Non-Cochrane · intervention · PM42346677
Scaffold-Based Biomaterials for Periodontal Regeneration in Periodontitis: A Systematic Review and Meta-Analysis.
Beresescu Felicia Gabriela, Mucenic Simona, Monea Adriana, et al. · Journal of functional biomaterials · 2026 · PubMed · doi:10.3390/jfb17060286
Findings
35 findings
| Population | ||||
|---|---|---|---|---|
| Adults with periodontitis and intrabony or furcation defects | Scaffold-based periodontal regenerative interventions (all scaffold types) | Conventional regenerative or surgical therapy | Clinical attachment level (CAL) gain 12 months · Periodontal regenerative surgery | MD 0.30 [-0.03, 0.63] Very low 10 studies · 320 participants |
| Adults with periodontitis and intrabony or furcation defects undergoing regenerative surgery | Scaffold-based periodontal regenerative interventions (all scaffold types) | Conventional regenerative or surgical therapy (open flap debridement, GTR with conventional membranes, bone grafts, SRP) | Radiographic defect fill All time points combined | MD 0.1 [-0.2, 0.4] GRADE not reported 14 studies · 485 participants |
| Adults with periodontitis and intrabony or furcation defects | Scaffold-based periodontal regenerative interventions (all scaffold types) | Conventional regenerative or surgical therapy | Probing depth (PD) reduction 24 months · Periodontal regenerative surgery | MD -0.41 [-0.97, 0.15] Very low 3 studies · 83 participants |
| Adults with periodontitis and intrabony or furcation defects undergoing regenerative surgery | Scaffold-based periodontal regenerative interventions (all scaffold types) | Conventional regenerative or surgical therapy (open flap debridement, GTR with conventional membranes, bone grafts, SRP) | Probing depth (PD) reduction All time points combined | MD -0.26 [-0.38, -0.14] GRADE not reported 28 studies · 979 participants |
| Adults with periodontitis and intrabony or furcation defects | Scaffold-based periodontal regenerative interventions (all scaffold types) | Conventional regenerative or surgical therapy | Radiographic defect fill 12 months · Periodontal regenerative surgery | MD 0.51 [0.07, 0.95] Low 6 studies · 207 participants |
| Adults with periodontitis and intrabony or furcation defects undergoing regenerative surgery | Scaffold-based periodontal regenerative interventions (all scaffold types) | Conventional regenerative or surgical therapy (open flap debridement, GTR with conventional membranes, bone grafts, SRP) | Clinical attachment level (CAL) gain All time points combined | MD 0.05 [-0.19, 0.29] GRADE not reported 29 studies · 1017 participants |
| Adults with periodontitis and intrabony or furcation defects | Scaffold-based periodontal regenerative interventions (all scaffold types) | Conventional regenerative or surgical therapy | Clinical attachment level (CAL) gain 6 months · Periodontal regenerative surgery | MD -0.20 [-0.47, 0.07] Very low 16 studies · 616 participants |
| Adults with periodontitis and intrabony or furcation defects | Scaffold-based periodontal regenerative interventions (all scaffold types) | Conventional regenerative or surgical therapy | Radiographic defect fill 6 months · Periodontal regenerative surgery | MD -0.16 [-0.55, 0.23] Very low 8 studies · 278 participants |
| Adults with periodontitis and intrabony or furcation defects | Scaffold-based periodontal regenerative interventions (all scaffold types) | Conventional regenerative or surgical therapy | Probing depth (PD) reduction 12 months · Periodontal regenerative surgery | MD -0.21 [-0.41, -0.01] Moderate 10 studies · 312 participants |
| Adults with periodontitis and intrabony or furcation defects | Scaffold-based periodontal regenerative interventions (all scaffold types) | Conventional regenerative or surgical therapy | Probing depth (PD) reduction 6 months · Periodontal regenerative surgery | MD -0.27 [-0.43, -0.10] Moderate 15 studies · 584 participants |
| Adults with periodontitis and intrabony or furcation defects | Scaffold-based periodontal regenerative interventions (all scaffold types) | Conventional regenerative or surgical therapy | Clinical attachment level (CAL) gain 24 months · Periodontal regenerative surgery | MD 1.00 [0.53, 1.47] Low 3 studies · 81 participants |
