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The effect of chronic parathyroid extract on tooth eruption and dental tissues in osteopetrotic mice.

The grey lethal mouse is an osteopetrotic mutant in which there is diffuse sclerosis of the entire skeleton and the teeth remain trapped in the jaws. The condition was treated with daily subcutaneous injections of PTE beginning at birth. PTE induced molar tooth eruption in some mutants and improved root formation (without eruption) in others. However, the zone of predentine in the crown of the tooth remained abnormally wide and dentinogenesis remained irregular. Resorption of alveolar bone was adequate to permit complete tooth eruption in some animals and increased root formation in others.

Animals↗

Osteogenesis imperfecta: fibronectin in dentin matrix.

Deciduous and permanent teeth from seven patients with five different osteogenesis imperfecta (OI) syndromes and three normal subjects were demineralized with ethanolic trimethylammonium EDTA, enzymatically pretreated and immunostained with antihuman plasma fibronectin (FN) sera. Staining for FN in the dentin matrix was positive in halo and reticular patterns in the one patient with Sillence type I B OI and in two patients of three with type IV B OI, all with dentinogenesis imperfecta (DI). The staining was negative in type I A OI without DI, in type III, in one patient with type IV B, and in an unidentified type of OI, all with DI. In normal control teeth no staining of the dentin matrix was observed. The staining differences between OI types (also with DI) may reflect genetic heterogeneity. The diverse results in type IV B OI were suggestive of interfamilial variability within the OI syndrome. The presence of FN in the dentin matrix in OI may be due to its continuous synthesis or decreased degradation during dentin development.

Dentin↗

[Dentinal dysplasia type I].

Dentinal dysplasia is one of the rarest hereditary disturbances of dentin formation characterized by the teeth present with short blunt roots, considerably reduced or obliterated pulp spaces, periapical abscess or cysts without an obvious causative factor, and spontaneous exfoliated. These features were observed on a patient referred for prosthodontic assessment, and an investigation of other members of the family revealed that the father and two siblings were also affected. The report described the clinical, radiographic, histologic and scanning electron microscopic features and discussed the features which separated from dentinogenesis imperfecta.

Dentin Dysplasia↗

[Genetic heterogeneity of osteogenesis imperfecta. Study of 6 cases].

Osteogenesis imperfecta one of the most common disorders of connective tissue, has been known for centuries. The most characteristic alterations which define it are: osteoporosis, osseous fragility with multiple fractures, blue sclerae, deafness and imperfect dentinogenesis. Important advances in the biochemical, anatomopathological, genetic, therapeutic and prophylactic fields have resulted in a great present-day interest in this disease. In this work we report six cases of osteogenesis imperfecta according to the current classification and we review the most outstanding aspects.

Adult↗

[The use of organic bone matrix as material for direct pulp capping].

The effect of bone matrix soaked in thyrocalcitonin on vitally amputated pulp was studied in beagle dogs with light and electron microscopy. All treated teeth were vital after eight weeks; the area of implantation was densely populated with cells. Formation of hard tissue differing from normal dentinogenesis had begun.

Animals↗

Molecular heterogeneity in the mild autosomal dominant forms of osteogenesis imperfecta.

Mild osteogenesis imperfecta (OI type I and OI type IV) is characterized by postnatal onset of fractures, absence of skeletal deformity, presenile hearing loss with or without blue sclerae, and dentinogenesis imperfecta. Using one common DNA polymorphism associated with the pro alpha 2(I) human collagen gene, we found genetic heterogeneity in this disorder. In three families, the OI phenotype segregated independently of the DNA polymorphism, whereas in one family, the OI phenotype cosegregated with a DNA polymorphism in a manner suggesting linkage. Use of DNA polymorphisms associated with both type I procollagen genes should provide a tool to unravel the molecular heterogeneity of various heritable disorders of the connective tissue.

DNA Restriction Enzymes↗

[Osteogenesis imperfecta: contribution to pathobiochemistry].

