A review of the literature indicates that one of the major elements of the healing pattern after periodontal surgery is the growth of granulation tissue originating from the periphery of the surgical wound, the periodontal ligament, and the underlying bone. In the past, the periosteum has been given great importance in the process of tissue regeneration; in the current study the authors examined the possible results of removal of the periosteum, which would leave bare bone as the only source of tissue regeneration. The review of a previous study involving perforations to the cortical plate to promote communication between marrow spaces and the receptor bed surface indicated the potential of bone regeneration through the endosteum. The purpose of this article was to stimulate studies devoted to a better understanding of bone potential in periodontal regeneration.