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One of the important goals of periodontal therapy is the restoration of the lost periodontium and conversion of the periodontitis affected root surface into a substrate, which is biologically hospitable for epithelial and connective tissue cell adherence and attachment. An objective of periodontal treatment is the predictable regeneration of the periodontium in areas previously affected by periodontal disease. Periodontitis affected root surfaces show many changes and the root is commonly referred to as 'pathologically exposed'. The traditional treatment of pathologically altered root surfaces has relied on mechanical removal of plaque and calculus, root bound toxins and contaminated cementum. It is not possible to decontaminate a periodontitis affected root surface completely by mechanical means alone. The instrumented surface will inevitably be covered by a smear layer which is usually comprised of remnants of dental calculus, necrosed root cementum, flecks of hydroxyapatite crystals, microorganisms and their products. The root surface serves as a wound margin during regeneration so it is necessary to rehabilitate the root surface for cell attachment and fiber insertion.
Growth factors are a class of natural biologic mediators which regulate key cellular events in tissue repair i.e. cell proliferation, chemotaxis (directed migration), differentiation and matrix synthesis via binding to specific cell surface receptors. The expression of various growth and differentiation factors following bone and soft tissue injury like what happens in a periodontal disease may regulate the repair and regeneration process. The capacity of these mitogenic growth factors to initiate a programmed cellular cascade that results in the induction of bone in a functionally conserved process utilized in embryonic development recapitulated in post fetal osteogenesis and can be re-exploited for the therapeutic initiation of periodontal tissue regeneration.
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