Osteogenesis imperfecta (OI) is a hereditary disease characterized by increased bone fragility and marked skeletal deformities. As a generalized connective tissue disorder, many patients present with other typical symptoms, such as blue sclerae, dentinogenesis imperfecta, impaired hearing, joint laxity, and easy bruising of the skin. According to clinical and genetic characteristics, Sillence classified four different groups. Metabolic alterations of connective tissue components are thought to be responsible for the pathogenesis of OI. Collagen, the main constituent of connective tissue, was analyzed in autoptic tissue and/or skin fibroblasts from patients with OI. In fibroblast culture of patients with OI group I, the range of synthesized collagen type III is elevated to 15-48% (normal up to 15%). Patients in groups II and III show an increased presence of hydroxylysine in alpha-chains of collagen types I and III. The hydroxylation of lysyl residues of the cartilage specific collagen type II is slightly elevated. In both groups, the hydroxypyroline content in all tested collagen types was normal. In our investigation, the collagen of patients with OI group IV appeared normal. Although the clinical features of patients with OI of all groups were not homogeneous, OI group III and some subtypes of group II had similar clinical courses and biochemical findings. In addition, there are patients with OI who present with clinical symptoms, but who cannot be classified into any of the known groups. For a better differentiation, biochemical examination of collagen should be performed complementary to clinical and genetic criteria.

Adolescent↗

Effect of oxygen tension on matrix formation and mineralization in hamster molars during development in vitro.

The effect of 3 oxygen tensions (20%, 50% and 95%) on the pre-eruptive tooth development in vitro was studied biochemically and histologically in 2nd maxillary molars of the hamster. The specific uptakes (uptake per microgram dry weight) of 3H-proline and 45Ca were used as parameters for matrix production and mineralization, respectively. The best results were obtained at 50% O2. Histologically, considerable amounts of predentine, dentine and enamel matrix were found in these molars. Biochemically, appreciable synthesis of matrix and mineralization were measured. In an atmosphere containing 20% O2 less predentine, dentine and enamel matrix were formed. Moreover, production of the matrices occurred in a less regular way. In particular, dentinogenesis in the deeper parts of these molars was affected. The odontoblasts in these areas showed an abnormal and decreased matrix production and eventually dedifferentiated. Biochemically, a lower matrix synthesis and mineralization were measured in these molars.

Amelogenesis↗

[Functional anatomy of the blood vessels of the dental pulp in the white rat].

Applying a complex of modern microangiological techniques, the organization of the blood bed in the incisor and molar pulp has been studied in the white rat mandible. Production of the dental tissue components in the zones of dentinogenesis is ensured by an increased density of the capillary and venular bed of the pulp, a tight connection of the capillaries with predentin. The morphometric data obtained make it possible to prognosticate a high intracapillary pressure and the hydratation degree of the interstitial gel in the incisor pulp, which is close to maximal figures. Differences in angio-architectonics of the incisor pulp and the molar pulp depend on the peculiarities of the histostructure and functional state of the pulp, on the geometry of the dental cavity and the radicular canals. The pulp blood bed possesses a complex apparatus that ensures the blood stream regulation (duplication of the nutrition sources, arteriolar and venular area, various types of anastomoses, precapillary sphincters and others).

Animals↗

[Use of dysprosium considered as an activable tracer in the study of tooth structures].

After 32 days of administration to rats of dysprosium in drinking water, this element has been studied by neutron activation analysis in the intra-oral part of the incisors as well as in the molar crowns. This element was absent in the intra-osseous parts of the incisors, the femurs and the liver. After intravenous injection of 13 mg or 26 mg of Dy in several doses over 32 days, this element was found in the incisor formation and maturation zones as well as in the part having erupted in the oral cavity. It was also found in the molars, the femurs and the liver. The structural study has shown that no cytotoxic effect was observed with the dysprosium doses used. Dentinogenesis and amelogenesis were not disturbed. The final structures were homogeneous. By comparing the two administration ways of dysprosium we have at our disposal a study model using an inducible tracer of the incorporation of adsorption of a mineral element in dental structures during early or late maturations.

