REGENERATIVE DENTISTRY VERSUS SYNTHETIC BIOMATERIALS: A COMPARATIVE REVIEW OF BIOLOGICAL AND ENGINEERED APPROACHES TO ORAL TISSUE REPAIR

Objective: This review compares regenerative dentistry, which seeks to restore diseased or damaged oral tissues using the body's own biological processes, with the long-established approach of replacing lost tissue with synthetic biomaterials. The aim was to critically appraise the evidence for biologically driven regeneration of the dentin-pulp complex, periodontium and alveolar bone relative to conventional synthetic alternatives, and to identify where the two approaches converge. 
Methods: A narrative literature review was conducted using PubMed, Scopus and Web of Science, focusing on publications from 2017 to 2025, supplemented by earlier landmark studies where they remain clinically relevant. Sources covering dental pulp stem cell therapy, calcium silicate bioceramics, guided tissue and bone regeneration membranes, enamel matrix derivative, platelet concentrates and polymer-based scaffolds were selected for their methodological relevance to the pulp-dentin complex, periodontium and alveolar bone. 
Results: Regenerative strategies, including dental pulp stem cell transplantation and enamel matrix derivative, have shown biologically authentic tissue formation and favourable clinical outcomes in pilot and randomised trials, but remain constrained by cost, technical complexity and variable long-term evidence. Synthetic biomaterials, particularly calcium silicate bioceramics and resorbable polymer membranes, offer predictable handling, regulatory maturity and lower cost, though they generally repair rather than truly regenerate tissue architecture. Hybrid strategies that combine synthetic scaffolds with biological signalling molecules or autologous cells appear to outperform either approach in isolation. Conclusion: Regenerative and synthetic strategies are complementary rather than mutually exclusive. Material selection should be guided by defect type, patient factors and the balance between biological fidelity and clinical practicality, with hybrid bioactive constructs representing the most promising direction for future clinical practice.