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Dentin mineralization and the role of odontoblasts in calcium transport.

Dentin is formed by two simultaneous processes, in which the odontoblasts are instrumental--the formation of the collagenous matrix, and mineral crystal formation in this matrix. This pattern of formation is similar to that of bone, another mineralized connective tissue. Dentin and bone also have chemical compositions which are similar but with distinct differences. It is of fundamental importance to understand how the ions constituting the inorganic phase are transported from the circulation to the site of mineral formation and how this transport is regulated. For dentinogenesis, calcium is essentially the only ion for which data are available. Recent evidence suggests that a major portion of the Ca2+ ions are transported by a transcellular route, thus being under cellular control. The cells maintain a delicate Ca2+ ion balance by the concerted action of transmembraneous transport mechanisms, including Ca-ATPase, Na+/Ca2+ exchangers and calcium channels, and of intracellular Ca(2+)-binding proteins. The net effect of this is a maintenance of a submicromolar intracellular Ca2+ activity, and an extracellular accumulation of Ca2+ ions in predentin, at the mineralization front. Predentin can be regarded as a zone of formation and maturation of the scaffolding collagen web of the dentin organic matrix. In addition to collagen, it contains little but proteoglycan. Simultaneous with mineral formation, additional non-collagenous macromolecules are added to the extracellular matrix of dentin, these presumably being transported within the odontoblast process. Among these are highly phosphorylated dentin phosphoprotein (phosphophoryn) and another pool of proteoglycan.(ABSTRACT TRUNCATED AT 250 WORDS)

Calcium↗

The effect of glucocorticosteroid treatment on dentine formation in the Lewis rat, a histological study.

Glucocorticosteroids are widely used in the treatment of chronic illnesses and have been reported to cause premature obliteration of the pulp space. During the active stages of dentinogenesis, odontoblasts are growth hormone receptor (GHr) positive. The aims of this study were to determine if the glucocorticosteroid, prednisone, affected the rate of dentine deposition and odontoblast expression of GHr in the rat molar. Following subcutaneous injection of 0.05 mg/kg, 1.0 mg/kg or 5.0 mg/kg prednisone for 20 days, immature and mature molars from rats aged 3 and 6 weeks respectively, were examined histologically. Distribution of GHr expression was determined immunohistochemically. No morphological differences were observed in molars from prednisone treated animals. Prednisone did not appear to enhance dentine deposition in immature molars but in mature molars significantly increased dentine deposition on the roof of the pulp chamber at a dosage of 5.0 mg/kg (p < 0.001). In all immature molars, odontoblasts and pulp cells expressed GHr immunoreactivity. In mature molars, odontoblasts and pulpal cells from controls did not show GHr immunoreactivity. However, odontoblasts and pulp cells were GHr immunoreactive in mature molars from animals treated with prednisone.

Animals↗

Evidence for a local action of growth hormone in embryonic tooth development in the rat.

Studies in non-dental embryonic tissues have suggested that an interaction between growth hormone and its receptor may play a role in growth and development before the foetal pituitary gland is competent. This study reports the distribution of growth hormone, its receptor and binding protein in developing rat tooth germs from embryonic day 17 to 21 and postnatal day 0 using antibodies specific for each of these proteins. Four foetal rats were processed at each time point (E17, E18, E20/21 and postnatal day 0). Following routine fixation and paraffin embedding, sections were treated with antisera to rat growth hormone, rat growth hormone binding protein and growth hormone receptor. Localization of antibody/antigen complexes was subsequently visualized by addition of biotinylated IgG and reaction with streptavidin peroxidase and diaminobenzidine. Assessment of the level of staining was qualitative and based on a subjective rankings ranging from equivocal to very strong staining. Overall, growth hormone and its binding protein were located both in the cellular elements and throughout the extracellular matrix, whereas the growth hormone receptor showed an exclusively intra-cellular location. All three proteins were detectable in cells of the dental epithelium and mesenchyme at the primordial bud stage (E17) which occurs prior to expression of pituitary growth hormone. At the cap stage of odontogenesis (E18-19), numerous cells in both the dental epithelium and mesenchyme were intensely immunoreactive for growth hormone, its binding protein and receptor. In the succeeding early bell stage (E20-21), most of the mesenchymal cells in the dental pulp were mildly positive for these proteins, while the dental epithelium and adjacent mesenchyme were more immunoreactive. At the late bell stage (postnatal day 0), all three proteins were localized in dental epithelium, differentiating mesenchymal cells the cuspal surface facing the epithelial-mesenchymal interface, preodontoblasts, and odontoblasts forming dentine. From these observations, immunoreactive growth hormone, its receptor and binding protein appear to be expressed in odontogenic cells undergoing histodifferentiation, morphodifferentiation and dentinogenesis in a cell-type and stage-specific pattern throughout embryonic tooth development. This suggests the possibility that growth hormone, or a growth hormone-like protein, plays a paracrine/autocrine role in tooth development in utero.

