: is it still a goal in clinical periodontology?

Abstract

In the last decades, Periodontal Regeneration has been one of the most discussed topics in Periodontics, attracting the attention of researchers and clinicians. This can be justified by the evident and continuous progress observed in the field, characterized by a better understanding of the biological mechanisms involved, significant improvement of operative and technical principles, and the emergence of a wide range of biomaterials available for this purpose. Together, these aspects put the theme much in evidence in the search for functional and esthetic therapeutic solutions for periodontal tissue destruction. Despite the evident evolution, periodontal regeneration may be challenging and require the clinician to carefully evaluate each case before making a therapeutic decision. With a critical reassessment of the clinical and preclinical literature, the present study aimed to discuss the topic to answer whether Periodontal Regeneration is still a goal in clinical periodontology. The main aspects involved in the probability of success or failure of regenerative approaches were considered. A greater focus was given to intrabony and furcation defects, clinical conditions with greater therapeutic predictability. Aspects such as more appropriate materials/approaches, long-term benefits and their justification for a higher initial cost were discussed for each condition. In general, deep intrabony defects associated with residual pockets and buccal/lingual class II furcation lesions have predictable and clinically relevant results. Careful selection of the case (based on patient and defect characteristics) and excellent maintenance are essential conditions to ensure initial and long-term success.

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

“…[43][44][45][46] Comparatively, the regeneration of class III furcation defects currently remains challenging. [45][46][47][48] Apart from treating periodontitis, regenerative strategies are also employed for root coverage procedures to treat mid-buccal gingival recessions, a highly prevalent condition associated with traumatic toothbrushing. [49][50][51][52][53] This review aims to provide an overview of the current periodontal regenerative technologies used in clinical practice, discussing their composition, mechanism of action, and applications to shed light on the limitations in the field and suggest areas for future research.…”

Shedding light on the therapeutic efficacy of oxygen-releasing gel and photodynamic therapy in the repair of periodontal tissue. A study in rats

“…The treatment of periodontitis has traditionally centered on reducing bacterial load through subgingival instrumentation. However, this approach may have limited success in regenerating the lost alveolar bone [9] . Consequently, the modulation of the host immune response emerges as a crucial factor in managing and resolving this condition [9,10] .…”

“…However, this approach may have limited success in regenerating the lost alveolar bone [9] . Consequently, the modulation of the host immune response emerges as a crucial factor in managing and resolving this condition [9,10] . By enhancing the healing and repair process, particularly in susceptible periodontal patients, the emphasis shifts towards achieving more comprehensive outcomes [11] .…”

Multidisciplinary approach involving strategic implant placement before orthodontic (SIMBO) treatment for generalized stage IV grade C periodontitis: A case report with 10‐year follow‐up

“…[4][5][6][7][8][9][10][11][12] Although the substantial elimination of plaque is pivotal to establishing an ideal oral environment for predictable oral rehabilitation in periodontitis patients, regeneration of periodontal tissue is considered the ultimate goal of periodontal therapy. 9,13 Considerable progress has recently been made in periodontal regenerative/reconstructive therapies such as minimally invasive surgery using a microscope and micro instruments, offering favorable clinical and radiographic outcomes for various periodontal defects. [14][15][16] In periodontitis patients with multiple missing posterior teeth and severe attachment loss, anchorage teeth for orthodontic treatment might not be available.…”