Bioactive Scaffolds for Periodontal Tissue Regeneration: Synergistic Strategies in Controlled Active Ingredient Delivery and Pathologically Responsive Microenvironment Modulation.

The periodontium is a connective tissue complex comprising alveolar bone, cementum, periodontal ligament, and gingiva and provides structural support and physiological protection for dentition. Pathological conditions, including traumatic injuries, neoplastic processes, and chronic inflammatory states, can induce progressive tissue degradation. Regenerative engineering of periodontal osseous tissues is a multifaceted biological process. It relies on precise biomaterial-cell interactions, which are coregulated by local microenvironmental factors and systemic signaling molecules. Significant research efforts have focused on innovating therapeutic strategies through structural engineering, including encompassing fabrication methodologies, surface functionalization, compositional optimization, and controlled bioactive agent delivery. Scaffolds design paradigms emphasize synergistic integration of osteoinductive capacity with multitherapeutic modalities. These modalities specifically target inflammation suppression, ROS clearance, immune modulation, angiogenesis, and microbial control. This perspective comprehensively evaluates current advancements in optimized drug-loading scaffolds designed to address the multifactorial challenges of the periodontal microenvironment. The discussion concludes with an evaluation of persistent limitations and promising research trajectories in this evolving field.