Figure 1.

Cell- and gene-based technologies using scaffolding matrices for periodontal tissue engineering. A) Extraoral and intraoral stem cells represent a viable and accessible alternative source to harvest and expand multipotent colonies. Adequate cell density could be reached in vitro under a controlled environment and made readily available for reimplantation into a periodontal defect site. B) The available direct and cell-based delivery of a therapeutic gene has been shown to increase the regenerative potential and enhance the availability of important factors. The gene of interest is either injected directly into the periodontal defect via a retrovirus or alternatively could be incorporated into an embryonic stem cell (ES) or adult stem cell that is subsequently expanded and delivered into the area of interest. C) Prefabricated and image-based scaffolds are becoming an essential component in regenerative medicine. A defined supporting structure allows the localization and guidance of the appropriate cells and proteins and the establishment of a mechanically competent environment. Currently, scaffolds for periodontal regeneration are available in particulated, solid, and injectable forms. New developing technology has allowed the customization of scaffolds that fit into the periodontal defect and include an external and internal architecture that enhances tissue orientation and regeneration. This figure highlights the potential of integrating the available tissue engineering strategies to enhance the outcome of periodontal regenerative therapy.