Aplicabilidade clínica da engenharia tecidual no tratamento periodontal regenerativo

Abstract

Tissue engineering has become a relevant and innovative approach in Periodontics, used to overcome the limitations of conventional therapies and promote the regeneration of periodontal tissues. This work aims to evaluate the clinical applicability of tissue engineering in regenerative periodontal treatment, focusing on the advances made and the decision between using bioengineering resources or conventional surgical methods. To achieve this goal, a literature review was conducted based on articles published in the "Journal of Periodontology," using filters for open access and documents dated from 2015 onwards. The included studies consisted of in vitro studies, animal models (in vivo), randomized clinical trials, evidence-based consensus articles, observational cohorts, and meta-analyses with human samples, ensuring an updated scientific analysis on the topic. Mesenchymal stem cells derived from adipose tissue, dental pulp, and the periodontal ligament showed potential for differentiation and functional regeneration. Biomaterials such as collagen matrices, enamel matrix derivatives, live cell sheets, and recombinant factors - like recombinant human platelet-derived growth factor-BB - were associated with improved clinical attachment, reduced periodontal pocket depth, and a high degree of aesthetic satisfaction. The analysis of clinical trials revealed that integrated techniques (such as surgery with enamel matrix derivative, platelet-rich fibrin, or cellular scaffolds) not only equal but often surpass the results of conventional approaches, especially in complex or aesthetically demanding defects. The combination of tissue engineering and periodontal surgery, including early orthodontic movement, was shown to be safe and effective, with sustained benefits in follow-ups of up to 10 years. We conclude that tissue engineering has broad clinical applicability and the potential to transform the landscape of periodontal regeneration. Its adoption should be guided by individualized protocols, risk stratification, and a multidisciplinary integration.