The Role of Autophagy in the Mineralization Process of Bone and Dentin.

Autophagy is a cellular process that recycles intracellular macromolecules and degrades toxic cytoplasmic material to provide the cell with nutrients and facilitate survival. Although autophagy and its role in the differentiation of osteoblasts, osteoclasts, and odontoblasts has been described, the importance of autophagy during matrix mineralization remains unaddressed. This review aims to characterize the autophagy/matrix mineralization relationship and elucidate the significance of autophagy during matrix mineralization. During the mineralization process, autophagy is important for cell survival and promotes the differentiation of osteoblasts and odontoblasts, the key cells that facilitate bone and dentin formation. Differentiation of these cells results in the synthesis of an organic proteinaceous matrix which subsequently forms the template for the deposition of calcium and phosphate to ultimately form crystalline hydroxyapatite. In bone, autophagy influences osteoblastic/osteoclastic activity and bone remodeling. In dentin, autophagy participates in odontogenic differentiation and facilitates odontoblastic secretion of dentin matrix proteins. This review aims to show that autophagy is critical for bone mineralization and tooth formation by supporting intracellular signaling pathways required for cell differentiation and subsequent matrix mineralization.