Evolving new strategies for periodontal, endodontic, and alveolar bone regeneration

This chapter describes evolving experimental approaches that are geared toward periodontal/bone regeneration. Currently, the pinnacle of regenerative periodontal treatment is the use of bone substitutes combined with barrier membranes, which already demonstrates how far we have progressed from the old resective approaches that dominated the field. Thus, the focus of the clinical repertoire shifted from a purely surgical to biologically oriented treatment of the detrimental effects of periodontal disease and bone defects that may prevent future implant placement. The continuous presence of bacteria at the tooth-epithelium or implant-epithelium junction results in a progressive inflammatory process, which leads to the destruction of the gingival connective tissue and subsequently of the alveolar bone, periodontal ligament (PDL), and cementum on the root surface. This process, when left undisturbed, will lead eventually to the loss of the involved tooth or implant. Not only is this loss of periodontal support detrimental to the stability and function of the tooth or implant, it also hampers the restoration of the diseased area with implants following the removal of the ailing tooth/implant. Therefore, the clinical art of periodontology has been paying a tremendous amount of attention to periodontal regeneration.