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Timp-1, -2 and -3 show coexpression with gelatinases A and B during mouse tooth morphogenesis.

Matrix metalloproteinases (MMPs) have been implicated in tissue remodelling and in regulation of cell-matrix interactions during organ development. The activity of MMPs is regulated by members of the TIMP (tissue inhibitors of metalloproteinase) family. We analyzed by in situ hybridization the expression of gelatinase A (MMP-2) and gelatinase B (MMP-9) as well as Timp-1, -2 and -3 during different stages of mouse tooth development. Gene expression was generally found in mesenchymal tissues except for Timp-3, which also was found in dental epithelial cells. During early tooth development, gelatinase A and Timp-2 were widely expressed in the branchial arch, while gelatinase B and Timp-1 and Timp-3 expression showed clear association with epithelial morphogenesis and was restricted to the mesenchyme at the tip of the growing tooth bud. Gelatinase A and Timp-1 showed transient expression in secretory odontoblasts at the time of basement membrane degradation, while Timp-2 expression continued throughout the dental papilla. At the time of tooth eruption, Timp-3 was expressed in most dental epithelial cells except secretory ameloblasts, and gelatinase B was intensely expressed in osteoclasts in the jaw bone. The exact co-localization of gelatinase A and Timp-1 in secretory odontoblasts, and the correlation between gelatinase B and Timp-3 during bone resorption may indicate interaction of the proteins during degradation of the basement membrane and in the control of ECM turnover in connection with tooth eruption.

Animals↗

Structural changes in the dental and periodontal tissues of the rat incisor following application of orthodontic loads.

The present study deals with the morphometric changes in the loaded rat incisor and its supporting structures 3 months after load removal. The material examined was limited to that part of the tooth that is located between 8 and 20 mm from the tooth apex. Of the ten albino rats in whom laterointrusive loads (19 +/- 0.6 g) were applied to the lower left incisor for a period of 2 weeks, the rate of tooth eruption returned to normal in four animals (group A); in six rats, eruption remained grossly impaired (group B). These two groups were compared with a control group of four rats in whom the incisors were allowed to erupt normally during the 3 months of the experiment. The left mandibles were dissected and fixed; the incisors were demineralized, embedded in paraplast, and cut into transverse serial sections of 6 micron, which were used to produce a three-dimensional reconstruction of all tissue components by means of computerized histomorphometry. The parameters of pulp and dentin, and the total tooth size and shape in group A were similar to those of the control group. In group B, pulp and dentin were changed significantly, tooth size increased, and the oval shape was altered into a more rounded contour, together with a significant enlargement of the socket. Although the total PDL volumes remained similar in all three groups, the tooth/socket relation, as expressed by PDL width and PDL area at the different tooth sides and at varying distances from tooth apex, diverged from normal significantly in all teeth that had been subjected to loading.

Alveolar Process↗

The role of RANKL (TRANCE/TNFSF11), a tumor necrosis factor family member, in skeletal development: effects of gene knockout and transgenic rescue.

We report the skeletal manifestations of restoring RANKL (TNFSF11/TRANCE; see foot note on nomenclature) expression in null mice using a lymphocyte-specific promoter. RANKL was discovered independently by immunologists and bone researchers by virtue of its essential roles in lymph node organogenesis, normal cellular immunity, and osteoclastogenesis. "Rescue" of RANKL knockout mice by a T- and B-cell expressed transgene reversed many immunological manifestations of the knockout, while it had highly selective effects on the skeletal pathology. RANKL-null mice exhibit severe osteopetrosis, no tooth eruption, markedly reduced skeletal growth, and growth plate chondrodystrophy. The transgene induced tartrate-resistant acid phosphatase (TRAP) positive cells in long bones as early as 3 days postpartum, restored marrow spaces in long bones, produced lamellar bone in the diaphyses, and restored osteoclasts at many endosteal sites, but not in periosteum nor the jaws. It did not improve the chondrodystrophy, chondroosseous junction defects, or tooth eruption. The ends of limb and axial skeletal elements remained highly sclerotic while diaphyses became osteopenic, and growth retardation persisted. Together, these results demonstrate the importance of local delivery of RANKL for many skeletal processes.

Animals↗

The role of epithelium in the development, structure and function of the tissues of tooth support.

