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Cloning and expression analysis of the bovine dentin matrix acidic phosphoprotein gene.

The dentin matrix acidic phosphoprotein gene has been mapped to human chromosome 4q21 and mouse chromosome 5q21. Expression studies have implicated a role for this gene in the mineralization of dentin. In the current investigation, a cDNA encoding bovine dentin matrix acidic phosphoprotein has been cloned and sequenced. A comparison of the bovine gene with its rat counterpart has indicated that the genes are conserved (67.4% identity; 79.5% similarity), particularly in the region of presumed functional elements such as the hydrophobic signal peptide sequence, the cell attachment Arg-Gly-Asp tripeptide, and numerous serine residues which are likely candidates for phosphorylation. Zoo blot analysis further indicated that a similar gene is found in all mammalian species tested, but not in chicks. However, Northern analysis has indicated that in the cow the message is detectable at high levels in fetal bovine brain and cultured long bone as well as in odontoblasts. These results support a potential role for dentin matrix acidic phosphoprotein in dentinogenesis.

Amino Acid Sequence↗

Amelogenesis imperfecta in a new animal model--a mutation in chromosome 5 (human 4q21).

Candidate genes for amelogenesis imperfecta (AI) and dentinogenesis imperfecta (DI) are located on 4q21 in humans. We tested our hypothesis that mutations in the portion of mouse chromosome 5 corresponding to human chromosome 4q21 would cause enamel and dentin abnormalities. Male C3H mice were injected with ethylnitrosourea (ENU). Within a dominant ENU mutagenesis screen, a mouse mutant was isolated with an abnormal tooth enamel (ATE) phenotype. The structure and ultrastructure of teeth were studied. The mutation was located on mouse chromosome 5 in an interval of 9 cM between markers D5Mit18 and D5Mit10. Homozygotic mutants showed total enamel aplasia with exposed dentinal tubules, while heterozygotic mutants showed a significant reduction in enamel width. Dentin of mutant mice showed a reduced content of mature collagen cross-links. We were able to demonstrate that a mutation on chromosome 5 corresponding to human chromosome 4q21 can cause amelogenesis imperfecta and changes in dentin composition.

Amelogenesis Imperfecta↗

Isolation and expression of FIP-2 in wounded pulp of the rat.

Pulpal wound healing followed by cavity preparation may involve reactionary or reparative dentinogenesis in relation to the cavity position; however, little is known about the molecular responses. We aimed to isolate and analyze genes induced or suppressed in the wounded pulp to identify molecular processes involved in the pulp responses to injury. Twenty-three cDNAs were isolated by cDNA subtraction between healthy and wounded pulp of rats. By library screening, we identified rat 14.7K-interacting protein (rFIP)-2A and B genes homologous to human FIP-2, being involved in regulating membrane trafficking and cellular morphogenesis. RT-PCR analysis showed induction for only rFIP-2B in the wounded pulp. In situ hybridization analysis revealed that both rFIP-2s were expressed strongly in condensing mesenchymal cells of the palatal process and surrounding Meckel's cartilage, but not in intramembranous chondrogenic cells. Thus, up-regulated rFIP-2B expression may play a role in regulating membrane trafficking or cellular morphogenesis of these embryonic and wounded pulpal cells.

Amino Acid Sequence↗

Genetic and cellular toxicology of dental resin monomers.

