摘要

Objectives: Polyester biostimulators—PLLA, PDLLA, and PCL—promote collagen through biodegradation, but outcomes depend on balancing inflammation and regeneration. This session reviews how polymer crystallinity, particle morphology, size, and degradation rate shape tissue responses, from gentle macrophage activation to granuloma risk. By integrating scientific and clinical insights, it offers an evidence-based guide to selecting the right biostimulator for true regenerative integration. Introduction: Polyester-based injectable biostimulators, including poly-L-lactic acid (PLLA), poly-D,L-lactic acid (PDLLA), and polycaprolactone (PCL), stimulate collagen remodeling through controlled biodegradation and foreign body response pathways. However, regenerative outcomes are strongly influenced by polymer characteristics that determine the balance between physiologic tissue remodeling and excessive inflammation. Understanding these material-dependent variables is essential for optimizing efficacy and minimizing complications. Materials / method: A narrative evidence-based review was performed integrating polymer science, biomaterial immunology, and clinical literature regarding PLLA, PDLLA, and PCL biostimulators. Key variables analyzed included polymer crystallinity, particle morphology, particle size, surface characteristics, and degradation kinetics. Their influence on macrophage activation, collagen stimulation, foreign body giant cell response, tissue integration, and granuloma formation risk was evaluated. Results: Polymer composition and structural properties demonstrated substantial influence on inflammatory intensity and regenerative behavior. PDLLA exhibited more controlled degradation due to its amorphous structure, while polymer crystallinity and degradation kinetics affected the duration and magnitude of tissue stimulation. Particle morphology and surface characteristics influenced cellular adhesion and inflammatory response, whereas particle size and dispersion patterns affected macrophage interaction and foreign body reactions. Appropriate biomaterial selection and injection technique were criti Conclusion: Successful collagen biostimulation extends beyond polymer biodegradation alone and depends on achieving equilibrium between inflammation and tissue regeneration. Understanding biomaterial science provides a framework for evidence-based selection of polyester biostimulators, enabling clinicians to optimize regenerative outcomes while minimizing adverse events and promoting long-term tissue integration.