Angiogenesis and Autophagy in Oral and Maxillofacial Regions: Implications for Periodontitis and Beyond

The oral and maxillofacial regions are rich in vascular tissue, and dental pulp regeneration involves in situ pulp revascularization. Angiogenesis is an essential physiological process that plays a vital role in growth, tissue remodeling, and tissue repair, including the alteration of maxillofacial regions and periodontal tissue reconstruction. However, dysregulation of angiogenesis in the oral cavity can result in pathogenesis development and progression, such as oral submucous fibrosis (OSF) and maxillofacial cancer metastasis. Autophagy has been shown to be involved in periodontitis angiogenesis, skin wound healing, oral mucosa, and oral tissue cancer.

Studies have demonstrated that the expression of HIF-1α and VEGF significantly increases in gingival crevicular fluid and saliva in both chronic and aggressive forms of periodontitis. Additionally, the autophagy level and angiogenin of PDLSCs are also elevated in the periodontitis microenvironment. Autophagy enhancement increases the tube formation ability of PDLSCs, whereas autophagy blocking decreases angiogenesis in PDLSCs. These findings may explain why periodontitis patients are more susceptible to gingival bleeding.