Monomers are released from dental resin materials, and thus cause adverse biological effects in mammalian cells. Cytotoxicity and genotoxicity of some of these methacrylates have been identified in a vast number of investigations during the last decade. It has been well-established that the co-monomer triethylene glycol dimethacrylate (TEGDMA) causes gene mutations in vitro. The formation of micronuclei is indicative of chromosomal damage and the induction of DNA strand breaks detected with monomers like TEGDMA and 2-hydroxyethyl methacrylate (HEMA). As a consequence of DNA damage, the mammalian cell cycle was delayed in both G1 and G2/M phases, depending on the concentrations of the monomers. Yet, the mechanisms underlying the genetic and cellular toxicology of resin monomers have remained obscure until recently. New findings indicate that increased oxidative stress results in an impairment of the cellular pro- and anti-oxidant redox balance caused by monomers. It has been demonstrated that monomers reduced the levels of the natural radical scavenger glutathione (GSH), which protects cell structures from damage caused by reactive oxygen species (ROS). Depletion of the intracellular GSH pool may then significantly contribute to cytotoxicity, because a related increase in ROS levels can activate pathways leading to apoptosis. Complementary, cytotoxic, and genotoxic effects of TEGDMA and HEMA are inhibited in the presence of ROS scavengers like N-acetylcysteine (NAC), ascorbate, and Trolox (vitamin E). Elevated intracellular levels of ROS can also activate a complex network of redox-responsive macromolecules, including redox-sensitive transcription factors like nuclear factor kappaB (NF-kappaB). It has been shown that NF-kappaB is activated probably to counteract HEMA-induced apoptosis. The induction of apoptosis by TEGDMA in human pulp cells has been associated with an inhibition of the phosphatidylinositol 3-kinase (PI3-K) cell-survival signaling pathway. Although the details of the mechanisms leading to cell death, genotoxicity, and cell-cycle delay are not completely understood, resin monomers may be able to alter the functions of the cells of the oral cavity. Pathways regulating cellular homeostasis, dentinogenesis, or tissue repair may be modified by monomers at concentrations well below those which cause acute cytotoxicity.

Animals↗

Ultrastructural localization of complex carbohydrates in odontoblasts, predentin, and dentin.

Glycosaminoglycans (GAGs) and glycoproteins (GPs) are essential components for dentinogenesis. We have examined rat odontoblasts, predentin, and dentin decalcified with EDTA and stained with: 1) Spicer's hig-iron diamine-thiocarbohydrazide-silver proteinate (HID-TCH-SP) method for sulfated glycoconjugates, and 2) Thiéry's periodate-thiocarbohydrazide-silver proteinate (PA-TCH-SP) method for vicinal glycol-containing glycoconjugates. HIS-TCH-SP stained distended portions of Golgi saccules and secretory granules. The predentin contained three times the number of HID-TCH-SP stain precipitates when compared to the mineralization front of the dentin matrix. PA-TCH-SP weakly stained membranes of Golgi saccules and cisternae of rough endoplasmic reticulum (RER), whereas stronger staining was observed in secretory granules, lysosomes, and multivesicular bodies (MVBs). Collagen fibrils in predentin demonstrated moderate PA-TCH-SP staining. In contrast, strong PA-TCH-SP staining was observed on and between collagen fibrils in the mineralization front of the dentin matrix. TCH-SP controls of unosmicated specimens lacked significant staining, however, osmicated control specimens did contain some TCH-SP stain deposits in the mineralization front. These results indicate that sulfated and vicinal glycol-containing glycoconjugates are packaged in the same type of secretory granule and released into the extracellular matrix; subsequently vicinal glycol-containing glycoconjugates concentrate in the calcification front, whereas sulfated glycoconjugates accumulate in the predentin and are either removed or masked to staining in the dentin.

Animals↗

Immunohistochemical localization of glycosaminoglycans and proteoglycans in predentin and dentin of rat incisors.

We examined immunocytochemically the type and distribution of glycosaminoglycans and proteoglycans (PG) in predentin and dentin demineralized with EDTA after aldehyde fixation of rat incisors using (a) four monoclonal antibodies (1-B-5,9-A-2,3-B-3, and 5-D-4) which recognize epitopes in unsulfated chondroitin (C0-S), chondroitin 4-sulfate (C4-S), chondroitin 6-sulfate (C6-S), and keratan sulfate (KS) associated with the PG, and (b) monoclonal (5-D-5) and polyclonal antibodies specific for the core protein of large and small dermatan sulfate (DS) PG. Light microscope immunoperoxidase staining after pre-treatment of tissue sections with chondroitinase ABC localized the majority of stainable PG (C4-S, KS, DSPG, C0-S, and C6-S) in predentin and, to a lesser extent (C4-S and small DSPG), in the dentin matrix. The former site demonstrated relatively homogeneous PG distribution, whereas the latter site revealed that strong staining of C4-S and small DSPG was confined mostly to dentinal tubules surrounding odontoblastic processes, with only weak staining in the rest of the dentin matrix. These results indicate that there is not only a definite difference between PG of predentin and dentin but also a selective decrease in the concentration or alteration of these macromolecules during dentinogenesis and mineralization.

Animals↗

Transcription of a mutant collagen I gene is a cell type and stage-specific marker for odontoblast and osteoblast differentiation.

