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A comparison of radiographic methods of assessing skeletal and dental maturation, and an evaluation of the correlations among the various maturity indicators in the 8-12 year age range.
Dentin sialophosphoprotein [designated DSPP and cleaved into dentin sialoprotein (DSP) and dentin phosphoprotein (DPP)], enamelysin and ameloblastin are each expressed in unique fashions during tooth development. It is possible that these components participate in cell differentiation and the conversion of unmineralized matrix into mineralized structures. In order to delineate the timing and the positioning of these three molecules in a physiological context, we compared their expression profiles by performing in situ hybridization experiments on consecutive sections in developing mouse tissues. Hybridization signals were uniquely detected for DSPP mRNA in odontoblasts and preameloblasts, for enamelysin mRNA in odontoblasts and in the facing ameloblast layer, and for ameloblastin mRNA in preodontoblasts, polarizing odontoblasts and ameloblasts. Immunohistochemistry showed that DSP and ameloblastin transcripts were translated into proteins that were deposited at the apical pole of the differentiated cells (odontoblasts and ameloblasts, respectively). The interrelated expression profiles found for these tooth-specific molecules illustrate the importance of a specific molecular network to initiate highly regulated processes such as cytodifferentiation and the subsequent mineralization.
In a study from Finland in 1986 it was shown that celiac disease was often associated with tooth enamel defects of permanent teeth. This study also showed a strong association between the time of gluten challenge in the diagnostic procedure and enamel defects. In the current study, dental examinations were carried out for a group of 40 children and adolescents suffering from celiac disease diagnosed according to the criteria of The European Society of Paediatric Gastroenterology and Nutrition (ESPGAN) at the Department of Paediatrics, Hospital of Uddevalla, Sweden. A control group made of 40 healthy children of the same age, sex and living area was examined in the same way. The results failed to show disturbances of the same type, degree of severity or frequency as was reported in Finland and no statistically significant differences concerning enamel defects were found between the patients with celiac disease and the controls.
OBJECTIVES: The objectives were to find out whether hypomineralized permanent first molars and incisors, known as Molar Incisor Hypomineralization (MIH), occurs all over Europe, whether its prevalence in each country is known and whether or not it is considered to be a clinical problem. SAMPLE AND METHODS: Clinical photos of MIH and a five-item questionnaire were sent to members of the European Academy of Paediatric Dentistry (EAPD). A total of 59 questionnaires were sent to members in 31 countries. After one month a reminder was sent to non-responders. RESULTS: Fifty-four dentists (92%) in 30 countries (97%) returned the questionnaire. MIH was stated to occur in all but one country (the Czech Republic). Nearly all the responders (97%) stated that they were familiar with the clinical appearance of MIH and a majority saw it as a clinical problem. Furthermore, a large majority of the responders (90%) considered it important to map the prevalence of MIH in European countries as such data are available to only a limited extent. CONCLUSION: Paediatric dentists in Europe are aware of MIH and the majority consider it to be a clinical problem. Only limited data are available on the prevalence of MIH. Comparable and representative prevalence studies are therefore urgently needed to gain more knowledge about the magnitude of MIH and related clinical problems.
Vertebrate mineralized tissues are vital to the adaptive evolution of various traits. Among these traits is the tooth, which consists of two characteristic mineralized tissues, a highly mineralized surface layer (enamel in tetrapods and enameloid in fish) and a softer body (dentin), both supported by basal bone. However, enamel and enameloid are significantly different in development, and dentin shows many histological variations; hence their evolution has been intensively studied. Nevertheless, their genetic basis has been revealed only in tetrapods. We previously reported that many genes involved in tetrapod tissue mineralization arose from a common ancestor and constitute the secretory calcium-binding phosphoprotein (SCPP) gene family. Now we show that teleost fish also use many SCPPs for enameloid and dentin mineralization, but none of these directly corresponds to tetrapod SCPPs. This finding suggests that teleost and tetrapod SCPP genes have experienced independent parallel duplication histories. Thus, through phenogenetic drift, the tooth has remained a stable trait in jawed vertebrates, while evolving distinct genetic bases in teleosts and tetrapods. The characteristics of teleost SCPP genes and their expression domains in tooth development suggest the possibility that enameloid arose from dentin and enamel from enameloid more than once in vertebrate evolution. In fugu (puffer fish), expression of SCPP genes is also detected in an unusual beak-like structure that shelters numerous teeth. Their expression pattern suggests that the jaw consists of the dentin beak and supportive bone. These findings illustrate the complexity of the homology concept in understanding evolution, particularly the evolution of mineralized tissues.
