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Greater understanding of growth factors, cytokines, extracellular matrix molecules, and their roles in cell-mediated healing processes have made these regenerative therapies more clinically viable and will continue advancing the fields of tissue engineering and grafting. However, millions of oral and non-oral bone-grafting procedures are performed annually, and only a small percentage yield the most desirable results. Here we review the heparan-sulfate-decorated extracellular biomolecule named perlecan and the research relating to its potential as an adjunct in bone-regenerative procedures. The review includes an overview of bone graft substitutes and biological adjuncts to bone-regenerative procedures in medicine as they apply to periodontal disease, alveolar ridge augmentation, and barrier membrane therapy. Perlecan is discussed as a potential biological adjunct in terms of growth factor sequestration and delivery, and promoting cell adhesion, proliferation, differentiation, and angiogenesis. Further, we propose delivery and application schemes for perlecan and\/or its domains in bone-regenerative procedures, with particular emphasis on its heparan-sulfate-decorated domain I. The perlecan molecule, with its heparan sulfate glycosylation, may provide a multi-faceted approach for the delivery of a more comprehensive stimulus than other single potential adjuncts currently available for bone-regenerative procedures.<\/jats:p>","DOI":"10.1177\/154405910608500203","type":"journal-article","created":{"date-parts":[[2009,1,8]],"date-time":"2009-01-08T19:39:42Z","timestamp":1231443582000},"page":"122-132","source":"Crossref","is-referenced-by-count":17,"title":["The Role of Heparan Sulfate and Perlecan in Bone-regenerative Procedures"],"prefix":"10.1177","volume":"85","author":[{"given":"A.A.","family":"DeCarlo","sequence":"first","affiliation":[{"name":"Agenta Biotechnologies, Inc., OADI Technology Center, 2800 Milan Court, Suite 382, Birmingham, AL 35211, USA; and"},{"name":"Biomaterials & Tissue Engineering, Graduate School of Biomedical Engineering, University of New South Wales, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J.M.","family":"Whitelock","sequence":"additional","affiliation":[{"name":"Agenta Biotechnologies, Inc., OADI Technology Center, 2800 Milan Court, Suite 382, Birmingham, AL 35211, USA; and"},{"name":"Biomaterials & Tissue Engineering, Graduate School of Biomedical Engineering, University of New South Wales, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2006,2,1]]},"reference":[{"key":"AMAR-ETAL-1995","doi-asserted-by":"publisher","DOI":"10.1016\/0003-9969(94)00201-L"},{"key":"ANDRIESSEN-ETAL-1997","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1096-9896(199711)183:3<264::AID-PATH940>3.0.CO;2-3"},{"key":"AVIEZER-ETAL-1994","doi-asserted-by":"publisher","DOI":"10.1016\/0092-8674(94)90031-0"},{"key":"AVIEZER-ETAL-1997","doi-asserted-by":"publisher","DOI":"10.1128\/MCB.17.4.1938"},{"key":"BANESH-MEYER-2000","unstructured":"Banesh-Meyer MJ -2000- Tissue engineering in periodontics using rhBMP-2 J New Zeal Soc Periodont 85:10\u201314."},{"key":"BASAK-ETAL-2004","doi-asserted-by":"publisher","DOI":"10.1089\/0882824041310603"},{"key":"BATTAGLIA-ETAL-1993","unstructured":"Battaglia C, Aumailley M, Mann K, Mayer U, Timpl R -1993- Structural basis of beta-1 integrin-mediated cell adhesion to a large heparan sulfate proteoglycan from basement membranes. 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