title: Recent advances in the development of GTR/GBR membranes for periodontal regeneration--a materials perspective.
abstract: Periodontitis is a major chronic inflammatory disorder that can lead to the destruction of the periodontal tissues and, ultimately, tooth loss. To date, flap debridement and/or flap curettage and periodontal regenerative therapy with membranes and bone grafting materials have been employed with distinct levels of clinical success. Current resorbable and non-resorbable membranes act as a physical barrier to avoid connective and epithelial tissue down-growth into the defect, favoring the regeneration of periodontal tissues. These conventional membranes possess many structural, mechanical, and bio-functional limitations and the "ideal" membrane for use in periodontal regenerative therapy has yet to be developed. Based on a graded-biomaterials approach, we have hypothesized that the next-generation of guided tissue and guided bone regeneration (GTR/GBR) membranes for periodontal tissue engineering will be a biologically active, spatially designed and functionally graded nanofibrous biomaterial that closely mimics the native extra-cellular matrix (ECM).
  
  
  OBJECTIVE
  This review is presented in three major parts, including (1) a brief overview of the periodontium and its pathological conditions, (2) currently employed therapeutics used to regenerate the distinct periodontal tissues, and (3) a review of commercially available GTR/GBR membranes as well as the recent advances on the processing and characterization of GTR/GBR membranes from a materials perspective.
  
  
  CONCLUSIONS
  Studies of spatially designed and functionally graded membranes (FGM) and in vitro antibacterial/cell-related research are addressed. Finally, as a future outlook, the use of hydrogels in combination with scaffold materials is highlighted as a promising approach for periodontal tissue engineering.
authors.affiliation: Indiana University School of Dentistry, Department of Restorative Dentistry/Division of Dental Biomaterials, Indianapolis, IN 46202, USA.
authors.forename: Marco C
authors.initials: MC
authors.lastname: Bottino
authors.forename: Vinoy
authors.initials: V
authors.lastname: Thomas
authors.forename: Gudrun
authors.initials: G
authors.lastname: Schmidt
authors.forename: Yogesh K
authors.initials: YK
authors.lastname: Vohra
authors.forename: Tien-Min Gabriel
authors.initials: TM
authors.lastname: Chu
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Kowolik
authors.forename: Gregg M
authors.initials: GM
authors.lastname: Janowski
mesh_terms: D001861:Bone Regeneration; D016557:Guided Tissue Regeneration, Periodontal / Q000379:methods*; D006801:Humans; D020100:Hydrogels / Q000627:therapeutic use; D008567:Membranes, Artificial; D049329:Nanostructures / Q000737:chemistry / Q000627:therapeutic use; D010518:Periodontitis / Q000534:rehabilitation / Q000628:therapy*; D010519:Periodontium / Q000033:anatomy & histology / Q000503:physiopathology; D023822:Tissue Engineering / Q000295:instrumentation / Q000379:methods* / Q000639:trends; D054457:Tissue Scaffolds
chemical_list: D020100:Hydrogels; D008567:Membranes, Artificial