Polymer-Based Biomaterials in Periodontal and Peri-Implant Soft Tissue Augmentation: Biological Rationale, Clinical Applications, and Future Perspectives

Abstract

Soft tissue deficiencies around teeth and dental implants remain a significant challenge in contemporary periodontology and implant dentistry. These deficiencies influence a number of factors, including esthetic outcomes, peri-implant tissue stability, long-term maintenance, and patient satisfaction. Although autogenous connective tissue grafts remain the clinical gold standard for soft tissue augmentation, their use is limited by donor-site morbidity, increased surgical time, and restricted tissue availability. Consequently, polymer-based biomaterials have emerged as promising alternatives or adjunctive regenerative materials capable of improving wound healing while reducing surgical invasiveness. This narrative review compares natural polymers, including collagen, hyaluronic acid, extracellular matrix-derived scaffolds, fibrin-based platelet concentrates, and gelatin-based materials, with synthetic polymeric systems, such as polycaprolactone, polylactic acid, polyethylene glycol, and advanced composite hydrogels. The influence of these materials on angiogenesis, fibroblast migration, extracellular matrix remodeling, immune modulation, and soft tissue integration is reviewed in the context of periodontal plastic surgery and peri-implant soft tissue reconstruction. This narrative review summarizes the current landscape of polymer-based biomaterials used for periodontal and peri-implant soft tissue augmentation, integrating material science with clinical evidence. The advantages, limitations, indications and future perspectives of polymer-based substitutes are discussed in comparison with autogenous grafting procedures.