periodontalregenerative

Periodontal regeneration, or periodontal regenerative therapy, refers to dental procedures aimed at restoring the architecture and function of the periodontium lost to periodontitis. The periodontium comprises cementum, periodontal ligament, and alveolar bone; regeneration seeks to reestablish these tissues in their original arrangement rather than merely repairing the damage.

Regenerative approaches combine surgical techniques with biologic and material interventions to create a conducive healing environment. Common methods include guided tissue regeneration using barrier membranes to exclude soft tissue entrogression, and the use of bone grafts or substitutes to provide a scaffold for new bone growth. Biologic mediators such as enamel matrix derivatives, platelet-derived products, and bone morphogenetic proteins may enhance tissue formation. Root surface conditioning and meticulous debridement are integral to most regenerative protocols. Regeneration is most consistently achieved in contained intrabony defects and certain furcation defects, with outcomes influenced by defect morphology, patient factors (such as smoking and diabetes), oral hygiene, and clinician experience.

Clinical outcomes are typically evaluated by gains in clinical attachment level, reduction in probing depth, and radiographic evidence of bone fill. However, regeneration is not guaranteed for every defect, and results can be variable. Indications must be balanced against patient risk factors and alternative treatments, including non-surgical therapy, resective procedures, or tooth replacement with implants when regeneration is unlikely or not feasible.

Current evidence supports selective use of regenerative techniques for specific defect types, with ongoing research aimed at optimizing materials, biologics, and treatment protocols.