Regenerative materials: an overview.

Periodontal reconstructive therapies have demonstrated the ability to reverse the destruction due to periodontitis provided that they are implemented according to their individual indications. By properly evaluating a site, one can employ an evidence-based approach to effectively and predictably treat intrabony defects and furcation involvements. It also should be emphasized that a thorough evaluation of the therapeutic outcome should be continuously performed on all sites in order to determine treatment success and the possible need for further intervention. This is based on the long-term follow-up of cases treated with regenerative therapies, which have shown maintenance of results if the patient had good oral hygiene and was enrolled in a proper maintenance program. With respect to the preceding discussion: 1. The main periodontal reconstructive therapies employed by periodontists are GTR, bone replacement grafts and biologic mediators. 2. It is possible to achieve regeneration when using barriers, autografts, allografts, bovine-derived xenografts and EMDs. 3. Currently, regenerative techniques can be used for the treatment of intrabony defects and furcation involvements given the proper evaluation of each individual site. 4. Various regenerative materials are capable of achieving similar results in intrabony defects and are very predictable when employing evidence-based treatment. 5. A combination of regenerative materials such as barriers and grafts in intrabony defects has not demonstrated any improvement over their use alone. 6. A combination of regenerative materials such as barriers and grafts in mandibular class II furcations has demonstrated improvement over the use of the graft or barrier alone. 7. A combination of regenerative materials such as barriers and grafts in maxillary class II furcations has some limited evidence to support improvement over the use of the graft or barrier alone, but the predictability should not be considered high. 8. A combination of regenerative materials such as barriers and grafts in class III furcations has very limited evidence to support improvement over the use of the graft or barrier alone and should not be considered predictable. 9. Beyond the initial healing phase postsurgically, maintenance and oral hygiene play the largest role in long-term therapeutic success.