Periodontal regenerative materials and their applications: Mechanisms of action

Barrier membrane technology, gene delivery and stimulatory proteins for cell growth and metabolism are potential methods for enhancing periodontal regeneration. Factors that contribute to growth and differentiation of connective tissue and bone regulate diverse cells of periodontal origin. Although these agents have significant appeal in promoting periodontal wound healing and bone regeneration, the outcome of current methods may be attenuated in an inflammatory environment. Focused generation of required components for periodontal regeneration is a challenge in the context of molecular redundancy associated with multiple isoforms. Epithelial / mesenchymal tissue interactions are closely modulated by several pleiotropic actions of soluble molecular signals in mineralized and non-mineralized tissues. Significant advances in regenerative tissue engineering rely on fine tuning of activity profiles of redundant isoforms of human osteogenic proteins towards more streamlined activity. Accurate dissemination of active agents to connective tissue and bone, underscores regenerative procedures. Targeted therapy comprising slow release devices, loaded scaffolds, fillers and vehicular microcapsules, delivers stimulatory agents over critical temporal phases of wound healing. Techniques for tissue engineering and gene therapy enhance expansion of cell populations and protein expression. Applications for growth stimulatory factors delivered via barriers, scaffolds, cell sheets and other variants have been addressed alongside recent patents in this context; which pave the way for future applications with more consistent outcome in the human subject.