The roles of epithelium in the development, structure and function of the tissues of tooth support are reviewed. Epithelium is involved in initiating odontogenesis which includes the tissues of tooth support and this role is discussed. Particular attention is paid to Hertwig's epithelial root sheath and its participation in the formation of the hyaline layer on the root surface as well as its possible role in initiating the differentiation of cementoblasts. The possible functions of the epithelial cell rests are reviewed and it is concluded that as yet no function can be ascribed to them. Evidence for an increasing role for dental epithelium in tooth eruption is presented and the role of dental epithelium in establishing the dentogingival junction is discussed, with the conclusion drawn that this role temporary.

Animals↗

Oral findings in Carpenter syndrome.

Acrocephalopolysyndactyly Type II (Carpenter Syndrome) is determined by autosomal recessive inheritance. Only some 40 cases have been described. Variable clinical signs have been described including prolonged retention of primary teeth and hypodontia. This paper describes the oral and dental findings in a family containing two affected brothers. The family pedigree is informative, as the mother has had children by three partners. The two affected individuals are full brothers. The first affected brother has delayed dental development, severe hypodontia and small tooth crown size. Mesio-distal and bucco-lingual dimensions were measured on the study models and compared with population data. The younger brother also has delayed dental development but only mild hypodontia. Their half sister has severe hypodontia but no signs of Carpenter Syndrome. This family study demonstrates two affected individuals with typical clinical features and a pedigree compatible with autosomal recessive inheritance. Small tooth crown size has been shown by standardized measurement and evidence advanced that hypodontia is not part of the syndrome but a coincidental finding which segregates independently. We have also shown that the marked delay in emergence of teeth is associated more with problems of tooth eruption, possibly related to the bony abnormalities, than to a generalized delay in dental development.

Acrocephalosyndactylia↗

The influence of jaw innervation on the dental maturation pattern in the mandible.

OBJECTIVES: To explore the relationship between mandibular dental maturation and the pattern of jaw innervation. SETTING AND SAMPLE POPULATION: The sample included 365 panoramic radiographs taken in the period 1965-1969 in a Danish municipality. DESIGN: For assessing dental maturity, the seven left mandibular teeth (M2, M1, P2, P1, C, I2, I1) were given a dental maturity score according to a method introduced by Demirjian. Spearman correlation coefficients between the maturity score of an index tooth (one of each teeth) and the maturity score of the 6 other teeth was calculated and illustrated. RESULTS: All the correlation coefficients were larger than 0.5 indicating a rather high level of association between the development of mandibular teeth in the same individual. Thus, associations between the pattern of dental maturation and jaw innervation were not obvious. CONCLUSION: When the correlation between the dental maturity stages was analysed, no significant relation was found between dental maturation and jaw innervation in the mandible. This is interesting considering the results presented in a recent study, which showed that the clinical observed tooth eruption was closely related to the pattern of jaw innervation. Those authors suggested that the factors influencing the eruption might be associated with jaw innervation. In our study, the stepwise dental maturation process, however, is not equally associated with jaw innervation.

Adolescent↗

Congenital nasal pyriform aperture stenosis and single central maxillary incisor: preoperative evaluation with three-dimensional computed tomography.

BACKGROUND AND PURPOSE: Congenital nasal pyriform aperture stenosis (CNPAS) is an uncommon cause of nasal airway obstruction in neonates and infants. It is frequently associated with a single central maxillary incisor (SCMI). The purpose of this study was to assess whether 3-dimensional spiral computed tomography (3D spiral CT) could be used for the diagnosis of CNPAS and for detecting SCMI in CNPAS patients before tooth eruption. METHODS: From January 1996 to December 2001, 16 patients (mean age, 2 +/- 3 months) with clinically suspected CNPAS and 13 normal control subjects (mean age, 28 +/- 32 months) were studied prospectively by 3D spiral CT. On the 3D CT image of each subject, the middle pyriform aperture width (MPAW), upper 1/4 PA width (UPAW), and middle internasal process width (MINPW) were measured. In addition, the ratios of MINPW to MPAW and of MINPW to UPAW were calculated. SCMI was identified as a bigger tooth with singular convexity. RESULTS: SCMI was diagnosed in 11 of the 16 CNPAS patients. In the CNPAS patient group, the mean MINPW (5 +/- 1 mm) was significantly shorter than the mean MPAW (9 +/- 1 mm) and the mean UPAW (8 +/- 1 mm) [p < 0.001]. However, in the normal control group, the mean UPAW (13 +/- 2 mm) was significantly shorter than the mean MPAW (16 +/- 3 mm) and the mean MINPW (16 +/- 3 mm) [p < 0.01]. In the CNPAS patients, the mean ratios of both MINPW to MPAW (0.5 +/- 0.1) and of MINPW to UPAW (0.6 +/- 0.1) were significantly lower than the corresponding mean ratios in the normal control subjects (1.0 +/- 0.1 and 1.3 +/- 0.2, respectively; both p < 0.001). CONCLUSION: Our results indicate that CNPAS is frequently associated with a SCMI and CNPAS patients have a significant reduction in the MINPW and in the ratios of MINPW to MPAW and of MINPW to UPAW. We conclude that 3D spiral CT can be used for diagnosis of CNPAS and for detecting SCMI in CNPAS patients before tooth eruption.

