materials Review Biomaterials for Periodontal and Peri-Implant Regeneration Leonardo Mancini 1, * , Mario Romandini 2 , Adriano Fratini 1 , Lorenzo Maria Americo 1 , Saurav Panda 3,4 and Enrico Marchetti 1   Citation: Mancini, L.; Romandini, M.; Fratini, A.; Americo, L.M.; Panda, S.; Marchetti, E. Biomaterials for Periodontal and Peri-Implant Regeneration. Materials 2021, 14, 3319. https://doi.org/10.3390/ma14123319 Academic Editor: Rafael Delgado-Ruiz Received: 20 May 2021 Accepted: 9 June 2021 Published: 15 June 2021 Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affil- iations. Copyright: © 2021 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https:// creativecommons.org/licenses/by/ 4.0/). 1 Department of Life, Health and Environmental Sciences, University of L’Aquila, 67100 L’Aquila, Italy; Adriano.fratini@graduate.univaq.it (A.F.); Lorenzomaria.americo@gmail.com (L.M.A.); Enrico.marchetti@univaq.it (E.M.) 2 ETEP Research Group (Etiology and Therapy of Periodontal and Peri-implant Diseases), University Complutense, 28040 Madrid, Spain; mario.romandini@gmail.com 3 Department of Periodontics and Oral Implantology, Institute of Dental Sciences, Siksha O Anusandhan (Deemed to Be) University, Bhubaneswar 759146, Odisha, India; drsaurav87@gmail.com 4 Department of Biomedical, Surgical and Dental Sciences, University of Milan, 20122 Milan, Italy * Correspondence: Leonardo.mancini@graduate.univaq.it Abstract: Periodontal and peri-implant regeneration is the technique that aims to restore the damaged tissue around teeth and implants. They are surrounded by a different apparatus, and according to it, the regenerative procedure can differ for both sites. During the last century, several biomaterials and biological mediators were proposed to achieve a complete restoration of the damaged tissues with less invasiveness and a tailored approach. Based on relevant systematic reviews and articles searched on PubMed, Scopus, and Cochrane databases, data regarding different biomaterials were extracted and summarized. Bone grafts of different origin, membranes for guided tissue regeneration, growth factors, and stem cells are currently the foundation of the routinary clinical practice. Moreover, a tailored approach, according to the patient and specific to the involved tooth or implant, is mandatory to achieve a better result and a reduction in patient morbidity and discomfort. The aim of this review is to summarize clinical findings and future developments regarding grafts, membranes, molecules, and emerging therapies. In conclusion, tissue engineering is constantly evolving; moreover, a tailor- made approach for each patient is essential to obtain a reliable result and the combination of several biomaterials is the elective choice in several conditions. Keywords: tissue engineering; periodontal regeneration; biomaterials; 3D printing; growth factors; regeneration 1. Introduction The improved quality and expectancy of life of the current population leads to an increase in injuries and bone disease in older people who have a diminished capacity to restore and regenerate the damaged tissues [1]. Oral and craniofacial tissue injuries are still a very challenging situation for dentists and oral surgeons. To facilitate dentists in their clinical practice, tissue engineering is in constant evolution, and each year several biomaterials are proposed to achieve better results in periodontal and peri-implant re- generation [2]. The principal target of periodontal and peri-implant tissue engineering is to regenerate the supporting tissue of the teeth or implants. Tooth loss, bone, and soft tissue remodeling are consequences of an inflammatory process or age-related decay [3,4]. Periodontitis has been estimated in about 27% of the global population, and to restore missing tooth implants, therapy is a primary alternative to mobile prosthesis [5–7]. This condition leads the clinician to evaluate the predisposition of bone and supporting tissue around the missing tooth site. In several conditions, this required a regenerative approach before or during the implant insertion [8,9]. Peri-implantitis has been estimated in 20% of the population and is defined as an inflammatory process that occurs around implants with soft tissue inflammation and supporting bone loss [10]. Materials 2021, 14, 3319. https://doi.org/10.3390/ma14123319 https://www.mdpi.com/journal/materials