Advances in harnessing biological macromolecules for periodontal tissue regeneration: A review

Periodontitis is a chronic multifactorial inflammatory oral disease that can lead to gingival recession, destruction of the periodontal ligament, alveolar bone loss, and tooth loss. Solutions for periodontal tissue regeneration utilize biological macromolecules, including natural ones (such as collagen (COL), alginate (ALG), chitosan (CS), silk fibroin (SF), hyaluronic acid (HA), etc.), inorganic ones (such as hydroxyapatite (HAp), β-tricalcium phosphate (β-TCP), bioactive glass (BG), etc.), synthetic, composite, and nanomaterials. Carrier materials, including hydrogels, nanofibers, nanoparticles, microneedles, and thin films, are used to effectively deliver therapeutic agents and biological factors such as stem cells, bioactive molecules, and genes, so as to promote the elimination of bacteria and tissue regeneration at the damaged periodontal sites. This review mainly focuses on the latest progress of biological macromolecules and tissue engineering technologies in periodontal regeneration in recent years. It aims to inspire the design and development of innovative biomaterials and delivery systems for novel regenerative periodontal treatments.