Role of Fibroblast Populations in Periodontal Wound Healing and Tissue Remodeling

Abstract

After injury to periodontal tissues, a sequentially phased healing response is initiated that enables wound closure and partial restoration of tissue structure and function. Wound closure in periodontal tissues involves the tightly regulated coordination of resident cells in epithelial and connective tissue compartments. Multiple cell populations in these compartments synergize their metabolic activities to reestablish a mucosal seal that involves the underlying periodontal connective tissues and the attachment of these tissues to the tooth surface. The formation of an impermeable seal around the circumference of the tooth is of particular significance in oral health since colonization of tooth surfaces by pathogenic biofilms promotes inflammation, which can contribute to periodontal tissue degradation and tooth loss. The reformation of periodontal tissue structures in the healing response centrally involves fibroblasts, which synthesize and organize the collagen fibers that link alveolar bone and gingiva to the cementum covering the tooth root. The synthesis and remodeling of nascent collagen matrices are of fundamental importance for the reestablishment of a functional periodontium and are mediated by diverse, multi-functional fibroblast populations that reside within the connective tissues of gingiva and periodontal ligament. Notably, after gingival wounding, a fibroblast sub-type (myofibroblast) arises, which is centrally involved in collagen synthesis and fibrillar remodeling. While myofibroblasts are not usually seen in healthy, mature connective tissues, their formation is enhanced by wound-healing cytokines. The formation of myofibroblasts is also modulated by the stiffness of the extracellular matrix, which is mechanosensed by resident precursor cells in the gingival connective tissue microenvironment. Here, we consider the cellular origins and the factors that control the differentiation and matrix remodeling functions of periodontal fibroblasts. An improved understanding of the regulation and function of periodontal fibroblasts will be critical for the development of new therapies to optimize the restoration of periodontal structure and function after wounding.

Intermittent compressive force promotes osteogenic differentiation in human periodontal ligament cells by regulating the transforming growth factor-β pathway

“…The periodontal ligament (PDL) is a connective tissue that links the tooth root to alveolar bone 1,2 . Fibroblasts are the main cell type residing in the PDL 3 . The PDL's mechanoreceptors play an important role in the reflexes that prevent damage to the tooth and periodontium 4,5 .…”

Role of the small GTPase activating protein IQGAP1 in collagen phagocytosis

“…Mammalian connective tissues undergo remodeling by the synthesis and degradation of matrix proteins to maintain tissue homeostasis and preserve tissue function. The rapid remodeling of periodontal connective tissues by phagocytosis (Sodek, 1977) facilitates study of the regulation of this remarkable matrix homeostatic process (Smith, Martinez, Martinez, & McCulloch, 2019). The degradation of collagen fibers requires extracellular matrix metalloproteinases or the cathepsin-dependent phagocytic pathway (Melcher & Chan, 1981).…”

Current Insight of Collagen Biomatrix for Gingival Recession: An Evidence-Based Systematic Review

“…Col is synthesised twofold lower in the gingival tissue compared with the skin [ 37 ]. Furthermore, Col type III makes up as the major component for granulation tissue in the gingival structure [ 38 ]. However, upon maturation, Col reduced to 20% of the total Col content [ 29 ].…”

“…However, upon maturation, Col reduced to 20% of the total Col content [ 29 ]. During the healing phase, particularly for gingival, Col deposition will exceedingly increase to support the rapid healing as a natural mechanism [ 38 , 39 ]. However, in the final healing phase, Col formation will decrease gradually.…”