Synthetic bone replacement materials continue to be much discussed in the current periodontal literature. Numerous reports have shown their clinical use in the treatment of intraosseous defects. Periodontal treatment aims also include regeneration of a new functional attachment. Although histologic studies have shown that most of the synthetic bone substitutes can enhance bone formation, they are not able to promote new attachment of periodontal tissues to the root surface previously exposed. Future studies are needed to assess whether these materials could be of use together with growth factors in composite grafts or in conjunction with guided tissue regeneration techniques.