Autophagy and Angiogenesis in Oral and Maxillofacial Regions: Implications for Periodontal Health

The oral and maxillofacial regions are rich in vascular tissue, and dental pulp regeneration involves in situ pulp revascularization. The development and reconstruction of maxillofacial regions and periodontal tissue are closely linked to angiogenesis, which is a vital physiological process during growth, tissue remodeling, and tissue repair. However, dysregulation of angiogenesis in the oral cavity can lead to the development and progression of oral submucous fibrosis (OSF), maxillofacial cancer metastasis, and other pathologies [114]. Numerous studies have demonstrated that autophagy plays a crucial role in the angiogenesis of periodontitis, skin wound healing, oral mucosa, and oral tissue cancer.

A previous study showed that HIF-1α and VEGF expression significantly increased in the gingival crevicular fluid and saliva of both chronic and aggressive forms of periodontitis [115]. Moreover, the autophagy level and angiogenin of periodontal ligament stem cells (PDLSCs) were found to increase in the periodontitis microenvironment [116]. Enhancing autophagy increased the tube formation ability of PDLSCs, while blocking autophagy decreased angiogenesis in PDLSCs. This indicates that periodontitis patients are more likely to suffer from gingival bleeding due to dysregulated angiogenesis.