Current regenerative periodontal therapy

Healing, after subgingival curettage, leads to the formation of a long junctional epithelium. This is a repair process and not one of regeneration. Flap procedures of themselves also seem to lead to the formation of a long junctional epithelium, notwithstanding some evidence of bone repair. Bone grafts favour osseus repair without creating new attachment, for the previous architecture and function of the tissues is not restored. Recently, use of porous hydroxyapatite implants in block or granular form has led to pocket depth reduction and attachment gain. Conditioning of the root surface, after planing, with citric acid, attachment proteins or tetracycline has been widely investigated. The use of citric acid has not led to significant periodontal regeneration but the local use of slow-release tetracycline may prove to be of value. Guided regeneration aims to re-populate the root surface with active periodontal ligament cells. In recent experiments substantial reductions in pocket depth have been achieved.