| Adults with periodontitis and intrabony or furcation defects | Scaffold-based periodontal regenerative interventions: natural scaffolds | Conventional regenerative or surgical therapy | Clinical attachment level (CAL) gain 6 months · Periodontal regenerative surgery · Meta-regression, natural vs composite scaffold (reference) | MD 0.203 [-0.589, 0.995] GRADE not reported Studies not reported |
| Adults with periodontitis and intrabony or furcation defects | Scaffold-based periodontal regenerative interventions: natural scaffolds | Conventional regenerative or surgical therapy | Probing depth (PD) reduction 6 months · Periodontal regenerative surgery · Meta-regression, natural vs composite scaffold (reference) | MD -0.256 [-0.723, 0.212] GRADE not reported Studies not reported |
| Adults with periodontitis and intrabony or furcation defects | Scaffold-based periodontal regenerative interventions: natural scaffolds | Conventional regenerative or surgical therapy | Probing depth (PD) reduction 6 months · Periodontal regenerative surgery · Natural scaffolds | MD -0.37 [-0.57, -0.16] GRADE not reported 8 studies · 320 participants |
| Adults with periodontitis and intrabony or furcation defects | Scaffold-based periodontal regenerative interventions: natural scaffolds | Conventional regenerative or surgical therapy | Clinical attachment level (CAL) gain 6 months · Periodontal regenerative surgery · Natural scaffolds | MD -0.16 [-0.56, 0.24] GRADE not reported 9 studies · 350 participants |
| Adults with periodontitis and intrabony or furcation defects | Scaffold-based periodontal regenerative interventions: natural scaffolds | Conventional regenerative or surgical therapy | Radiographic defect fill 6 months · Periodontal regenerative surgery · Meta-regression, natural vs composite scaffold (reference) | MD -0.702 [-1.744, 0.341] GRADE not reported Studies not reported |
| Adults with periodontitis and intrabony or furcation defects | Scaffold-based periodontal regenerative interventions: natural scaffolds | Conventional regenerative or surgical therapy | Radiographic defect fill 6 months · Periodontal regenerative surgery · Natural scaffolds | MD -0.29 [-0.98, 0.41] GRADE not reported 4 studies · 132 participants |
| Adults with periodontitis and intrabony or furcation defects | Scaffold-based periodontal regenerative interventions: synthetic scaffolds | Conventional regenerative or surgical therapy | Radiographic defect fill 6 months · Periodontal regenerative surgery · Synthetic scaffolds | MD -0.25 [-0.65, 0.15] GRADE not reported 2 studies · 62 participants |
| Adults with periodontitis and intrabony or furcation defects | Scaffold-based periodontal regenerative interventions: synthetic scaffolds | Conventional regenerative or surgical therapy | Radiographic defect fill 6 months · Periodontal regenerative surgery · Meta-regression, synthetic vs composite scaffold (reference) | MD -0.851 [-2.206, 0.503] GRADE not reported Studies not reported |
| Adults with periodontitis and intrabony or furcation defects | Scaffold-based periodontal regenerative interventions: synthetic scaffolds | Conventional regenerative or surgical therapy | Clinical attachment level (CAL) gain 6 months · Periodontal regenerative surgery · Synthetic scaffolds | MD -0.35 [-1.25, 0.54] GRADE not reported 3 studies · 112 participants |
| Adults with periodontitis and intrabony or furcation defects | Scaffold-based periodontal regenerative interventions: synthetic scaffolds | Conventional regenerative or surgical therapy | Probing depth (PD) reduction 6 months · Periodontal regenerative surgery · Meta-regression, synthetic vs composite scaffold (reference) | MD -0.246 [-0.724, 0.233] GRADE not reported Studies not reported |
| Adults with periodontitis and intrabony or furcation defects | Scaffold-based periodontal regenerative interventions: synthetic scaffolds | Conventional regenerative or surgical therapy | Clinical attachment level (CAL) gain 6 months · Periodontal regenerative surgery · Meta-regression, synthetic vs composite scaffold (reference) | MD -0.092 [-1.005, 0.821] GRADE not reported Studies not reported |
