Contemporary Opinions on the Peculiarities of Oral Mucosa Wounds Healing: A Literature Review

Abstract

The purpose of the study is to update data on the features of oral mucosa (OM) wound healing through a systematic assessment of sources of scientific and medical information. Materials and Methods. An analysis of the data obtained during the information search in the online databases “PubMed”, “SciELO”, “Medscape”, and “Science of Ukraine: access to knowledge” was performed using the key words (tags): “mucous membrane of the oral cavity”, “oral mucosa”, “wounds of the mucous membrane”, “healing”, “regeneration”. Publications in periodical scientific issues, methodological recommendations, and reports were included in the list of sources of information. Results. According to the results of clinical observations, experimental studies on laboratory animals and volunteer patients, it was established that the healing of the OM wounds is qualitatively different from a similar process on the skin. This fact was established for both humans and animal models. Wound healing in the human body is a well-defined typical process aimed at restoring tissues after damage. Unlike the skin, OM wounds heal relatively quickly and with little or no scar tissue. And all this happens against the background of constant movement of soft tissues, stress (tension), mechanical abrasion, and contact with a large number of microorganisms in oral fluid. The leading factors of higher-quality regeneration of OM can be considered a moist wound healing environment, direct contact with the protective and regenerative systems of oral fluid which contains a high concentration of commensal microorganisms with immunomodulatory properties and more than 1000 protective and regulatory factors of saliva. There are distinct differences in the properties of the germ layer cells between the skin and OM and the cytokine profile of wound healing is also significantly different. Most reactions that take place in the main phases of the wound process in the oral cavity are faster and more intense. The processes of accumulation of collagen and elastin fibers, remodeling of the intercellular matrix (amorphous substance) are more qualitative. Conclusions: the data from the literature and the results of a significant number of studies allow us to state that faster wound closure, presence of saliva, faster immune response, increased release of anti-inflammatory cytokines, matrix metalloproteinase-mediated cleavage of chemokines, and remodeling of the extracellular matrix contribute to better wound healing and reduced scar formation on the OM, which, unfortunately, does not relate to the skin.