Post-translational modifications in the oral microenvironment: Stem cell regulation from periodontal regeneration to oral cancer therapy

The oral microenvironment plays a pivotal role in determining stem cell fate, driving both regeneration and pathological transformation. Emerging evidence suggests that post-translational modifications (PTMs) play a role as dynamic molecular signatures that regulate key signaling networks in dental-derived mesenchymal stem cells. These PTMs not only influence stem cell self-renewal and differentiation in periodontal tissue regeneration but also contribute to cancer stem cell plasticity and therapeutic resistance in oral squamous cell carcinoma (OSCC). At the pathway level, PTM programs interface with Wnt/β-catenin and bone morphogenetic protein/SMAD axis and integrate mitogen-activated protein kinase (p38/c-Jun N-terminal kinase) → runt-related transcription factor 2 in regeneration, whereas in OSCC/cancer stem cell they converge on Janus kinase/signal transducer and activator of transcription 3, phosphatidylinositol 3-kinase/protein kinase B/mammalian target of the rapamycin, and transforming growth factor-beta/SMAD-driven epithelial-mesenchymal transition. This review expounds on recent advances in PTM-mediated regulatory mechanisms in dental-derived mesenchymal stem cells, outlines their functional implications in inflammatory and tumor microenvironments, and discusses translational strategies-including localized, time-staged PTM modulation for regeneration and pathway-anchored combinations for OSCC-for regenerative medicine and targeted cancer therapies. Future research directions emphasize the integration of single-cell and spatial multi-omics with PTM profiling as a new approach to precision-based dental and oncological therapies.