Autophagy and Angiogenesis in Oral and Maxillofacial Tissues: Implications for Regeneration and Disease

The oral and maxillofacial regions are highly vascularized, and dental pulp regeneration involves in situ pulp revascularization. Angiogenesis plays a crucial role in maxillofacial tissue reconstruction and is a fundamental process during growth, tissue remodeling, and repair. However, dysregulation of angiogenesis in the oral cavity can lead to the development and progression of pathogenesis, such as oral submucous fibrosis (OSF) and maxillofacial cancer metastasis [114]. Autophagy has been shown to play a role in angiogenesis in periodontitis, skin wound healing, oral mucosa, and oral cancer.

Research has demonstrated that both chronic and aggressive forms of periodontitis result in a significant increase in HIF-1α and VEGF expression in gingival crevicular fluid and saliva [115]. Furthermore, the autophagy level and angiogenin of periodontal ligament stem cells (PDLSCs) were found to be increased in the periodontitis microenvironment [116]. Autophagy enhancement increased the tube formation ability of PDLSCs, while blocking autophagy decreased angiogenesis in PDLSCs. This could explain why patients with periodontitis are more likely to experience gingival bleeding.