Case-Control Studies↗

[Microstructure of dental cementum and individual biological age estimation].

Evaluation of annual incremental lines of dental cementum is one of potentially valuable methods for biological age estimation in forensic anthropology. The objective of this work was to elucidate the relation between the number of those lines and the chronological age of an individual. Material of the study consisted of undecalcified sections of 227 permanent teeth of 178 individuals (89 males, 89 females, average age 47.5 years) (3-4 of each tooth, thickness 33-35 mum). Sections were analyzed under magnification of 20-40 times, photographed and evaluated using digitalized visual analysis system. Biological age was estimated by pooling the number of lines counted and the average age of tooth eruption. It was found that the number of lines strongly correlates with the chronological age (r>0.95, p<0.001). Factor of sex has no significant influence on the number of lines. Absolute average error was 5.58 years (11.75%), but the preciseness of the method decreases with age: among younger individuals it is lower - 3.71 years (10.09%), and higher among older - 7.86 years (13.1%). Regression power equation produces higher error than the traditional method: the best results are obtained by pooling the number of lines and average age of tooth eruption. Conclusion is made that the method is suitable for forensic anthropology, and digitalized system enhances the count and provides better results.

Adolescent↗

Secondary retention in the primary dentition.

Secondary retention refers to cessation of tooth eruption after emergence. The aim of this study was to evaluate the clinical, radiographic, and histological characteristics of secondary retention as well as the treatment results in a group of thirty-four patients with seventy-seven secondarily retained primary molars. The most important clinical and radiographical criterion for diagnosing secondary retention was infraclusion. Percussion was not a reliable diagnostic tool. Secondary retention in the primary dentition may predispose to a similar disorder in the permanent dentition. In many cases, occlusal disturbances and underdevelopment of the alveolar process disappeared spontaneously after eruption of the permanent successor, unless a similar disorder was observed in the permanent dentition. Active therapy is necessary only in case of severe infraclusion, severe malocclusion, dislocation or agenesis of the successor.

Adolescent↗

Low birth weight, developmental milestones, and behavioral problems in Chinese children and adolescents.

This study examined the association of low birth weight (LBW) and developmental milestones with behavioral and emotional problems in a general population sample of 3344 Chinese children and adolescents aged 6-16 years in 1997. Parents completed a self-administrated questionnaire including information about birth weight and developmental milestones (i.e. lifting the head up, tooth eruption, speech, walking and bedwetting cessation), and the Child Behavioral Checklist (CBCL). Teachers completed the Teacher's Report Form (TRF) to assess classroom behavior problems. Results indicated that LBW and delayed developmental milestones were significantly associated with an increased risk for almost all parent- and teacher-reported behavioral problems after controlling for the potential effects of child's gender, age and birth order, parental ages at birth, education, occupation, complications at birth and number of children in the family. LBW was significantly associated with delay in achieving all developmental milestones including lifting of the head, tooth eruption, sitting without support, walking without help, speech as saying words with meaning, and bedwetting cessation. It is concluded that LBW and delayed early childhood development may predict the occurrence of a wide range of behavioral and emotional problems in later childhood and adolescence.

Adolescent↗

Craniofacial growth in olive baboons (Papio cynocephalus anubis): browridge formation.