Animals↗

[Therapeutic possibilities in the changing dentition in generalized developmental disorders of the hard substance, ultrastructurally diagnosed I].

Three 5 to 14-year old patients with generalized developmental disturbances of dental hard substance--clinical diagnosis: dentinogenesis imperfecta--are used as examples of age-specific therapy groups in order to demonstrate the various courses of therapy. Early therapy of permanent teeth consists of treating enamel defects with UV hardening resin of the Nuva system. To evaluate adhesion of dental hard substances to resin, it is proposed to use adhesive matrices.

Adolescent↗

[Dental pulp and dentin reaction to oxyphosphate cement].

Tetracycline labelling was employed to assess pulp and dentin reactivity to the use of oxyphosphate cement in the dog. A comparison was made of dentine conditions below control cavities and those containing the cement. In the former, the pulp and dentin response consisted of enhanced dentinogenesis, whereas in the latter this parameter showed no particular changes throughout the experimental period.

Animals↗

Proteoglycans in predentin: the last 15 micrometers before mineralization.

Small leucine-rich proteoglycans (SLRPs) regulate extracellular matrix organization. In order to investigate the distribution and potential functions of decorin, biglycan (BGN), and fibromodulin (3 SLRPs, potentially related to dentinogenesis), we performed light and electron immunochemistry on teeth from rats, and on wild-type and biglycan knockout mice (BGN KO). Immunohistochemical data demonstrate that chondroitin sulfate/dermatan sulfate (CS/DS) and keratan sulfate (KS) distributions displayed reverse gradients in predentin. The decrease of CS/DS labeling from the proximal to the distal predentin contrasted with the sharp decorin increase observed in the distal predentin near the predentin/dentin transition, an effect possibly attributable to the deglycosylation action of stromelysin-1. In contrast, BGN concentration was apparently constant throughout the whole predentin. Additional immunolabelings showed, for the first time, the presence of fibromodulin in predentin. Compared with the wild-type mouse, the mean diameter of collagen fibrils in the BGN KO was smaller in the proximal predentin but larger in the central and distal predentin, the metadentin was broader, and the dentin mineralization appeared altered and heterogeneous. Altogether, our data suggest an important role for BGN in dentin formation and mineralization.

Animals↗

Dental structural diseases mapping to human chromosome 4q21.

Genetic diseases affecting tooth structure have been classified by the tissue affected enamel versus dentin, and their pattern of inheritance autosomal dominant, autosomal recessive, or X-linked. Advances in molecular genetics and the Human Genome Project have provided substantial progress regarding the identification of genes involved in the pathogenesis of human diseases. These include dental diseases affecting enamel and dentin formation: amelogenesis imperfecta (AI), dentinogenesis imperfecta (DGI) types II and III, and dentin dysplasia (DD) type II. Linkage studies using large informative families have provided insight identifying two proximal gene clusters on human chromosome 4q21 that contain the critical loci for five dental structural diseases. Studies related to the autosomal dominant forms of AI, representing approximately 85% of all cases, have established linkage to 4q21 for two forms: local hypoplastic and smooth hypoplastic AI. Two enamel matrix proteins, ameloblastin and enamelin, have been mapped within the critical regions for these diseases. Located more toward the telomere is another cluster containing loci for three dentin diseases: DGI type II, type III, and DD type II. Located within an overlapping segment of these diseases is a dentin/bone gene cluster that contains osteopontin, bone sialoprotein, matrix extracellular phosphoglycoprotein also known as osteoblast/osteocyte factor 45 or osteoregulin, dentin matrix protein 1, and dentin sialophosphoprotein. Continuing molecular genetic studies will facilitate the identification of novel tooth matrix proteins within these two tooth matrix gene clusters as well as the identification of additional autosomal dominant AI loci.

Amelogenesis Imperfecta↗

[Diagnosis and treatment of developmental defects of enamel and dentin in young children].

Developmental defects of enamel and dentin are frequently observed in the pediatric dental clinic. Proper diagnosis may improve the clinician's dental care. The importance of prevention is emphasized as well as the proper management of a growing child from both dental and psychological aspects. This article presents the clinical management of some common dental defects: hypoplasia, diffuse and demarcated opacities, amelogenesis imperfecta and dentinogenesis imperfecta.

Amelogenesis Imperfecta↗

Matrix vesicle heterogeneity: possible morphogenetic functions for matrix vesicles.

