Dentinogenesis imperfecta. Report of a 5-generation family.
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OBJECTIVE: The aim of this in vivo study was to evaluate the response of the pulp-dentin complex following application of resin-modified glass-ionomer cement, calcium hydroxide hard-setting cement and EDTA-soluble preparation of dentine matrix proteins (ESDP) in deep cavities prepared in non-human primate teeth. METHODS: Eighteen deep Class V buccal cavities were prepared in premolars of four capuccin monkeys. In Groups 1 and 2, the cavity floor was lined with ESDP or a resin-modified glass-ionomer cement (Vitrebond - 3M ESPE), respectively. In Group 3 (control), the cavity was lined with a hard setting calcium hydroxide cement (Dycal - Dentsply). The cavities were subsequently filled with amalgam. After 6 months, the animals were sacrificed and the teeth were prepared for microscopic assessment. Six-micron thick serial sections were stained with H/E, Masson's trichrome and Brown & Brenn techniques. RESULTS: No inflammatory pulpal response was observed for all experimental and control Groups. However, the amount of reactionary dentin deposition differed between groups in the rank order ESDP (Group 1) > calcium hydroxide (Group 3) > resin-modified glass-ionomer (Group 2). These differences were statistically significant. CONCLUSIONS: All materials were biocompatible when applied in deep cavities. ESDP stimulated higher deposition of reactionary dentin matrix than Vitrebond and Dycal.
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The classification and prevalence of amelogenesis imperfecta is updated based upon new information in the literature. Problems with the currently used classification of inherited dentin defects are discussed.
Cyclosporin A (CsA), a widely used immunosuppressive drug, induces gingival overgrowth and modifications of bone remodelling. The scope of this study was to investigate the possible effect of CsA on dentin. Thirty mg/kg/day of CsA were administered orally to male Sprague-Dawley rats for nineteen weeks. The same number of control rats received oil-based vehicle solution. Rats were anesthetized, and tissues were fixed by an intracardiac perfusion of fixative solution. Mandibles were dissected, demineralized, and processed for Epon embedding. Semi-thin sections of the first molars revealed alterations at the secondary dentin-pulp interface in four out of six experimental animals. The changes consisted of the formation of: 1) osteodentin spurs, in which the volume and interface with the secondary dentin varied from about 25,000 to 75,000 microns 3 and from 1400 to 3530 microns 2, respectively; 2) abnormally shaped and irregularly spaced incremental lines; and 3) numerous globular formations embedded in dentin or free in the pulp. These results indicate that CsA induces abnormal mineralized matrix formation in dentin and in the peripheral part of the pulp in rat molars.
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The effects of a large dose of vinblastine sulfate (2 mg/kg body weight) on proliferating odontoblast precursors and secretory odontoblasts in the continuously growing rat incisor were studied. The rats were killed 6 h, 24 h, 3 d and 7 d after vinblastine injection. Most cells in the proliferating zone contained arrested mitoses, or had perished after 24 h. After 3 and 7 d, the odontoblasts derived from this zone were reduced in number, and showed altered cell shapes. The odontoblasts had produced irregular dentin. The secretory odontoblasts had displaced nuclei and altered cell shapes after 24 h. Those most affected were opposite early mineralized dentin. In some incisors the cells had perished. In the protracted experiments almost all the odontoblasts were changed and had produced abnormal dentin. In the early mineralized dentin area, accumulations of cells were present after 3 d, and osteodentin-like material after 7 d.
Vincristine was administered to 60 rats in four groups in doses of 0.1, 0.3, 0.5 and 0.7 mg/kg. Histomorphologic investigation of the dentin and odontoblasts in the maxillary incisors after 1, 2 and 3 weeks revealed a moderate to severe disturbance of dentin production in some parts of the incisors. In some of the affected areas the effect seemed to be reversible in that normal-appearing dentin was found pulpal to the dentinal derangements after 2 and 3 weeks. The distribution and severity of the lesions were similar to those previously observed 3 days after injection of the same doses of vincristine.
Colchicine in doses of 0.5, 1.0 and 1.5 mg/kg was administered to 15 rats divided in three experimental groups. Histomorphologic investigation of the maxillary incisors after 2 weeks revealed; 1) alterations in the odontoblasts mainly related to size, shape, polarity and staining properties, and 2) presence of irregular dentin separated from normal dentin by one or two incremental lines. The dentinal irregularities were dose-dependent and consisted of twisting of the dentinal tubules, globular formations and cellular inclusions in addition to niche-like defects.
Colchicine (CLC) in doses of 0.5 and 1.5 mg/kg was administered to 40 female Wistar rats in two equal groups. The animals were sacrificed after 5 h, 24 h, 3 d and 7 d, and the effects of CLC on pulp, odontoblasts and dentin in the continuously growing incisors were studied. With the lowest dose a few arrested mitoses were observed in the germinative part of the pulp after 5 and 24 h. With the highest dose an increasing number of mitoses were observed in the germinative part of the pulp after 5 and 24 h. More incisally the odontoblasts were pale, swollen and granulated after 5 h, and necrotic and disintegrated after 24 h. After 3 and 7 d dentinal derangements, consisting of moderately and severely irregular dentin, osteodentin and a niche-like defect in the labial dentin, were seen. Labially one or two incremental lines traversed the dentin from the apical to the incisal part of the incisors.
Previously described dentin reactions to cyclophosphamide (CPhA) were studied by means of fluorescent labeling and microradiography. Ten adult rats received 20 mg/kg calcein i.p. on days 0, 4, 7, 10, and 40 mg/kg CPhA 30 min after the first calcein injection. Two animals served as controls. The observation time was 14 d. Fluorescence microscopy and microradiography of the maxillary incisors revealed 1)niche-like defects in dentin starting in mineralize 1-4 d after the CPhA administration labially, while lingually the niches developed later and were completed earlier, 2)localized reduced and increased growth lingually, 3)continuous but reduced apposition of a hypomineralized dentin in the niches, and 4)niche osteodentin produced by pulp cells.
An extra oral approach was made to 26 pairs of Wistar rat incisors and a small bur used to expose the pulps which were then dressed with either calcium hydroxide paste (Pulpdent) zinc oxide-eugenol cement (Kalzinol) or a triamocinolone acetonide/tetracycline containing cement (Ledermix). Animals were sacrificed at 7 days, incisors removed, a window cut to the pulp opposite the site of exposure, soft tissues removed with 7% NaOCl for 30 minutes before teeth were dehydrated in graded concentrations of acetone and gold coated for examination under SEM. Calcium hydroxide produced rapid complete repair with a remarkably regular formation of calcospherites, except for a zone of relative inhibition perforated by nutrient canals at the periphery of each lesion. Both zinc oxide-eugenol and triamcinolone acetonide cements inhibited both bridging of the defect created by the exposure and dentine formation in the surrounding pulpal wall. Data was grouped according to the degree of hard tissue repair. The results were statistically significant (Chi-square p < or = 0.001). This method demonstrated qualitative and quantitative differences in the repair process resulting from chemical variations in the dressings applied.
The characterization of poly(ethylene) glycol calcium citrate microspheres is described. The calcium content and content uniformity of microspheres, prepared at five concentrations ranging from 46.56 micrograms/g to 81.49 mg/g, were determined by spectroscopy. Under sink conditions first-order in vitro dissolution kinetics were observed. Granules containing approximately 80 mg Ca++/g PEG gave an in vitro calcium release over a 3-day period similar to that of a calcium hydroxide product, Pulpdent.