The examination of a developmental series of skulls of olive baboons has led to the generation of a model for browridge formation. Evidence in support of the model comes from surface configuration of browridge bone as studied by scanning electron microscopy, histology of the bone by the analysis of thin sections and by measurements that reflect both depositional cycles in browridge bone and the biomechanics of mastication. The model relates sudden changes in the biomechanical system caused by the tooth eruption cycle to cyclical changes in the formation of browridge bone. We suggest that browridge bone is added during periods of peak stress caused by the positive response of the masticatory muscles to relatively sudden reduction of their biomechanical efficiency.

Animals↗

Diverse roles of the tumor necrosis factor family member TRANCE in skeletal physiology revealed by TRANCE deficiency and partial rescue by a lymphocyte-expressed TRANCE transgene.

Tumor necrosis factor-related, activation-induced cytokine (TRANCE), a tumor necrosis factor family member, mediates survival of dendritic cells in the immune system and is required for osteoclast differentiation and activation in the skeleton. We report the skeletal phenotype of TRANCE-deficient mice and its rescue by the TRANCE transgene specifically expressed in lymphocytes. TRANCE-deficient mice showed severe osteopetrosis, with no osteoclasts, marrow spaces, or tooth eruption, and exhibited profound growth retardation at several skeletal sites, including the limbs, skull, and vertebrae. These mice had marked chondrodysplasia, with thick, irregular growth plates and a relative increase in hypertrophic chondrocytes. Transgenic overexpression of TRANCE in lymphocytes of TRANCE-deficient mice rescued osteoclast development in two locations in growing long bones: excavation of marrow cavities permitting hematopoiesis in the marrow spaces, and remodeling of osteopetrotic woven bone in the shafts of long bones into histologically normal lamellar bone. However, osteoclasts in these mice failed to appear at the chondroosseous junction and the metaphyseal periosteum of long bones, nor were they present in tooth eruption pathways. These defects resulted in sclerotic metaphyses with persistence of club-shaped long bones and unerupted teeth, and the growth plate defects were largely unimproved by the TRANCE transgene. Thus, TRANCE-mediated regulation of the skeleton is complex, and impacts chondrocyte differentiation and osteoclast formation in a manner that likely requires local delivery of TRANCE.

Animals↗

Dental caries in HIV-infected children versus household peers: two-year findings.

PURPOSE: This report will present a two-year comparison of the incidence and baseline prevalence of dental caries found in both the primary and permanent dentition among a cohort of HIV-infected children as compared to household peer control subjects who were not HIV-infected. METHODS: The subjects in this report were from an initial cohort of 171 children (104 HIV positive and 67 HIV negative), who were participants in the Children's Hospital AIDS Program in Newark, New Jersey, from 1993-1995. This two year analysis reports the findings on the children who completed baseline through Year 02 examinations (N = 121), aged 2-15 years old (68 HIV positive, 53 HIV negative). RESULTS: While the DMFS incidence at Year 02 among the 6-11 year old control subjects was 17% higher than that of the HIV-infected cases (2.1 vs. 1.8, respectively) this same incidence was eight-fold higher for the control subjects among the 12-15 year olds (e.g., 8.1 vs. 1.0, respectively). The mean cumulative dmfs score to date for HIV-infected cases was higher than for the control subjects for both the 2-5 year olds and the 6-11 year olds, (11.0 vs. 7.0) and (10.0 vs. 4.0, P = .02), respectively. In all three age groups, HIV-infected cases had a greater number of primary teeth and fewer number of permanent teeth than the control subjects (P < .01). CONCLUSION: Given that HIV-infected cases had lower DMFS scores and higher dmfs scores than their household peer controls, the fewer mean number of permanent teeth among the HIV-infected cases suggests that this delayed tooth eruption pattern in permanent teeth contributed to the lower DMFS scores seen in the HIV-infected cases.

Adolescent↗

In vivo expression of RANKL in the rat dental follicle as determined by laser capture microdissection.