Extracellular membranous matrix vesicles were localized and described using electronmicroscopy during chondrogenesis, osteogenesis, and dentinogenesis. Evidence indicates that matrix vesicles in each of these specific tissue types function to concentrate and transport ions and enzymes which serve as nucleation sites for the mineralization of hydroxylapatite. We have examined different developmental stages of Meckel's cartilage, alveolar bone and epithelial-mesenchymal interactions associated with tooth formation in newborn mice. These ultrastructural studies indicate matrix vesicle heterogeneity. Whereas most matrix vesicles contain alkaline phosphatase activity during cartilage, bone and dentine mineralization, in earlier developmental stages matrix vesicles contain acid phosphatase activities and little, if any, alkaline phosphatase. Tissue type, specific developmental stage, and ultrastructural criteria indicate various "classes" of matrix vesicles. During epithelial-mesenchymal interactions in tooth development, mesenchymal cells (preodontoblasts) appear to be the source of matrix vesicles as indicated by the complementarity between H-2 histocompatibility alloantigen specificity on the cell surface and that of the matrix vesicle outer surface; matrix vesicles are limited by a trilaminar membrane derived from the mesenchymal cells. Some of the vesicles located adjacent to dividing inner enamel epithelial cells contain RNA's as determined by electron microscopic autoradiography in situ, as well as by direct biochemical assays. We postulate that matrix vesicles have many different and important biological functions, one of which may be to mediate developmental information from mesenchyme to epithelia during "instructive" stages of tooth development.

Animals↗

A histologic study of the biocompatibility of a dentinal bonding system.

To assess the biocompatibility of an adhesive system, standard Class V cavities were prepared in vivo in human premolars that were to be extracted for orthodontic purposes. Histologic observation revealed that the Gluma Bond System elicited slight to severe pulpal responses, altered odontoblastic layers, and inhibited dentinogenesis. These alterations were observed after in vivo periods of up to 120 days. In this experiment, the dentinal adhesive was polymerized separately from the composite resin, a procedure not recommended by the manufacturer. This may explain the differences in the present results and those reported by the manufacturer.

Adolescent↗

Clinical aspects of dental anomalies.

Many inherited disorders have oral manifestations which can be detected on dental radiographs as alterations in the morphology or chemical composition of the teeth. Thus the dentist may be the first to detect disorders of development and metabolism of importance to the general health of the patient and his family. In one group of conditions the pulp chamber is larger than normal. This may be associated with taurodontism in such conditions as polyploidy of the -X chromosome and trisomy-21 or Down's syndrome. Taurodontism also occurs in a variety of other syndromes including the tricho-dento-osseous syndrome described by Robinson, Miller and Worth (1966) and Mohr's syndrome. It may also be associated with scanty hair endoligodentia. In certain metabolic conditions the pulp chamber may be enlarged but the teeth are of relatively normal from (cynodont). Such cases include hypophosphatemic vitamin D-resistant and dependent rickets, pseudo-hypoparthyroidism otodental syndrome and hypophosphatasia. Small pulp chambers and associated anomalies of root morphology also occur in hereditary disorders either alone or as part of various syndromes such as dentino-osseous dysplasia and brackioskeletogenital syndrome. Dentinogenesis imperfecta may occur alone or as one manifestation of osteogenesis imperfecta. Other developmental defects including pulpal dysplasia, labodontia and dens invaginatus are also associated with small pulp chambers.

Bone Diseases, Developmental↗

The cellular and extracellular distribution of osteocalcin and dentin phosphoprotein in teeth of vitamin D-deficient rats.

Experimental and clinical data indicate that dentin mineralization is vitamin D-dependent. This calcium-regulating steroid controls protein synthesis, for instance that of osteocalcin in osteoblasts. This protein also elaborated by odontoblasts was used as a molecular marker for vitamin D action on odontoblasts. Since the most characteristic protein synthesized by odontoblasts is the dentin phosphoprotein which is thought to regulate hydroxyapatite growth, its cellular and extracellular distribution was also studied. Tooth formation in the molars and incisors of successive generations of vitamin D-deficient animals (-D) and in controls (+D) was compared by microadiography, toluidine blue histochemistry, and immunocytochemistry. In -D samples, the presence of dentin phosphoprotein in odontoblasts indicated that their differentiation occurred despite major morphological disturbances at the cusp tips. In contralateral teeth, osteocalcin was depleted in odontoblasts and dentin, suggesting an inhibition of protein synthesis induced by vitamin D-deficiency. In the extracellular matrix of +D animals, phosphoprotein distribution was associated with dentin, especially within actively forming calcospherites at the mineralization front. In contrast, in -D dentin, the mineralization defects corresponded to irregular absence of histochemically detectable phosphoprotein. This protein indeed appeared either absent or uniformly sparse in -D dentin by immunocytochemistry. These data suggest that vitamin D acts directly on odontogenic cells at various synthetic (osteocalcin) or secretory (phosphoprotein) levels indicating that odontoblasts are target-cells for vitamin D. Therefore, this hormone could contribute to the regulation of extracellular mineralization during dentinogenesis, via different mechanisms in the processing of matrix protein.

