Recent Advances in 3D Printing and Bioprinting for Periodontal Regeneration: A Review

Periodontal disease is a chronic inflammatory condition initiated by microbial biofilms and perpetuated by a dysregulated host immune response, leading to progressive destruction of the tooth-supporting structures, including gingiva, periodontal ligament (PDL), cementum, and alveolar bone. Three-dimensional (3D) printing and bioprinting are emerging as advanced tools for periodontal regeneration, enabling patient-specific scaffolds and precise tissue engineering. The periodontium, comprising alveolar bone, periodontal ligament, cementum, and gingiva has a complex architecture that makes complete regeneration challenging. Current regenerative approaches such as guided tissue regeneration, bone grafts, membranes, and biologic agents show variable outcomes, particularly in complex defects such as furcations and fenestrations. These limitations are largely attributed to inadequate space maintenance, poor defect adaptation, and the inability to recreate the native hierarchical architecture of periodontal tissues. Bioprinting strategies allow controlled placement of cells, biomaterials, and growth factors, closely mimicking the native periodontal environment. Advances in 3D bioprinting enable precise spatial control of cells, biomaterials, and bioactive molecules, allowing the fabrication of scaffolds that closely mimic the native periodontal microenvironment. This review highlights bioprinting techniques, bioink formulations, and their applications for alveolar bone, periodontal ligament, and gingival regeneration. By enabling functional and spatially organized tissue regeneration, 3D bioprinting represents a promising shift from conventional reparative therapies toward true biological and clinically relevant periodontal regeneration. Although challenges related to vascularization, degradation kinetics, and long-term clinical predictability remain, continued technological refinement and clinical validation position 3D bioprinting as a key strategy for achieving biologically driven and functionally integrated periodontal regeneration.