| Adults with periodontitis and intrabony or furcation defects | Scaffold-based periodontal regenerative interventions: synthetic scaffolds | Conventional regenerative or surgical therapy | Probing depth (PD) reduction 6 months · Periodontal regenerative surgery · Synthetic scaffolds | MD -0.31 [-0.79, 0.16] GRADE not reported 3 studies · 112 participants |
| Adults with periodontitis and intrabony or furcation defects | Scaffold-based periodontal regenerative interventions: composite scaffolds | Conventional regenerative or surgical therapy | Probing depth (PD) reduction 6 months · Periodontal regenerative surgery · Composite scaffolds | MD -0.01 [-0.29, 0.28] GRADE not reported 4 studies · 152 participants |
| Adults with periodontitis and intrabony or furcation defects | Scaffold-based periodontal regenerative interventions: composite scaffolds | Conventional regenerative or surgical therapy | Clinical attachment level (CAL) gain 6 months · Periodontal regenerative surgery · Composite scaffolds | MD -0.17 [-0.47, 0.14] GRADE not reported 4 studies · 154 participants |
| Adults with periodontitis and intrabony or furcation defects | Scaffold-based periodontal regenerative interventions: composite scaffolds | Conventional regenerative or surgical therapy | Radiographic defect fill 6 months · Periodontal regenerative surgery · Composite scaffolds | MD 0.22 [-0.16, 0.60] GRADE not reported 2 studies · 84 participants |
| Adults with periodontitis and intrabony or furcation defects | Scaffold-based periodontal regenerative interventions with PRF/PRP enrichment | Conventional regenerative or surgical therapy | Probing depth (PD) reduction 6 months · Periodontal regenerative surgery · With PRF/PRP | MD -0.29 [-0.56, -0.03] GRADE not reported 6 studies · 260 participants |
| Adults with periodontitis and intrabony or furcation defects | Scaffold-based periodontal regenerative interventions with PRF/PRP enrichment | Conventional regenerative or surgical therapy | Probing depth (PD) reduction 6 months · Periodontal regenerative surgery · Meta-regression, PRF/PRP enrichment vs none | MD -0.161 [-0.576, 0.254] GRADE not reported Studies not reported |
| Adults with periodontitis and intrabony or furcation defects | Scaffold-based periodontal regenerative interventions with PRF/PRP enrichment | Conventional regenerative or surgical therapy | Radiographic defect fill 6 months · Periodontal regenerative surgery · With PRF/PRP | MD -0.47 [-1.28, 0.34] GRADE not reported 3 studies · 124 participants |
| Adults with periodontitis and intrabony or furcation defects | Scaffold-based periodontal regenerative interventions with PRF/PRP enrichment | Conventional regenerative or surgical therapy | Clinical attachment level (CAL) gain 6 months · Periodontal regenerative surgery · With PRF/PRP | MD -0.17 [-0.66, 0.32] GRADE not reported 8 studies · 312 participants |
| Adults with periodontitis and intrabony or furcation defects | Scaffold-based periodontal regenerative interventions with PRF/PRP enrichment | Conventional regenerative or surgical therapy | Clinical attachment level (CAL) gain 6 months · Periodontal regenerative surgery · Meta-regression, PRF/PRP enrichment vs none | MD -0.044 [-0.791, 0.703] GRADE not reported Studies not reported |
| Adults with periodontitis and intrabony or furcation defects | Scaffold-based periodontal regenerative interventions with PRF/PRP enrichment | Conventional regenerative or surgical therapy | Radiographic defect fill 6 months · Periodontal regenerative surgery · Meta-regression, PRF/PRP enrichment vs none | MD -0.703 [-1.595, 0.190] GRADE not reported Studies not reported |
| Adults with periodontitis and intrabony or furcation defects | Scaffold-based periodontal regenerative interventions without PRF/PRP (without biologics) | Conventional regenerative or surgical therapy | Probing depth (PD) reduction 6 months · Periodontal regenerative surgery · Without PRF/PRP | MD -0.26 [-0.48, -0.04] GRADE not reported 9 studies · 324 participants |
