Tissue engineering has emerged as a promising approach in periodontology aimed at achieving true regeneration of tissues lost due to periodontitis. Unlike conventional therapies that mainly result in repair, tissue engineering seeks to restore cementum, periodontal ligament, alveolar bone, and gingiva. It is based on the tissue engineering triad of cells, scaffolds, and signaling molecules. Cells provide regenerative potential, scaffolds serve as three-dimensional frameworks, and signaling molecules regulate cellular activities essential for tissue formation. Advances in biologics such as platelet-derived growth factor, bone morphogenetic proteins, transforming growth factor-beta, and enamel matrix derivative have enhanced regenerative outcomes. Modern biomaterials, nanotechnology, gene therapy, and 3D bioprinting have improved scaffold design and delivery systems, making periodontal regeneration more predictable. Although challenges remain, tissue engineering represents a major shift toward biologically driven regeneration and holds significant promise for the future of periodontal therapy.
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