Dentin sialophosphoprotein (Dspp) is mainly expressed in teeth by the odontoblasts and preameloblasts. The Dspp mRNA is translated into a single protein, Dspp, and cleaved into two peptides, dentin sialoprotein and dentin phosphoprotein, that are localized within the dentin matrix. Recently, mutations in this gene were identified in human dentinogenesis imperfecta II (Online Mendelian Inheritance in Man (OMIM) accession number 125490) and in dentin dysplasia II (OMIM accession number 125420) syndromes. Herein, we report the generation of Dspp-null mice that develop tooth defects similar to human dentinogenesis imperfecta III with enlarged pulp chambers, increased width of predentin zone, hypomineralization, and pulp exposure. Electron microscopy revealed an irregular mineralization front and a lack of calcospherites coalescence in the dentin. Interestingly, the levels of biglycan and decorin, small leucine-rich proteoglycans, were increased in the widened predentin zone and in void spaces among the calcospherites in the dentin of null teeth. These enhanced levels correlate well with the defective regions in mineralization and further indicate that these molecules may adversely affect the dentin mineralization process by interfering with coalescence of calcospherites. Overall, our results identify a crucial role for Dspp in orchestrating the events essential during dentin mineralization, including potential regulation of proteoglycan levels.
Terminal differentiation of odontoblasts, the principal cells in dentin formation, proceeds by synthesis of type I collagen and noncollagenous proteins. DSP and DPP are specific markers for terminally differentiated odontoblasts and are encoded by a single gene DSPP (dentin sialophosphoprotein). In an attempt to understand the molecular mechanisms required for tissue-specific expression of the DSPP gene, we have identified a novel interaction between two bZIP transcription factors, Nrf1 and the CCAAT enhancer-binding protein (C/EBP)beta. This interaction was confirmed by both immunoprecipitation and chromatin immunoprecipitation assays. In undifferentiated odontoblasts, Nrf1 and C/EBPbeta repress DSPP promoter activity individually and synergistically by cooperatively interacting with each other. This mutual interaction is facilitated by the bZIP domains in both the proteins. The repression domain in both Nrf1 and C/EBPbeta was determined, and deletion of this domain abolished transcriptional repression. In fully differentiated odontoblasts, the loss of interaction between Nrf1 and C/EBPbeta results in an increased DSPP transcription. Further, this interaction was found to be dependent on phosphorylation at Ser(599) of Nrf1. Thus, the physical interaction between Nrf1 and C/EBPbeta provide a novel mechanism for the transcriptional regulation of DSPP in odontoblasts.
Phosphoproteins of the organic matrix of bone and dentin have been implicated as regulators of the nucleation and growth of the inorganic Ca-P crystals of vertebrate bones and teeth. One such protein identified in the dentin matrix is phosphophoryn (PP). It is highly acidic in nature because of a high content of aspartic acid and phosphate groups on serines. The 244-residue carboxyl-terminal domain of rat PP, predominantly containing the aspartic acid-serine repeats, has been cloned, and the corresponding protein has been expressed recombinantly in Escherichia coli. This portion of PP, named DMP2 (dentin matrix protein 2), is not phosphorylated by the bacteria and thus provided a means to study the function of the phosphate groups, the major post-translational modification of native PP. The recombinant DMP2 (rDMP2) possessed much lower calcium binding capacity than native PP. Small angle x-ray scattering experiments demonstrated that PP folds to a compact globular structure upon calcium binding, whereas rDMP2 maintained an unfolded structure. In vitro nucleation experiments showed that PP could nucleate plate-like apatite crystals in pseudophysiological buffer, whereas rDMP2 failed to mediate the transformation of amorphous calcium phosphate to apatite crystals under the same experimental conditions. Collagen binding experiments demonstrated that PP favors the formation of collagen aggregates, whereas in the presence of rDMP2 thin fibrils are formed. Overall these results suggested that the phosphate moieties in phosphophoryn are important for its function as a mediator of dentin biomineralization.