| Adults with periodontitis and intrabony or furcation defects | Scaffold-based periodontal regenerative interventions without PRF/PRP (without biologics) | Conventional regenerative or surgical therapy | Radiographic defect fill 6 months · Periodontal regenerative surgery · Without PRF/PRP | MD 0.03 [-0.40, 0.46] GRADE not reported 5 studies · 154 participants |
| Adults with periodontitis and intrabony or furcation defects | Scaffold-based periodontal regenerative interventions without PRF/PRP (without biologics) | Conventional regenerative or surgical therapy | Clinical attachment level (CAL) gain 6 months · Periodontal regenerative surgery · Without PRF/PRP | MD -0.22 [-0.53, 0.10] GRADE not reported 8 studies · 304 participants |
Included primary studies 32
Open in Studies| Study | Year | Also included by | Outcomes it informs here | Trial data |
|---|---|---|---|---|
| Bahammam 2021 Expression of Vascular Endothelial Growth Factor Using Platelet Rich Fibrin (PRF) and Nanohydroxyapatite (nano-HA) in Treatment of… PMID:33424378 | 2021 | 3 other reviews | not stated | not extracted yet |
| Liu 2021 Treatment of periodontal intrabony defects using bovine porous bone mineral and guided tissue regeneration with/without platelet-rich… PMID:33569807 | 2021 | 2 other reviews | not stated | not extracted yet |
| Mubarak 2023 Adjunctive effect of collagen membrane coverage to L-PRF in the treatment of periodontal intrabony defects: a randomized controlled… PMID:37667213 | 2023 | 2 other reviews | not stated | not extracted yet |
| Abd El-Azeem 2023 The use of integrin binding domain loaded hydrogel (RGD) with minimally invasive surgical technique in treatment of periodontal intrabony… PMID:38126565 | 2023 | 1 other review | not stated | not extracted yet |
| Dubey 2025 Evaluation of nanofiber scaffolds laden Ashvakatri in the management of chronic periodontitis-a randomized, controlled split pocket study. PMID:40895264 | 2025 | 1 other review | not stated | not extracted yet |
| Górski 2020 Treatment of intrabony defects with modified perforated membranes in aggressive periodontitis: a 12-month randomized controlled trial. PMID:29411112 | 2018 | 1 other review | not stated | not extracted yet |
| Issa 2020 Guided tissue regeneration of intrabony defects with perforated barrier membranes, simvastatin, and EDTA root surface modification: A… PMID:31448832 | 2020 | 1 other review | not stated | not extracted yet |
| Liu 2022 Efficacy of periodontal minimally invasive surgery with and without regenerative materials for treatment of intrabony defect: a randomized… PMID:34414521 | 2022 | 1 other review | not stated | not extracted yet |
| Ustaoğlu 2020 Comparison of GTR, T-PRF and open-flap debridement in the treatment of intrabony defects with endo-perio lesions: a randomized controlled… PMID:31880284 | 2020 | 1 other review | not stated | not extracted yet |
| Agrawal 2022 Comparative evaluation of the efficacy of amniotic membrane with collagen membrane along with demineralized freeze-dried bone allograft in… PMID:36339389 | 2022 | this review only | not stated | not extracted yet |
| Al-agooz 2025 Clinical and radiographic evaluation of melatonin and chitosan loaded nanoparticles in the treatment of periodontal intra-bony defects: A… PMID:40312586 | 2025 | this review only | not stated | not extracted yet |
| Almoliky 2025 Low-Speed Platelet-Rich Fibrin Membrane in Conjunction With Demineralized Freeze-Dried Bone Allograft (DFDBA) Compared to Collagen… PMID:40028653 | 2025 | this review only | not stated | not extracted yet |
| Arumugam 2025 A comparative study of platelet-rich fibrin plugs versus biphasic calcium phosphate in treating infrabony defects in patients with… PMID:40485961 | 2025 | this review only | not stated | not extracted yet |
| Balice 2024 Treatment of Unfavorable Intrabony Defects with Autogenous Bone Graft in Combination with Leukocyte- and Platelet-Rich Fibrin or Collagen… PMID:39064520 | 2024 | this review only | not stated | not extracted yet |
