Periodontal disease is a chronic inflammatory condition that results in the destruction of supporting periodontal tissues, including alveolar bone, periodontal ligament, cementum, and gingival connective tissues. Traditional periodontal therapy primarily focuses on halting disease progression; however, regenerative periodontal procedures aim to restore the lost periodontal apparatus both structurally and functionally. Advances in biomaterials, guided tissue regeneration (GTR), bone grafting techniques, biologic mediators, growth factors, stem cell therapy, and tissue engineering have significantly improved clinical outcomes. This review explores contemporary regenerative procedures used in the management of periodontal defects, including their biological principles, clinical applications, advantages, limitations, and future developments. Current evidence suggests that regenerative therapy offers predictable improvements in attachment gain, bone regeneration, and periodontal stability when appropriately applied. Emerging technologies involving tissue engineering, stem cell-based regeneration, and personalized regenerative medicine hold considerable promise for the future of periodontal therapy.