Smart biomaterials in periodontology: a narrative review

Abstract

Periodontitis is a chronic inflammatory disease characterized by progressive destruction of the supporting structures of teeth, including gingiva, periodontal ligament, cementum and alveolar bone. Conventional periodontal therapies primarily focus on infection control and repair; however, complete regeneration of lost periodontal tissues remains a major clinical challenge. Recent advances in biomaterial science, nanotechnology, tissue engineering and regenerative medicine have led to the emergence of smart biomaterials, which possess the ability to respond dynamically to biological, chemical or physical stimuli within the periodontal microenvironment. These intelligent biomaterials can provide controlled drug delivery, antimicrobial action, immunomodulation, enhanced wound healing and targeted tissue regeneration. Smart biomaterials used in periodontology include stimuli-responsive hydrogels, nanoparticles, nanofibers, bioactive membranes, injectable scaffolds and stem cell-based matrices. These materials respond to various stimuli such as pH, temperature, enzymes, light, magnetic fields and inflammatory mediators, thereby improving therapeutic efficacy and minimizing adverse effects. In addition to periodontal regeneration, smart biomaterials have shown promising applications in guided tissue regeneration, peri-implantitis management, local drug delivery and bone tissue engineering. This narrative review discusses the concept, classification, mechanisms, applications, advantages, limitations and future perspectives of smart biomaterials in periodontology. The review also highlights emerging trends such as exosome-based therapy, 3D printing, nanotechnology, biosensor-integrated scaffolds and personalized regenerative approaches. Smart biomaterials represent a transformative advancement in modern periodontology and may significantly improve the predictability and success of regenerative periodontal therapy in the future.