Animals↗

[Dentofacial manifestations in children with vitamin D-dependent Rickets type II].

Calcification of the teeth, size of the teeth and dental arches, facial growth and calcification of the carpal bones were studied in three children with clinically different severities of vitamin D-dependent rickets (DDR), type II, with alopecia, which is 1,25-dihydroxyvitamin D-receptor-defect rickets and is particularly resistant to treatment with calciferol analogues. They were treated in a pediatric clinic with large doses of 1 alpha-hydroxyvitamin D3(1 alpha-(OH)D3) and 2 g/day of calcium lactate. The results were as follows: 1. Hypoplasia of enamel of the deciduous teeth was not found. 2. In the deciduous teeth, large pulp chambers and thin dentin were seen in radiographs before treatment. In patients 1 and 2, these abnormalities were reversed by treatment. In patient 3, who had the severest manifestations, large pulp chambers and thin dentin decreased but still remained. 3. Growth of permanent teeth was retarded before treatment and during resistance to treatment. After effective medication, it caught up and was corrected. 4. Problems concerning maxillary and mandibular growth were not found. However Nasions of three patients were more front and lower and Orbitals were lower than standard. 5. In patients 1 and 2, the calcification of carpal bones was accelerated and in patient 3 retarded. 6. Mesiodistal dimensions of erupted deciduous and permanent teeth were within the standard range, except for patient 3, who had smaller lower deciduous teeth. 7. A ground section of the extracted upper right first deciduous molar from patient 3 showed abundant inter-globular dentin and lack of pre-dentinal layer. From the above findings, it was felt that in all probability dentinogenesis was disturbed by the DDR type II. Abnormally large pulp chambers and thin dentin could be corrected by effective medication. In patients with vitamin D-dependent rickets type II, oral hygiene for caries prevention is the most important procedure, because the pulp will be infected immediately after initiation of dental caries. After effective medication, permanent teeth and jaw bones will probably grow normally.

Carpal Bones↗

[Case report of osteogenesis imperfecta].

Osteogenesis imperfecta (OGI) is a rare genetic disease which, as a result of a disorder in the formation of the organic stroma of the bone due to a defect in osteogenic function, induces brittle bones, whereby only weak forces bring about multiple, repeated pathological fractures. This disease is thought to entail various problems with regards to carrying out pediatric dentistry due to the ease with which bones may be fractured. We report here the findings obtained as a result of the careful examination of a 1-year-3-month-old girl encountered in our practice and who was diagnosed as having osteogenesis imperfecta. 1) Out of the three major symptoms for osteogenesis imperfecta, this case showed signs of fragile bones and blue scleras, but did not reveal signs of deafness. 2) There was retardation in system growth and development. 3) Aside from a high level of alkaline phosphatase, there were no notable abnormalities revealed in the biochemical blood tests. 4) Dentinogenesis imperfecta was observed throughout the erupted teeth. 5) There was a definite improvement in cooperation with each visit to the clinic.

Dental Care for Persons with Disabilities↗

In vivo morphogenetic activity of dentine matrix proteins.

Matrix proteins (EDTA-soluble and collagenase-released) from rabbit dentine have been demonstrated to show in vivo morphogenetic activity in exposed pulps of ferret canine teeth. In young adult ferrets, the reparative dentine resembled normal primary tubular dentine with odontoblast-like cells lining its formative surface. The reparative response in older animals was seen as osteo-dentine deposition. In both cases, the reparative response was characterized by its intensity within a comparatively short time period and also by the low grade or complete absence of any localized inflammatory response. Dentine matrix proteins implanted in exposed pulps of teeth provide a good experimental model for analysing the cell-matrix interactions and events taking place during odontoblast differentiation and dentinogenesis.

Aging↗

[Post-natal development of tooth structures in Didelphis albiventris].

The post-natal development of tooth germs has been studied in the opossum or South American marsupial (Didelphis albiventris) between the 2nd and 10th week. Dentinogenesis starts around the 3rd week. The enamel which begins to appear at this stage is deposited until the 8th-10th week. At 10 weeks, the enamel enters the maturation phase. It is unlikely that enamel tubules in these marsupials have a cellular origin. No specific histochemical reaction predicts their appearance which is observed in the mature tooth. This fact suggests that their origin is related either to enamel maturation or to the beginning of tooth function. The mineralizing dentine front presents on the one hand calcospherites where peritubular dentine is formed before intertubular dentine, and on the other hand a radiating mineralizing structure. These two aspects are exceptional in Vertebrates.

Amelogenesis↗