Periodontal regeneration following surgical treatment

Predictable and complete regeneration of lost periodontium remains an elusive goal, despite advances in surgical procedures and materials. Nevertheless, studies clearly demonstrate the potential for significant clinical improvements after regenerative therapy. Collectively, studies support the use of bone grafts and guided tissue regeneration (GTR) for the correction of intrabony and furcation defects. Results of several studies suggest the possibility of enhanced periodontal regeneration and enhanced stability following the use of combination techniques, such as GTR procedures with osseous grafts. Demineralized freeze-dried bone allograft (DFDBA) remains the most widely used allogeneic graft material in periodontics. Recent evidence suggests that substantial variations exist in the osteoinductive potentials of available DFDBA material. The predictability and extent of periodontal regeneration are associated with defect morphology, compliance, plaque control, inflammation, bacterial colonization, and smoking. Long-term (3- to 5-year) studies suggest that improvements following periodontal regeneration remain stable provided that patients comply with oral hygiene regimens and regular supportive periodontal treatment.