Recent Advances in Regenerative Therapies in Periodontology

Background/Objectives: Periodontal regeneration remains a primary goal in contemporary periodontal therapy, aiming to restore both the structural and functional integrity of tissues lost due to periodontitis. Recent advancements in biomaterials, growth factors, and biologically active matrices have expanded the therapeutic possibilities in clinical practice. This narrative review aimed to summarize recent developments in regenerative approaches in periodontology, emphasizing their biological principles, clinical outcomes, and current limitations. Methods: A literature search was conducted in PubMed Central and Scopus for randomized controlled trials and clinical trials published between January 2015 and July 2025. Human studies in English, available in open access and evaluating periodontal regenerative approaches, were included, while animal, in vitro, and non-clinical studies were excluded. A total of 67 articles met the eligibility criteria. Data were synthesized in both tabular and narrative form. Results: Most trials reported clinically relevant improvements in probing depth reduction, clinical attachment gain, and defect fill when regenerative biomaterials were applied in appropriately selected intrabony defects, although outcomes varied according to defect morphology, surgical protocol, and patient-related factors. Conclusions: Although substantial progress has been made, true periodontal regeneration remains challenging. Regenerative techniques such as GTR/GBR, EMD, platelet concentrates, and hyaluronic acid show favorable outcomes in appropriately selected cases, although overall predictability remains limited by variability in study design and short follow-up periods. High-quality, standardized RCTs are needed to consolidate current evidence and support guideline-based clinical decision-making.