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Dental pulps contain sulfated glycosaminoglycans (GAGs), such as chondroitin 4-sulfate (CSA/4CS), dermatan sulfate (CSB/DS), and chondroitin 6-sulfate (CSC/6CS). Sulfated GAGs play important roles in mineralization and collagen fibrillogenesis during primary, secondary, and reparative dentin formations. Transforming growth factor-beta (TGF-beta) is a potent regulator for several extracellular matrix (ECM) components and modulates the proliferation and differentiation. Using rat clonal dental pulp cells (RPC-C2A), we investigated the constituents of GAGs synthesized by the cells and the effect of TGF-beta on their synthesis by measuring the radioactivity of [35S]sulfate incorporated into GAG fractions. Cellulose acetate electrophoresis analysis revealed that RPC-C2A cells synthesized CSA and CSB but not CSC and that 10 ng/ml of TGF-beta increased the production of CSA and CSB in the cell/ECM fraction. Measurement of [35S]sulfate incorporation showed a significant increase in the amount of GAGs by TGF-beta, 1.3-fold CSA, and 1.2-fold CSB in the cell/ECM fraction. In the medium fraction the most secreted GAG was CSA, whereas CSB was stored in the cell/ECM fraction. Secreted CSA in the medium was markedly increased by 10 ng/ml of TGF-beta (1.7-fold). These findings indicate that CSA and CSB are major sulfated GAGs synthesized by RPC-C2A cells and that TGF-beta acts as a stimulator of sulfated GAG synthesis in dental pulp cells.
Transformation in the structure and composition of calcium-glycerophosphate (Ca-GP) was investigated using a scanning electron microscope fitted with an energy dispersive X-ray microanalysis (EDX) system. Ca-GP was packed inside roots that were subsequently implanted into the mandibles of rats to stimulate the formation of an apical barrier. Scanning electron microscopic observations of packed Ca-GP revealed three types of structures: globular aggregates, plate or flake-like aggregates, and granular aggregates. The average Ca/P molar ratios of EDX by area mode--postoperatively obtained at days 1, 3, 5, and 7--were 1.300, 1.533, 1.472, and 1.495 (analytic area: 0.01 to 0.03 mm2) and those of EDX by point mode were 1.220, 1.451, 1.487, and 1.467 (analytic point: 0.05 micron 2). The magnesium (Mg) weight percentage was found to be approximately 1.9 at days 3, 5, and 7, similar to Mg-substituted whitlockite. These findings suggest that Ca-GP are transformed, over a period of 3 days into Mg-substituted whitlockite as a result of being hydrolyzed by tissue fluid.
In the serum-free culture medium of bovine odontoblasts we detected active gelatinolytic metalloproteinases, matrix metalloproteinase (MMP)-2 and MMP-9 (gelatinases A and B). The activity of MMP-2, in particular, appeared suddenly around day 21 in the culture, coinciding with the development of odontoblastic cell processes and the loss of alkaline phosphatase. Reverse transcriptase-polymerase chain reaction analysis of these odontoblasts demonstrated that messages of MMP-2 but not MMP-9 increased significantly between day 15 and day 21. The in vitro observation indicates that medium conditioned by these odontoblasts and containing significant amounts of MMP-2 degrades not only the collagenous substrates but also purified dentin phosphophoryn as well. We have also observed that dephosphorylated dentin phosphoprotein becomes a better substrate for casein kinase II after limited proteolysis with MMP-2. These results support our working hypothesis that MMP-2-mediated proteolytic processing is an important step in accelerating the process of dentin matrix maturation, which includes phosphorylation and subsequent mineralization. As has been suggested previously, extracellular phosphorylation of matrix proteins is an important step in biomineralization both in bone and in dentin (Mikuni-Takagaki et al., J Bone Miner Res 1995;10:231-42; Zhu et al., Biochem J 1997; 323:637-43). Our present histochemical analysis in MMP-2 knockout mice confirms the concept with the delayed formation of mineralized tissues, dentin, and bone.
