Biologic Agents to Promote Periodontal Regeneration and Bone Augmentation

Periodontal regeneration is preferred over tissue repair and is accomplished through the exclusion of epithelial tissues, which allows cementum, bone, and connective tissue to repopulate the wound. Recently, biologic materials have emerged as adjuncts to aid in regeneration by augmenting the events of wound healing in the area. A review of biologic agents was conducted using the following MeSH terms: guided tissue regeneration, intercellular signaling peptides and proteins, and biologic factors. Enamel matrix derivative (EMD), platelet-derived growth factor (PDGF), platelet-rich plasma, bone morphogenetic proteins (BMPs), fibroblast growth factor (FGF), and parathyroid hormone (PTH) have all shown promise in promoting hard- or soft-tissue regeneration. No biologic agent is ideal for all clinical situations so the clinician must evaluate each situation to identify the best indication for its usage. Currently, EMD and PDGF have Food and Drug Administration approval for periodontal regeneration, whereas BMP-2 is approved for bone augmentation. FGF and PTH do not have Food and Drug Administration approval for periodontal applications and so their clinical usage is not indicated.