The Role of Angiogenesis and Autophagy in Oral and Maxillofacial Health

The oral and maxillofacial regions are abundant in vascular tissue, and the regeneration of dental pulp involves in situ pulp revascularization. Angiogenesis plays a crucial role in the reconstruction of periodontal tissue and alterations in the maxillofacial regions. It is a vital physiological process that occurs during growth, tissue remodeling, and tissue 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].

Numerous studies have demonstrated that autophagy is involved in angiogenesis in periodontitis, skin wound healing, oral mucosa, and oral cancer. A study demonstrated that both chronic and aggressive forms of periodontitis significantly increased the expression of HIF-1α and VEGF in gingival crevicular fluid and saliva [115]. In the microenvironment of periodontitis, the level of autophagy and angiogenin in PDLSCs also increases [116]. Enhancing autophagy increases the tube formation ability of PDLSCs, while blocking autophagy decreases angiogenesis in PDLSCs. This could explain why periodontitis patients are more prone to experience gingival bleeding.