Animals↗

Organ culture of tooth germs: relationship between alkaline phosphatase and mineralization in vitro.

In the 3rd day 2nd molar of the hamster, mineralization of the tooth germ has been studied in vitro starting from unmineralized predentine stage up to secretory amelogenesis. The explants were cultured in BGJb medium containing 15% foetal calf serum. The biochemical data on whole tooth germs were compared morphometrically with its main calcifying components. The alkaline phosphatase seems not to be related to cell-division but more to mineralization. There the alkaline phosphatase appeared to be more correlated with the phosphorus than with the calcium uptake. Its function in mineralization of the tooth germ seems also to be more expressed in dentinogenesis than in amelogenesis.

Alkaline Phosphatase↗

[The temporomandibular joint (TMJ) and osteogenesis imperfecta. A study of its embryologic development].

Although the most common oral manifestation of osteogenesis imperfecta is dentinogenesis imperfecta, several authors have described jaw fractures and radiolucent bone lesions associated with this disease. The authors, after reporting the main features of this disease, compare the cranial embryologic growth in twice fetuses of a 15 weeks old: one of these with osteogenesis imperfecta.

Gestational Age↗

Spectrum of dentin dysplasia in a family: case report and literature review.

The dentin dysplasias (DD), which may be classified as type 1 (DD1) or type 2 (DD2), form a group of rare, inherited dentin abnormalities that are clinically distinct from dentinogenesis imperfecta. Studies of affected families may help to distinguish different types of DD and provide further insight into their etiology and clinical management. This report describes a family that showed characteristic dental features of DD1, including clinically normal crowns in both primary and permanent dentitions, and mobile teeth that may be associated with premature exfoliation. Radiographic features included calcification of the pulp with crescent-shaped, radiolucent pulp remnants, short, tapering, taurodontic roots, and many periapical pathoses that may be cysts or granulomas. A spectrum of dentin dysplasia was noted within the family. Strategies to prevent pulp and periapical infections and early exfoliation of the teeth include meticulous oral hygiene and effective caries-preventive measures.

Child↗

Mild dental findings associated with severe osteogenesis imperfecta due to a point mutation in the alpha 2(I) collagen gene demonstrate different expression of the genetic defect in bone and teeth.

Serial intraoral photographs, radiographs, and ground sections from an extracted upper permanent canine served to characterize dental abnormalities in a 15-year-old girl suffering from severe (type III) osteogenesis imperfecta (OI) due to a point mutation that substituted glycine 688 of the alpha 2(I) chain of collagen I by serine. Dental records showed that all deciduous teeth exhibited clinical and radiographic characteristics of dentinogenesis imperfecta (DI), whereas permanent teeth including the removed canine appeared normal, although pulp chambers contained unusually large denticles. Despite the unconspicuous clinical appearance of the canine, histologic sections revealed small, canal-like, hypomineralized hard tissue patches that lacked a regular tubular structure and occupied a narrow band of the bulk of normal circumpulpal dentin at about the level of the cemento-enamel junction. The finding that a mutation in the gene for the alpha 2(I) collagen chain with serious consequences in bone has only minor effects in teeth would suggest that odontoblasts, unlike osteoblasts, can largely compensate for this particular genetic defect, possibly by excluding the abnormal alpha 2(I) chains and forming alpha 1(I) homotrimeric collagen I. The discrepant consequences in deciduous as opposed to permanent teeth and the specific localization of the dentinal abnormalities in permanent teeth lead us to speculate that the exclusion of defective alpha 2(I) chains could depend on the developmental stage and/or the rate of extracellular matrix formation.

Adolescent↗

[The role of the traditional radiological methods in conservative therapy and endodontics].