The Mov13 allele of the mouse alpha 1(I) collagen gene carries a retroviral insert in its first intron and had been reported to be transcriptionally silent. We have recently shown, however, that this mutant gene is expressed in odontoblasts of transplanted teeth derived from homozygous and heterozygous carrier embryos. The expression of the Mov13 allele has now been followed throughout in vivo development of mandibular teeth and bone in heterozygous animals, by in situ hybridization with a probe that specifically recognizes transcripts of the mutant gene. We show that the onset of its transcription precisely coincides with the final differentiation of odontoblasts and the onset of dentinogenesis, i.e. on day E16 for the incisor and at birth for the first molar. The mutant allele is also transcribed in osteoblasts of mandibular bone, again starting precisely with the onset of osteogenesis (day E13/14). No other cells were seen to transcribe the mutant gene. By these criteria, transcription of the Mov13 allele constitutes a true differentiation marker for odontoblasts and osteoblasts. Expression of the mutant allele in these two specialized cell types, in contrast to its transcriptional block in all other mesodermal cells ('fibroblasts'), suggests tissue-specific differences in the regulation of the alpha 1(I) collagen gene.

Alleles↗

[Physiology and pharmacology of hard tissues--effect of chemicals on the formation and the resorption mechanism of tooth and bone].

This review described the effects of several drugs on the formation and the resorption mechanism of tooth and bone. The enamel formed during high fluoride exposure showed marked hypocalcification, and the organic substances appeared on the incisors in these regions. Such changes following fluoride administration appear to indicate an inhibition of the mineral deposition and/or an inhibition of organic matrix withdrawal. The successive bisphosphonate (HEBP) injections reduced both the progress of the mineral deposition and the formation of the enamel matrix. Colchicine showed a remarkable inhibitory effect on the matrix-forming cells of the dentin and enamel in teeth through its striking inhibitory action on the cytoskeletal system and secretary function. The dentin formation in rabbit and rat incisor dentin was reduced markedly. Colchicine induced reparative dentinogenesis in dental pulp and ectopic calcification in the bone marrow. Both sodium salicylate and aspirin reduced dentin formation through a mechanism that reduces the incorporation of collagen precursors into odontoblasts. Sodium salicylate also inhibited the growth of the upper jaw and tibia in rats. The recruitment of osteoclast-like multinucleated cells was inhibited by sodium salicylate in vitro. A pharmacological approach for studying the formation and resorption mechanism of hard tissue is useful tool for developing hard tissue research.

Animals↗

Biomineralization, life-time of odontogenic cells and differential expression of the two homeobox genes MSX-1 and DLX-2 in transgenic mice.

Msx and Dlx homeobox genes encode for transcription factors that control early morphogenesis. More specifically, Msx-1, Msx-2, and Dlx-2 homeobox genes contribute to the initial patterning of the dentition. The present study is devoted to the potential role of those homeobox genes during the late formation of mineralized tissues, using the rodent incisor as an experimental system. The continuously erupting mandibular incisor allows (1) the coinvestigation of the whole sequences of amelogenesis and dentinogenesis, aligned along the main dental axis in a single sample in situ and (2) the differential characterization of transcripts generated by epithelial and ectomesenchymal odontogenic cells. Northern blot experiments on microdissected cells showed the continuing expression of Msx-2 and Dlx-2 in the later stages of dental biomineralization, differentially in epithelial and ectomesenchymal compartments. Transgenic mice produced with LacZ reporter constructs for Dlx-2 and Msx-1 were used to detect different components of the gene expression patterns with the sensitive beta-galactosidase histoenzymology. The results show a prominent epithelial involvement of Dlx-2, with stage-specific variations in the cells involved in enamel formation. Quantitative analyses identified specific modulations of Dlx-2 expression in ameloblasts depending on the anatomical sites of the incisor, showing more specifically an inverse linear relationship between the Dlx-2 promoter activity level and enamel thickness. This investigation extends the role of homeoproteins to postmitotic stages, which would control secretory cell activity, in a site-specific manner as shown here for Dlx-2.

Animals↗

Type V osteogenesis imperfecta: a new form of brittle bone disease.

