Oral Tissue Repair, Regeneration and Remodelling at the Oral-Systemic Interface

Advances in microbiology, immunology, and systems medicine have shown that cellular and molecular mechanisms regulate dental, periodontal, and oral tissue modifications during development, homeostasis, repair, and regeneration. Increasing evidence indicates that external stimuli as well as systemic conditions - including chronic kidney disease, cardiovascular disorders, metabolic syndromes, aging, eating disorders and salivary disfunctions - modify these pathways by altering immune response, vascular function, and mineral metabolism, while periodontal inflammation and pathology itself may contribute to systemic burden through bidirectional oral–systemic interactions (Chapple, I.L.C., Hirschfeld, J., Cockwell, P. et al. Interplay between periodontitis and chronic kidney disease. Nat Rev Nephrol 21, 2025).Despite growing knowledge, significant uncertainty remains regarding how systemic conditions influence periodontal soft- and hard-tissue turnover, mineralization capacity, regenerative potential, and responsiveness to preventive, restorative, orthodontic, periodontal, and regenerative therapies. Reliable biomarkers for risk assessment and prevention are still lacking. This collection aims to integrate systemic pathophysiology, mechanobiology, salivary biology, and oral tissue repair, regeneration and remodelling into the study of oral-systemic interactions, periodontal adaptation, alveolar bone dynamics and tooth-related structural changes. While physiological and mechanically induced bone changes have traditionally been investigated in healthy models, clinical reality shows that many patients present with systemic comorbidities that affect bone quality, inflammatory responses, vascular function, mineral metabolism, salivary protection, and healing capacity (Jaap C. Maltha, Anne Marie Kuijpers-Jagtman, Journal of the World Federation of Orthodontists 12, 4, 2023). Also, in addition to periodontal soft- and hard-tissue turnover, the collection welcomes contributions addressing tooth wear, non-carious cervical lesions, dentin hypersensitivity, enamel and dentin alterations, occlusal adaptation, and restorative challenges as interconnected manifestations of altered oral homeostasis in individuals with systemic comorbidities.Despite these insights, critical gaps remain in understanding how systemic conditions interact with microbial challenges and mechanical forces - such as orthodontic loading - to shape tissue-specific remodeling dynamics, mineralization capacity, and regenerative potential. Moreover, clinically applicable predictors of disease progression and treatment response are still limited.To elucidate these oral-systemic cross-talk mechanisms, the interdisciplinary research is needed including integrative and multidisciplinary approaches combining longitudinal clinical studies, refined animal models of systemic disease, high-resolution structural imaging, molecular profiling, tissue-engineered models, and functional mechanobiological analyses. Such strategies will support early risk stratification, targeted prevention, and the development of personalized therapeutic interventions aimed at preserving dental, periodontal, and oral tissues health within the context of systemic disease.For this Research Topic, we welcome manuscripts that advance our understanding of dental, periodontal, and oral tissue repair, regeneration and remodelling in health and systemic disease, with particular emphasis on the biological and mechanical drivers of soft- and hard-tissue adaptation. We also encourage contributions addressing how systemic conditions influence salivary function, alveolar bone dynamics, and periodontium- or tooth-related structural changes. We aim to highlight the mechanisms underlying systemic–oral cross-talk and their implications for prevention, risk assessment, and therapy. We welcome additional related contributions, including:• How do oral-systemic interactions regulate dental, periodontal, salivary, and oral tissue repair, regeneration, and remodeling across health, disease, and therapeutic intervention?• How do systemic diseases (e.g., CKD, cardiovascular disease, diabetes, liver disease) and altered oral environment influence periodontal soft- and hard-tissue remodelling, repair and/or regeneration?• Which molecular and cellular pathways mediate interactions between dysbiotic biofilms and systemic inflammatory or metabolic dysregulation?• How do systemic disorders alter dental, periodontal, and oral tissues dynamics, including turnover, density, microarchitecture, and responsiveness to inflammatory, mechanical, or regenerative stimuli? • What biomarkers (circulating, salivary, imaging-based) reliably predict disease progression or therapeutic outcomes?• How do disturbances in element metabolism, vascular function, and immune regulation affect the repair capacity, and structural integrity of dental, periodontal, and oral tissues? • What evidence supports bidirectional effects between periodontal inflammation and systemic disease progression?• Can mechanobiological modeling improve prediction of dentofacial growth and remodeling under systemic comorbidities?• What role do aging and multimorbidity play in dental, periodontal, and oral tissues adaptation and repair?• How do bacterial metabolites and host-derived mediators contribute to systemic inflammatory burden?• How does salivary dysfunction or altered oral fluid composition associated with systemic disease or medication use modify biofilm ecology, mineral balance, tissue resilience, and susceptibility to periodontal and dental surface breakdown? Topic editors: Marta Rizk, Foteini Machla, ATHINA BAKOPOULOU, Rayssa Ferreira Zanatta Source: https://www.frontiersin.org/research-topics/79275/oral-tissue-repair-regeneration-and-remodelling-at-the-oral-systemic-interface