| Deepika 2023 Evaluation of PRF and PLA-PGA Membrane Along with Hydroxyapatite Crystal Collagen Fibers Bone Graft in the Treatment of Infrabony Defects. PMID:37622620 | 2023 | this review only | not stated | not extracted yet |
| Deshpande 2021 Extracellular matrix containing nanocomposite bone graft in periodontal regeneration - A randomized controlled clinical and radiographic… PMID:34393402 | 2021 | this review only | not stated | not extracted yet |
| Dolińska 2025 Early healing after regenerative periodontal surgery with or without antibiotics. PMID:40843516 | 2025 | this review only | not stated | not extracted yet |
| Elgendy 2023 Clinical And Radiographic Assessment Of Autogenous Dentin Nanoparticles In Treatment Of Stage Iii Periodontitis: A Split-Mouth Clinical… PMID:37482878 | 2023 | this review only | not stated | not extracted yet |
| Eshwar 2023 Evaluation of Osteogenic Potential of Fucoidan Containing Chitosan Hydrogel in the Treatment of Periodontal Intra-Bony Defects-A… PMID:37504452 | 2023 | this review only | not stated | not extracted yet |
| Lee 2020 Adjunctive use of enamel matrix derivatives to porcine-derived xenograft for the treatment of one-wall intrabony defects: Two-year… PMID:31811645 | 2020 | this review only | not stated | not extracted yet |
| Limiroli 2023 Regenerative Surgery of Mandibular Class II Furcation Defects: A Comparison of Two Techniques in a Randomized Clinical Trial with 3D CBCT… PMID:36661872 | 2023 | this review only | not stated | not extracted yet |
| Ojha 2024 Clinical and Radiographic Evaluation of Calcium Phosphate-Poly(lactide-co-glycolide) Graft in Regeneration of Intrabony Defects:… PMID:38317387 | 2023 | this review only | not stated | not extracted yet |
| Pal 2022 Regenerative potential of biphasic calcium phosphate and enamel matrix derivatives in the treatment of isolated interproximal intrabony… PMID:36050839 | 2022 | this review only | not stated | not extracted yet |
| Rexhepi 2021 Efficacy of inorganic bovine bone combined with leukocyte and platelet-rich fibrin or collagen membranes for treating unfavorable… PMID:33547808 | 2021 | this review only | not stated | not extracted yet |
| Rithesh 2025 Clinical evaluation of injectable platelet-rich fibrin with synthetic nanocrystalline hydroxyapatite bone graft for the treatment of… PMID:40951743 | 2025 | this review only | not stated | not extracted yet |
| Sankar 2020 Development of biodegradable silkworm cocoon derived silk membrane for GTR in the treatment of grade II furcation DOI:10.26452/ijrps.v11i2.2033 | 2020 | this review only | not stated | not extracted yet |
| Sankar 2020 matched by author and year (probable) | NR | this review only | not stated | not extracted yet |
| Sneha 2021 Comparative Evaluation of Efficacy between Recombinant Human Bone Morphogenetic Protein-2 Impregnated with Absorbable Sponge and… PMID:35068843 | 2021 | this review only | not stated | not extracted yet |
| Sun 2025 A Randomized Controlled Study on the Treatment of Isolated Interdental Intrabony Defects Using the Modified Minimally Invasive Surgical… PMID:40386833 | 2025 | this review only | not stated | not extracted yet |
| Venkatesan 2021 Clinical efficacy of amniotic membrane with biphasic calcium phosphate in guided tissue regeneration of intrabony defects- a randomized… PMID:33958006 | 2021 | this review only | not stated | not extracted yet |
| Wang 2025a Crosslinked Versus Non-Crosslinked Resorbable Collagen Membranes for Periodontal Regeneration: A Multicenter, Randomized, Double-Blind,… PMID:39799466 | 2025 | this review only | not stated | not extracted yet |
| Wang 2025b Native vs. ribosome-crosslinked collagen membranes for periodontal regeneration: A randomized clinical trial. PMID:38962931 | 2025 | this review only | not stated | not extracted yet |
Overlap with other reviews
Reviews that include the same primary studies are not independent evidence. Shared counts match studies by PMID, DOI or NCT, and otherwise by author and year (a probable match). Only the non-Cochrane dental reviews have study lists, so overlap with Cochrane reviews is not counted yet.