Osteogenesis imperfecta (OI) is commonly subdivided into four clinical types. Among these, OI type IV clearly represents a heterogeneous group of disorders. Here we describe 7 OI patients (3 girls), who would typically be classified as having OI type IV but who can be distinguished from other type IV patients. We propose to call this disease entity OI type V. These children had a history of moderate to severe increased fragility of long bones and vertebral bodies. Four patients had experienced at least one episode of hyperplastic callus formation. The family history was positive for OI in 3 patients, with an autosomal dominant pattern of inheritance. All type V patients had limitations in the range of pronation/supination in one or both forearms, associated with a radiologically apparent calcification of the interosseous membrane. Three patients had anterior dislocation of the radial head. A radiodense metaphyseal band immediately adjacent to the growth plate was a constant feature in growing patients. Lumbar spine bone mineral density was low and similar to age-matched patients with OI type IV. None of the type V patients presented blue sclerae or dentinogenesis imperfecta, but ligamentous laxity was similar to that in patients with OI type IV. Levels of biochemical markers of bone metabolism generally were within the reference range, but serum alkaline phosphatase and urinary collagen type I N-telopeptide excretion increased markedly during periods of active hyperplastic callus formation. Qualitative histology of iliac biopsy specimens showed that lamellae were arranged in an irregular fashion or had a meshlike appearance. Quantitative histomorphometry revealed decreased amounts of cortical and cancellous bone, like in OI type IV. However, in contrast to OI type IV, parameters that reflect remodeling activation on cancellous bone were mostly normal in OI type V, while parameters reflecting bone formation processes in individual remodeling sites were clearly decreased. Mutation screening of the coding regions and exon/intron boundaries of both collagen type I genes did not reveal any mutations affecting glycine codons or splice sites. In conclusion, OI type V is a new form of autosomal dominant OI, which does not appear to be associated with collagen type I mutations. The genetic defect underlying this disease remains to be elucidated.

Adolescent↗

Osteogenesis imperfecta type VI: a form of brittle bone disease with a mineralization defect.

Osteogenesis imperfecta (OI) is a heritable disease of bone in which the hallmark is bone fragility. Usually, the disorder is divided into four groups on clinical grounds. We previously described a group of patients initially classified with OI type IV who had a discrete phenotype including hyperplastic callus formation without evidence of mutations in type I collagen. We called that disease entity OI type V. In this study, we describe another group of 8 patients initially diagnosed with OI type IV who share unique, common characteristics. We propose to name this disorder "OI type VI." Fractures were first documented between 4 and 18 months of age. Patients with OI type VI sustained more frequent fractures than patients with OI type IV. Sclerae were white or faintly blue and dentinogenesis imperfecta was uniformly absent. All patients had vertebral compression fractures. No patients showed radiological signs of rickets. Lumbar spine areal bone mineral density (aBMD) was low and similar to age-matched patients with OI type IV. Serum alkaline phosphatase levels were elevated compared with age-matched patients with type IV OI (409 +/- 145 U/liter vs. 295 +/- 95 U/liter; p < 0.03 by t-test). Other biochemical parameters of bone and mineral metabolism were within the reference range. Mutation screening of the coding regions and exon/intron boundaries of both collagen type I genes did not reveal any mutations, and type I collagen protein analyses were normal. Qualitative histology of iliac crest bone biopsy specimens showed an absence of the birefringent pattern of normal lamellar bone under polarized light, often with a "fish-scale" pattern. Quantitative histomorphometry revealed thin cortices, hyperosteoidosis, and a prolonged mineralization lag time in the presence of a decreased mineral apposition rate. We conclude that type VI OI is a moderate to severe form of brittle bone disease with accumulation of osteoid due to a mineralization defect, in the absence of a disturbance of mineral metabolism. The underlying genetic defect remains to be elucidated.

Adolescent↗

Long-term study of pulp capping in monkeys with three agents.

