Non-antibiotic antimicrobial agents against periodontal pathogens to improve periodontal regeneration

Aim and Background: Guided tissue regeneration (GTR) is a common approach used in periodontal tissue regeneration. It is based on barrier membranes that prevent the migration of the soft tissue element into the bone defect. Five key factors for an ideal membrane include biocompatibility, space creation, cell blocking, bioactivity, and proper handling. Failure of these membranes is often attributed to bacterial infection due to the absence of antimicrobial properties. This review discusses some substances with antimicrobial properties that have demonstrated significant results in improving the healing process in periodontitis. Methods: We present an overview of recent studies on the development of antibacterial agents that demonstrated antibacterial activity against periodontal pathogens. In order to find articles on non-antibiotic antibacterial substances, A search in two databases, PubMed and Google Scholar, was conducted with the key words antibacterial nanoparticles, antimicrobial peptides, and plant materials (natural products). Results and discussion: A number of substances with antibacterial properties, including some nanoparticles, antimicrobial peptides, and plant materials (natural products), have been studied. The findings indicated that these materials have had a noticeable impact on lowering periodontal disease-causing bacteria. Conclusion: Antibacterial nanoparticles including AgNP, ZnNP, CuNP, and MgNP, natural and synthetic antimicrobial peptides, and plant materials including curcumin, cinnamon, and ginger can be suitable alternatives to common antibiotics, and incorporation of these substances in GTR membranes as a route of administration can be a proper route.