Autophagy's Role in Oral Tissue Regeneration: A Comprehensive Review

The oral cavity is a unique environment that requires consistently remodeling and generation, meaning autophagy is essential for oral tissue regeneration. The oral cavity usually contains many bacterial colonizers, and many oral diseases are caused by bacterial infection and subsequent immune reaction [14]. Studies have shown autophagy's involvement in controlling infectious agents, limiting inflammatory pathologies, regulating myeloid/lymphoid cell differentiation, and coordinating multicellular immunity [14]. Combined with its role in repairing damaged tissue, autophagy has a close association with oral tissue regeneration. Although many studies have explored autophagy's role in oral diseases and oral tissue regeneration, no systematic reviews have focused on its role in oral tissue regeneration.

This review aims to summarize and analyze the current literature on the role of autophagy in oral tissue regeneration, including the mechanisms involved, the effects on various types of oral tissues, and the potential clinical applications.

Autophagy is a highly conserved cellular process involving the degradation of damaged organelles and proteins through lysosomal pathways. It plays a crucial role in maintaining cellular homeostasis and responding to stress conditions, such as nutrient deprivation, oxidative stress, and infection. In the oral cavity, autophagy is involved in various physiological and pathological processes, including tooth development, saliva secretion, periodontal disease, and oral cancer.

Several studies have shown that autophagy is essential for tooth development and homeostasis. Autophagy-deficient mice exhibit defective ameloblast differentiation, abnormal enamel formation, and impaired dentin mineralization. In addition, autophagy plays a critical role in saliva secretion, essential for oral health and digestion. Autophagy dysfunction in salivary glands can lead to xerostomia, a common side effect of radiotherapy.

Autophagy is also involved in periodontal disease, a chronic inflammatory condition affecting the supporting tissues of teeth. Autophagy activation can limit the inflammation and tissue damage caused by periodontal pathogens, such as Porphyromonas gingivalis. Moreover, autophagy induction can promote the regeneration of periodontal tissues, including alveolar bone and cementum.

Autophagy is also implicated in oral cancer, a highly aggressive and heterogeneous group of tumors that arise from various oral tissues. Autophagy can either promote or inhibit oral cancer progression, depending on the tumor type and stage. Autophagy inhibition can sensitize oral cancer cells to chemotherapy and radiotherapy, while autophagy activation can enhance the immune response against cancer cells.

In conclusion, autophagy plays a crucial role in oral tissue regeneration by maintaining cellular homeostasis, responding to stress conditions, and regulating immune and inflammatory responses. Autophagy dysfunction can lead to various oral diseases, while autophagy activation can promote tissue repair and regeneration. Further studies are needed to elucidate the precise mechanisms of autophagy in oral tissue regeneration and to develop novel therapeutic strategies based on autophagy modulation.