The pulps of 40 permanent teeth of two monkeys were mechanically exposed and contaminated with adjacent saliva or plaque for 3 to 5 1/2 hours. The pulps were then capped with either Keflin (an antibiotic), Durelon (a polycarboxylate cement), or Dycal (a calcium hydroxide compound). Varnish and then amalgam were inserted. Each monkey received at least one dose of Procion red H-8BS vital dye. The teeth were extracted from one monkey 23 months after capping and from the other monkey 29 months after capping. Serial, decalcified, 7 mum-thick paraffin sections were prepared. Alternate slides were stained with hematoxylin ane eosin. Unstained sections were examined for Procion labeling, and selected slides were stained by the Brown-Brenn method for bacteria. Of 13 teeth capped with Keflin, only 4 responded satisfactorily. All of the Dycal and Durelon-capped pulps were successful at both time intervals. All of the Dycal-capped pulps showed complete bridging and no inflammation or pulp obliteration. Bridging was complete in only three of the Durelon-capped pulps. The findings of this study support the findings in our previous study3 and further substantiate the effectiveness of Dycal as a pulp-capping agent. The often-repeated claim that calcium hydroxide compounds exert a persistent stimulating effect on the pulp resulting in its eventual obliteration was not supported. Durelon is not recommended for pulp capping since the material apparently lacks an antibacterial effect and does not stimulate reparative dentinogenesis at the exposure site. The low rate of satisfactory responses of pulps capped with Keflin, as used, precludes its use of pulp capping.

Acrylates↗

Osteogenesis imperfecta: practical treatment guidelines.

Osteogenesis imperfecta (OI), an inherited connective tissue disorder of remarkable clinical variability, is caused by a quantitative or qualitative defect in collagen synthesis and is characterised by bone fragility. The number of fractures and deformities, and the age at which they begin greatly influence the prognosis and the achievement of walking and autonomy. A multidisciplinary team approach is essential for diagnosis, for communication with patient and parents, and to tailor treatment needs to the severity of the disease and the age of the patient. Three types of treatment are available: nonsurgical management (physical therapy, rehabilitation, bracing and splinting), surgery (intramedullary rod positioning, spinal and basilar impression surgery), and drugs to increase the strength of bone and decrease the number of fractures. An aggressive rehabilitative approach is indicated to optimise functional ability and walking capacity; appropriately timed surgery to insert intramedullary rods provides improved function of extremities. Despite a high rate of complications, intramedullary telescopic roding has proven to be the most successful method for preventing and correcting fractures and deformities of long bones, improving walking capability and leading to successful rehabilitation of even severely affected patients. Surgery may be required in patients with progressive spinal deformity and in those with symptomatic basilar impression. Hearing function, dentinogenesis imperfecta, cardiac and respiratory function, and neurological changes must be monitored. The causal defect of the disease cannot be corrected with medical treatment and, currently, only symptomatic therapy is available. In recent years growth hormone (GH) and bisphosphonate agents have been used in OI therapy. GH is beneficial in patients with moderate forms of OI, showing a positive effect on bone turnover, bone mineral density and height velocity rate. Bisphosphonates have proved beneficial in children with severe OI, increasing bone mineral density and reducing the fracture rate and pain with no adverse effects reported. These data require confirmation in double-blind controlled studies; however, bisphosphonates have markedly improved morbidity in patients with OI. Future developments in genetic therapy may be directed towards either replacing cells carrying the mutant gene with normal cells or silencing the mutant allele using antisense suppression therapy, thus transforming a biochemically severe form of OI into a mild form.

Child↗

Culture medium modulates the behaviour of human dental pulp-derived cells: technical note.

In vitro approaches have extensively been developed to study reparative dentinogenesis. While dental pulp is a source of unidentified progenitors able to differentiate into odontoblast-like cells, we investigated the effect of two media; MEM (1.8 mM Ca and 1 mM Pi) and RPMI 1640 (0.8 mM Ca and 5 mM Pi) on the behaviour of human dental pulp cells. Our data indicate that MEM significantly increased cell proliferation and markedly enhanced the proportion of alpha-smooth muscle actin positive cells, which represent a putative source of progenitors able to give rise to odontoblast-like cells. In addition, MEM strongly stimulated alkaline phosphatase activity and was found to induce expression of transcripts encoding dentin sialophosphoprotein, an odontoblastic marker, without affecting that of parathyroid hormone/parathyroid hormone related protein-receptor and osteonectin. In conclusion, these observations demonstrate that not only proliferation but also differentiation into odontoblast-like cells was induced by rich calcium and poor phosphate medium (MEM) as compared to RPMI 1640. This study provides important data for the determination of the optimal culture conditions allowing odontoblast-like differentiation in human pulp cell culture.

Alkaline Phosphatase↗

Observation of the internal configuration of rat incisor odontoblasts by scanning electron microscopy using the AODO method.