Review question
| Element | Planned (methods) | Found (results) |
|---|---|---|
| Population | Adults with chronic or aggressive periodontitis presenting intrabony (1-3 wall) or furcation defects treated with regenerative surgery; tooth-supported periodontium only | Adults with chronic/aggressive periodontitis, Stage II-IV, or endo-perio lesions with intrabony (1-3 wall) or furcation defects (n=31 trials, more than 1200 patients) |
| Intervention | Scaffold-based periodontal regenerative interventions (natural, synthetic or composite biomaterials used as a 3D structural or space-maintaining framework), with or without biologic enrichment (PRF/PRP, rhBMP-2, EMD, other) | Natural (n=15), synthetic (n=10) and composite (n=6) scaffolds; 12 trials with PRF/PRP enrichment |
| Comparison | Conventional regenerative or surgical controls (open flap debridement, standard bone grafts or membranes, scaling and root planing) without an emerging scaffold construct | Open flap debridement, GTR with conventional membranes, bone grafts, MIST, SRP, PRF, CGF (n=31) |
| Outcomes | PD reduction, CAL gain, radiographic or 3D defect fill | PD reduction, CAL gain, radiographic defect fill at 6, 12 and 24 months |
| Study designs | Randomized controlled trials published January 2020 to 1 March 2026, English | RCTs (n=31) |
| Timing | 6, 12 and 24 months | Follow-up 2 to 48 months; pooled at 6, 12 and 24 months |
AMSTAR 2 items
Two independent extractors rated each item. Their ratings are shown side by side because they have not been reconciled yet. The overall rating follows Shea et al. 2017: one critical flaw gives Low, more than one gives Critically Low.
| Item | Extractor A | Extractor B | Agree |
|---|---|---|---|
| 1Research question includes PICO components | Yes | Yes | yes |
| 2Protocol established before the reviewcritical | Partial Yes | Partial Yes | yes |
| 3Choice of study designs explained | No | No | yes |
| 4Comprehensive literature searchcritical | Partial Yes | Partial Yes | yes |
| 5Study selection in duplicate | Yes | Yes | yes |
| 6Data extraction in duplicate | Yes | Yes | yes |
| 7List of excluded studies with reasonscritical | No | No | yes |
| 8Included studies described in detail | Partial Yes | Partial Yes | yes |
| 9Risk of bias assessed satisfactorilycritical | RCT: Yes · NRSI: N/A | NRSI: N/A · RCT: Yes | no |
| 10Funding of included studies reported | No | No | yes |
| 11Appropriate meta-analysis methodscritical | RCT: No · NRSI: N/A | NRSI: N/A · RCT: No | no |
| 12Impact of risk of bias on the pooled results | Yes | Yes | yes |
| 13Risk of bias accounted for in interpretationcritical | Yes | Yes | yes |
| 14Heterogeneity explained | Yes | Yes | yes |
| 15Publication bias investigatedcritical | No | No | yes |
| 16Conflicts of interest reported | Yes | Yes | yes |
| Overall | Critically Low | Critically Low | yes |