Regenerative periodontal surgery relies on the interplay between wound stabilization, space maintenance, and biological signaling. The expanding array of available biomaterials — including bone substitutes, barrier membranes, and biologically active agents — has paradoxically complicated clinical decision-making. This review proposes a simplified, biologically driven framework for biomaterial selection, shifting focus from material-centric protocols to the enhancement of the regenerative microenvironment. By prioritizing angiogenesis, clot stability, and cell recruitment over graft volume alone, clinicians can rationalize indications for grafting versus non-grafting approaches. Evidence-based criteria are discussed to guide site-specific decisions, ultimately improving predictability while reducing procedural complexity in everyday clinical practice.