Regeneration Materials: Types, Prognosis and Indications

Abstract

Regenerative dentistry has as main purpose to find new therapeutic approaches for edentulism, bone defects, periodontitis and other tissue loss-related pathologies. The periodontal disease and bone defects are explained with their updated classification. The main materials developed for periodontal regeneration are the autografts, allografts and xenografts besides the platelet-derived-growth factor (PDGF) and the enamel matrix derivatives (EMD) which provide additional stimuli necessary to enhance it. Finally, barrier membranes are introduced among which the non-resorbable and resorbable membranes. Objectives: this work will focus in highlightening the main materials used for the regeneration of the periodontium and their indications depending on different clinical situations. Methodology: research through scientific articles found in MEDLINE, PUBMED and Google Scholar. Supportive clinical trials and systematic reviews have been found also by looking through the bibliography of the main chosen articles. Discussion: comparisons between the scaffold materials have been made, in particular between cortical DFDBA and cancellous DFDBA, then FDBA and DFDBA. Also between non resorbable and resorbable membranes. Finally different clinical cases have been presented in order to understand the different materials to use for each clinical situation and bone defect. Conclusion: For periodontal regeneration to occur regenerative dentistry uses autografts, allografts or xenografts used alone or together with the growth factors PDGF or EMD and/or with nonresorbable or resorbable membranes. Currently there is not an ideal grafting material since they all present advantages and limitations. There is not a better choice between non-resorbable and resorbable membranes, the final considerations are different according to the surgical site in question. For the regeneration of intraosseous defects clinical studies failed to demonstrate more efficacy of EMD over GTR but the use of EMD is safer. In the case of critical-size defects relevant are the GBR and/or conservative surgical techniques.