Teratomas of the head and neck in infants and children, though uncommon, should be included in the differential diagnosis of head and neck masses in this age group. Roentgenographic examinations should be an integral part of the initial evaluation. Characteristic tooth-like calcifications are often present within teratomas. Sonographic procedures may be useful in differentiation of cystic, solid, or mixed tumors. Computerized tomography may be recommended to evaluate the extent of the lesion and to assess intracranial involvement. As in the case we have presented, surgical excision is curative. Complications of surgery have been due to hemorrhage and/or respiratory difficulties.
Contrary to conventional wisdom, mineralization is not the only strategy evolved for the formation of hard, stiff materials. Indeed, the sclerotized mouthparts of marine invertebrates exhibit Young's modulus and hardness approaching 10 and 1 GPa, respectively, with little to no help from mineralization. Based on biochemical analyses, three of these mouthparts, the jaws of glycerid and nereid polychaetes and a squid beak, reveal a largely organic composition dominated by glycine- and histidine-rich proteins. Despite the well-known metal ion binding by the imidazole side-chain of histidine and the suggestion that this interaction provides mechanical support in nereid jaws, there is at present no universal molecular explanation for the relationship of histidine to mechanical properties in these sclerotized structures.
Biological apatite-crystal formation is a complex process starting with heterogeneous nucleation of inorganic calcium phosphate on an organic extracellular matrix [Cuisinier et al. (1995), J. Cryst. Growth, 156, 443-453]. Further stages of crystal growth are also controlled by the organic matrix and both nucleation and growth processes are under cellular control [Mann (1993), Nature (London), 367, 499-505]. The final mineral in calcified tissue is constituted by poorly crystalline hydroxyapatite (HA) with a low Ca:P ratio, containing foreign ions such as carbonate and fluoride. This study reports the first observation of octacalcium phosphate (OCP) [Brown (1962), Nature (London), 196, 1048-1055] in a biological tissue; OCP was found in the central part and HA at the extremities of the same crystal of calcifying dentine. This observation is of key importance in understanding the first nucleation steps of biological mineralization. The presence of OCP in a forming human dentine crystal and the observation in the same tissue of nanometer-sized particles with a HA structure [Houllé et al. (1997), J. Dent. Res. 76, 895-904] clearly proves that two mechanisms, direct nucleation of non-stoichiometric HA crystals and nucleation of OCP, occur simultaneously in same area of mineralization. OCP is found to be a transient phase during the growth of biological crystals. In small crystals, OCP is completely transformed into HA by a hydrolysis reaction (Brown, 1962) and can only be detected in larger crystals because of its slow kinetics of transformation.
OBJECTIVE: This study was undertaken in order to establish the structural and mineralization pattern of the response of dentine to alterations in enamel in hypocalcified amelogenesis imperfecta (AI). DESIGN: The images and data obtained with scanning electron microscopy and electron probe X-ray microanalysis in enamel and dentine specimens from control and affected teeth were compared in this study. PATIENTS AND METHODS: We compared 46 fragments of permanent teeth from patients with clinically diagnosed hypocalcified AI and 20 normal permanent teeth. All specimens were prepared for electron probe X-ray microanalysis. RESULTS: Dentine is characterized by thickening of the peritubular dentine and partial obliteration of the dentinal tubules that does not give rise to a compact sclerotic cast. In dentine, calcium levels were significantly higher in teeth with clinically hypocalcified AI in relation with control teeth (P < 0.001). CONCLUSIONS: Dentine is affected in hypocalcified AI increasing mineralization (narrower tubules and higher content of calcium) in response to enamel disorder.