The internal configuration of rat incisor odontoblasts was studied mainly by scanning electron microscopy (SEM) using the AODO method (low concentration aldehyde prefixation, osmium tetroxide postfixation, dimethyl sulfoxide (DMSO) freeze-fracture, osmium tetroxide maceration). The present SEM findings were compared with the results obtained by conventional transmission electron microscopy (TEM) of epon-embedded specimens. The following results were obtained: 1) Functioning odontoblasts were characterized by a concentric, laminar rough endoplasmic reticulum (rER) with many long mitochondria interposed. 2) A network of tubular smooth endoplasmic reticulum (sER) was observed in the odontoblast process and distal portion of both functioning and resting odontoblasts. 3) The tubulo-vesicular elements which have been found to present a modified Golgi-GERL organelle with secretory and absorptive functions were demonstrated in both the functioning and resting odontoblasts. Structurally they consist of the sER network and strings of granules and vesicles. 4) Various types of cytoplasmic bodies, e.g., lysosomes, cytosomes and multivesicular bodies, related to the sER were also noted in both functioning and resting odontoblasts. 5) Microapocrine secretion of membranous vesicles of various sizes into the predentin and along the lateral branchings of odontoblast processes in the circumpulpal dentin was observed during the matrix apposition stage of the odontoblasts. The present morphological study revealed the three-dimensional configuration of the intra- and extra-cellular structures related to dentinogenesis by odontoblasts.

Aldehydes↗

An intronic deletion leading to skipping of exon 21 of COL1A2 in a boy with mild osteogenesis imperfecta.

A mild form of osteogenesis imperfecta was diagnosed in a 5-year-old boy with short stature, osteoporosis, blueish sclerae, dentinogenesis imperfecta, hyperextensible joints and bruisable skin. His skin fibroblasts synthesized both normal and shortened pro-alpha 2(I) collagen chains. Procollagen I molecules containing the shortened pro-alpha 2 chains were unstable and thus virtually excluded from secretion at 37 degrees C. Secretion was only partially restored at 30 degrees C. Cyanogen bromide mapping confined the defect to peptide alpha 2(I)CB4. PCR amplification of cDNA showed that the 108 nucleotides corresponding to exon 21 (coding for residues 274 to 309 of the helical domain) were missing in about half of the COL1A2 mRNA. Genomic DNA analysis showed that both exons 21 of COL1A2 were intact, but nucleotides +2 to +40 in intron 21 were deleted on one allele. The intronic deletion altered the conserved nucleotides at position +2 and +5 of the splicing donor site and apparently caused skipping of exon 21 during mRNA splicing. The mild phenotype associated with this COL1A2 mutation may be explained by very poor secretion of the structurally defective procollagen I molecules, which minimizes their deleterious effects on extracellular matrix formation.

Alleles↗

The effects of spaceflight on the mineralization of rat incisor dentin.

The lower incisors of Male Wistar rats flown for 18.5 days on the Soviet Cosmos-1129 Biosatellite were sectioned and chemically analyzed with an electron microprobe in order to determine whether there were specific effects of spaceflight on dentin formation/mineralization. Control tissues were obtained from rats housed under identical conditions in a land-based mock-up of the Biosatellite. The profiles of calcium (Ca), phosphorus (P), and sulfur (S) concentrations in dentin were measured in continuous traverses (1.0 micron intervals) from the pulp to the dentinoenamel junction. The incisor dentin formed during spaceflight had higher than normal (at 1G) concentrations of Ca (+ 10-15%) and P (+ 20-30%), particularly in the temporally youngest tissues within 80 micron of the pulp which had been least affected by secondary mineralization. The S-concentration profiles tended to decrease with tissue age. Fourier analysis (to determine the growth rhythms) revealed abnormal distributional patterns of S in the recently formed dentin from the Flight rats. The sulfur fluctuations in Flight animals alone periodically peaked above the irregular background fluctuations. These observations indicate that spaceflight has measureable effects on dentinogenesis, and they may also bear on the problem of the regulatory role of proteoglycans in mineralization and in the maturation of mineral and matrix moieties in skeletal tissue.

Animals↗

The treatment of mandibular cysts associated with osteogenesis imperfecta.

A fifteen-year-old boy with osteogenesis imperfecta (OI) and dentinogenesis imperfecta also had a big cyst in the mandible and needed surgical therapy. Six months postoperatively we saw a complete regeneration of the bone-structures. We came to the conclusion that cysts which appear independently from the disease of OI can heal after surgical intervention.

Adolescent↗