This paper reviews the current clinical and histologic literature in the field of periodontal regeneration. Various procedures and agents that have been used to attain regeneration and new attachment are reviewed, including open flap debridement, root conditioning, the use of bone grafts and bone substitutes, guided-tissue regeneration, coronally positioned flaps, and a combination of these. Future directions for clinical and research efforts are discussed, with emphasis on growth factors, their delivery, and enhancement of the healing response. Literature identifying factors that will aid in the regeneration of lost periodontium is reviewed and critiqued.