Emerging Strategies for Periodontal Regeneration: Integrating Biology, Technology, and Clinical Evidence

Abstract

Periodontal regeneration represents a transformative approach aimed at restoring the cementum, periodontal ligament, and alveolar bone lost due to periodontitis, a disease with significant global prevalence and systemic implications. This review highlights key biological mechanisms including stem cell niches, signaling pathways, and immune modulation that underpin regeneration. It further explores advances in biomaterials such as nanostructured grafts, injectable hydrogels, and 3D-printed scaffolds, along with clinically validated biologics like enamel matrix derivatives, platelet concentrates, and recombinant growth factors. Cutting-edge strategies including stem cell therapies, exosome-based treatments, and smart responsive scaffolds are also discussed. While challenges like patient variability, regulatory complexity, and limited long-term data persist, the convergence of personalized medicine, minimally invasive technologies, and AI-guided protocols promises a more predictable and accessible future for periodontal regenerative therapies.