Periodontal Tissue Regeneration Based on Scientific Concepts ― A Knowledge Framework to Support Clinical Decision-Making ― - The 6th International Dental Symposium

Among the three pillars of the tissue engineering triad, signaling molecules play a pivotal role in orchestrating tissue regeneration and are indispensable for achieving predictable regenerative outcomes. In Japan, recombinant human basic fibroblast growth factor (FGF-2) has been approved as a therapeutic agent for periodontal regeneration. A decade has passed since its clinical introduction, providing substantial experience regarding its therapeutic efficacy and clinical utility. This presentation aims to consolidate current evidence on the clinical significance of FGF-2 in periodontal regenerative therapy, discuss its future prospects and remaining challenges, and explore its synergistic application with bone graft substitutes and other biomaterials that are expected to further enhance regenerative outcomes.

In periodontal regenerative therapy, the selection of bone graft substitutes should not be based solely on product names, handling properties, or familiarity. Rather, it should be guided by an understanding of how each material behaves biologically in vivo, including its space-maintaining capacity, osteoconductive potential, degradation or substitution pattern, and influence on wound healing. In this lecture, I will discuss practical criteria for selecting commercially available bone graft substitutes based on histological insights obtained from our large-animal preclinical studies. By linking biological evidence with clinical cases, I will highlight how differences among materials may influence regenerative outcomes in various defect morphologies and clinical situations. Particular attention will be given to how clinicians can interpret preclinical findings and translate them into daily decision-making. The goal of this presentation is to move beyond a material-centered approach and to propose a biology-guided framework for selecting bone graft substitutes in periodontal regenerative therapy.