Just over 10 years ago a group of imaginative periodontal researchers reported that tissues lost to the destructive mechanisms of inflammatory periodontal disease could be regenerated either in part or whole by the use of a surgical technique that would become universally known as guided tissue regeneration. Since then, tremendous progress has been made in adapting these early research principles into a clinical treatment modality that is now recognized as a viable component of contemporary periodontal therapy. However, many questions remain as to the mechanisms involved in regenerative tissue formation and how to design surgical procedures and materials to best harness the regenerative capacities of the periodontium. This article reviews current concepts and controversies regarding the biologic basis of periodontal regeneration and biomaterials used in guided tissue regeneration therapy. Pros and cons related to regenerative techniques currently in use are discussed along with future directions in the field of periodontal regeneration.