Tooth eruption is a localized event in which many of the genes required for eruption are expressed in the dental follicle. A major function of the follicle is to recruit mononuclear cells for osteoclastogenesis such that the alveolar bone can be resorbed. Osteoclastogenesis is primarily regulated by receptor activator of nuclear factor-kappa B ligand (RANKL), colony-stimulating factor-one (CSF-1) and osteoprotegerin (OPG). In the rat first mandibular molar, osteoclastogenesis is maximal at day 3 and CSF-1 is maximally expressed in the follicle at this time whereas OPG expression is reduced. Whether or not RANKL is expressed in vivo in the follicle is controversial, however. It is critical to determine this because others have shown that in partially-rescued mice null for RANKL, teeth do not erupt. This suggests that RANKL should be expressed in the follicle for eruption to occur. Thus, to precisely determine if RANKL is expressed in the follicle in vivo, laser capture microdissection (LCM) was used to excise dental follicle tissue from frozen sections followed by RNA isolation and RT-PCR. The results show that RANKL is expressed in the dental follicle at days 1-9 postnatally. The technique was confirmed by controls showing that LCM isolates of the follicle, and alveolar bone, express OPG. Also, LCM isolates of alveolar bone were positive for RANKL. Thus, RANKL has now been shown to be expressed in the follicle and it is probable that interactions between it, CSF-1 and OPG regulate locally the osteoclastogenesis needed for tooth eruption.

Animals↗

Severe vertical overlap: a modified method of treatment.

Severe vertical overlap may predispose the patient to abnormal function, improper mastication, excessive stress, and functional problems such as bruxing, clenching, and craniomandibular disorders. This report describes the establishment of a new occlusal relationship by using the potential of posterior tooth eruption with the Hawley bite plane or the canine platform method. It was used in patients with a full complement of teeth or with some missing teeth. Patients treated by either the Hawley bite plane or the canine platform demonstrate a stable and long-lasting new occlusal relationship. The method described is efficient, inexpensive, and convenient to the patient.

Bicuspid↗

Measurements of the isometric contractile forces generated by dog periodontal ligament fibroblasts in vitro.

One hypothesis for the mechanism of tooth eruption is that the periodontal ligament fibroblasts generate the eruptive force. To assess the force generated, these fibroblasts were obtained by explant culture of ligament from mandibular premolars of a dog and were cultured in collagen gel matrices. The forces generated by them under isometric conditions were continuously measured for 120 h with a strain gauge. At the same time the number of cells in the gel was counted and the force measured was calculated as the force generated by 10(4) cells. Shortly after the start of culture, the force per 10(4) cells increased rapidly; it reached 5.2 X 10(-4) N at 8 h, and then remained at the same level for about 48 h. Our findings suggest that fibroblasts of the periodontal ligament may generate sufficient force for tooth eruption.

Animals↗

Maxillary incisor crown-root relationships in different angle malocclusions.

The long axis of the maxillary incisor root is not always identical to that of the crown. Instead, there is appreciable variation in the crown-root angle, generally with the crown torqued lingual to the root axis. In orthodontic cases assessed before and at the end of full-banded treatment, the crown-root angle was significantly deflected in the Class III molar relationship series, notably so in moderate to severe cases where the maxillary incisors are constrained lingual to the lower arcade. Apical root resorption was not significantly associated with the crown-root angle before or after comprehensive orthodontics. Cephalometric predictors of the amount of deflection of the crown-to-root axis were localized to intertooth relationships (overjet, interincisal angle). It is proposed that the large collum angles in Class III cases develop during tooth eruption when the maxillary incisors are trapped within the lower arch; this torques the crown of the maxillary incisor but leaves the unmineralized portion of the root free to develop as if the crown were still in its prior, more procumbent orientation.

Adolescent↗

Repair of alveolar clefts with recombinant human bone morphogenetic protein (rhBMP-2) in patients with clefts.

This article demonstrates the feasibility of using recombinant human bone morphogenetic protein (rhBMP-2) as a substitute for autogenous iliac crest bone for repair of congenital facial clefts in humans. In this series, 50 cleft sites were repaired in 43 patients using rhBMP-2 without the use of autogenous graft tissue. Successful osseous union was achieved in 49 of the 50 sites. In one patient, the graft failed to consolidate. Severe clefts were managed by combining distraction osteogenesis and rhBMP-2. Eliminating the need to harvest autogenous iliac crest bone resulted in substantial decrease in morbidity. The constructed alveolus performed clinically as normal bone and responded to natural tooth eruption and orthodontic movement. Histology of the tissue constructed showed normal, vital bone. Although additional investigation is warranted to determine the optimum protocol for the use of this material in alveolar cleft repair, the technique should be considered as a viable treatment option in cases in which avoiding iliac crest harvesting is desirable.

Adolescent↗