The traditional radiographic examinations used in restorative dentistry and endodontics are: intraoral radiograph performed in the beta-wing or the paralleling technique, the partial extraoral radiograph (rotational narrow beam), the panoramic radiography and the periapical radiographs with the bisecting technique which is particularly suitable for visualization of the apex. Radiology is a valuable diagnostic means to evaluate the extension of primary caries, to identify secondary and interproximal initial decays and if required let the therapist measure the biological width. Several factors influence the radiographic interpretation of caries: cervical burnout, mach band effect, internal and external resorption, restorative materials for fillings and sub-bases, abrasions and/or erosions. Radiology allows the diagnosis of developmental and acquired abnormalities of the teeth which can have an influence on the treatment itself. Examples are: variations in the shape of the crown and root, dens in dente, enamel hypoplasia, dentinogenesis imperfecta. Radiograms are of major importance in the evaluation of restorative dentistry results: precision of the margins, congruous contact points, fractures. Moreover, it provides the endodontic procedures with useful diagnostic data and permits the measurements during the treatment, supplying the immediate and long term checks too.

Dental Caries↗

Bruck syndrome (osteogenesis imperfecta with congenital joint contractures): review and report on the first North American case.

We describe a patient who was born with flexion contractures and pterygia at the elbows, clubfeet, torticollis, and several rib fractures. During infancy and childhood, multiple fractures of the lower limbs occurred with minimal trauma and led to disabling deformities. When evaluated at age 19 years, he was normally intelligent, but extremely short, with severe kyphoscoliosis compromising his pulmonary function. Pterygia limited elbow extension to 90 degrees, and severe lower limb deformities prevented ambulation. He did not have blue sclerae, dentinogenesis imperfecta, or hearing loss. X-ray studies showed demineralized bones, severe deformity and cystic change at old fracture sites, and vertebral wedging. Collagen studies on skin fibroblasts were normal.

Abnormalities, Multiple↗

Histopathological studies on the effects of experimental trauma and N-methyl-N-nitrosourea on the developing molar in rats.

Physical trauma to the developing first molar after initial dentin formation (5-day-old rat) and apposition stage (10-day-old rat) caused disturbance in amelogenesis, dentinogenesis, root formation which lead to aberrant odontogenesis. On the other hand, a combination of trauma and injection of carcinogenic substance (NMU) produced a more pronounced disturbance in odontogenesis and higher incidence of unerupted tooth. The transformation of the retained reduced enamel epithelium to squamous type cells was an interesting finding and has not been reported elsewhere. The presence of large proliferating type of odontogenic cell rests was observed.

Animals↗

Vital tooth bleaching with Nightguard vital bleaching.

Between July 1994 and May 1996, several landmark articles were published concerning the safety and efficacy of vital tooth bleaching with 10% carbamide peroxide in a customfitted tray. The American Dental Association (ADA) published guidelines for ADA acceptance, and three products received approval. Long-term clinical trials on 38 patients indicated 92% successful bleaching after 6 weeks of treatment. Results were stable in 74% of the patients at 1.5 years, and in 62% of the patients at 3-year follow-up with no further treatment. Clinical pulpal studies and periodontal studies indicated no detrimental safety problems, although some laboratory cell studies suggested concerns. The noncarcinogenic potential of 10% carbamide peroxide was established in animal studies. Successful bleaching of tetracycline-stained teeth was achieved after 6 months of treatment, with no tooth problems detected clinically or by scanning electron micrograph. Extended treatment times are effective on other stains from dentinogenesis imperfecta or nicotine. On insertion in the mouth, 10% carbamide peroxide elevated the pH in the tray and saliva. After 4 hours of clinical wear, over 60% of the newer, thicker materials (Opalescence [Ultraclent Products, South Jordon, UT] and Platinum [Colgate Oral Pharmaceuticals, Canton, MA]) was present and active in the tray. Nightguard vital bleaching seems to be the most cost-efficient, user-friendly, patient-accepted method of bleaching teeth available to the profession and is safe and effective. Over-the-counter products can have harmful effects on tooth structure and may not lighten teeth.

Carbamide Peroxide↗