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Visualization of glycosaminoglycans in rat incisor predentin and dentin with cetylpyridinium chloride-glutaraldehyde as fixative.

Using cetylpyridinium chloride (CPC) in glutaraldehyde as fixative, we observed sinuous fiber-like structures 300-500 nm long and 7-14 nm thick in the spaces between the collagen fibers of rat incisor predentin. Small granules and fibrils were also detected. Electron-dense vesicles were seen inside the odontoblast processes. The plasma membrane was irregularly stained with material that adhered to its surface. In demineralized dentin, needle-like structures were seen at the periphery of globular structures which were not stained. Staining the sections with Alcian blue did not greatly improve the visualization of CPC-precipitated glycosaminoglycans. The specificity of staining was assessed on serial sections by selective dissociation of glycosaminoglycan aggregates with 2 M calcium chloride and their digestion by bovine testicular hyaluronidase. The glycosaminoglycans were probably combined with lipids, because treatment of the sections with a chloroform/methanol mixture removed the CPC-induced precipitates from both predentin and dentin.

Aldehydes↗

Preserving the vital pulp in operative dentistry: 2. Guidelines for successful restoration of unexposed dentinal lesions.

The exciting treatment possibilities arising from tissue engineering approaches are still some years away from involvement in dentistry. Meanwhile, it is important to optimize conventional treatments, although precise information on pulp responses to cavity preparation and restoration variables are limited. Odontoblast survival, pulp inflammation, and tertiary dentine area are used as measures of pulp injury and repair.

Analysis of Variance↗

Saving pulps--a biological basis. An overview.

AIM: Cavity preparation and restoration variables have an uncertain relationship to pulp injury and repair responses. The purpose of this paper is to determine the importance of cavity preparation and restoration variables, by ranking them according to their effect on pulp injury (odontoblast survival) and pulp repair (reactionary dentine secretion). METHOD: The seven studies reviewed are all based on the protocols described by Murray, Smith and colleagues in 2000 and 2001. RESULTS: The studies reviewed provide new perspectives on the importance of cavity preparation and restoration variables in mediating pulp activity. CONCLUSIONS: The onset of post-operative complications may be most productively minimised by focusing practitioner attention to aspects of treatment highlighted in this review.

Adolescent↗

Developmental expression and tissue distribution of Phex protein: effect of the Hyp mutation and relationship to bone markers.

Mutations in PHEX, a phosphate-regulating gene with homology to endopeptidases on the X chromosome, are responsible for X-linked hypophosphatemia (XLH). The murine Hyp homologue has the phenotypic features of XLH and harbors a large deletion in the 3' region of the Phex gene. We characterized the developmental expression and tissue distribution of Phex protein, using a monoclonal antibody against human PHEX, examined the effect of the Hyp mutation on Phex expression, and compared neprilysin (NEP), osteocalcin, and parathyroid hormone/parathyroid hormone-related protein (PTH/PTHrP) receptor gene expression in bone of normal and Hyp mice. Phex encodes a 100- to 105-kDa glycoprotein, which is present in bones and teeth of normal mice but not Hyp animals. These results were confirmed by in situ hybridization (ISH) and ribonuclease protection assay. Phex protein expression in femur and calvaria decreases with age, suggesting a correlation between Phex expression and bone formation. Immunohistochemical studies detected Phex protein in osteoblasts, osteocytes, and odontoblasts, but not in osteoblast precursors. In contrast to Phex, the abundance of NEP messenger RNA (mRNA) and protein is not significantly altered in Hyp bone. Similarly, osteocalcin and PTH/PTHrP receptor gene expression are not compromised in bone of Hyp mice. Our results are consistent with the hypothesis that loss of Phex function affects the mineralizing activity of osteoblasts rather than their differentiation.

Animals↗

Expression of a 1,25-dihydroxyvitamin D3 membrane-associated rapid-response steroid binding protein during human tooth and bone development and biomineralization.

The calciotropic hormone 1,25-dihydroxyvitamin D3 [1,25(OH)2D3] has been established to control skeletal tissue formation and biomineralization via the regulation of gene expression. This action involves the well-characterized nuclear 1,25(OH)2D3 receptor. However, it has been recognized that several cellular responses to 1,25(OH)2D3 may not to be related to the exclusive nuclear receptor. Indeed, this secosteroid is able to generate rapid responses that have been proposed to be mediated by interactions of the ligand, which is a putative cell membrane-associated rapid-response steroid (MARRS) binding protein for 1,25(OH)2D3 [1,25D3-MARRS]. The nongenomic pathway of 1,25(OH)2D3 was studied here in detail by immunolocalization of the 1,25D3-MARRS during the specific context of human prenatal development. Western blotting with proteins extracted from 4 week- to 27-week-old embryos was performed, evidencing a 65-kDa molecular species recognized by antibody Ab 099 generated against synthetic peptides corresponding to the N terminus of the 1,25D3-MARRS from chick intestinal basolateral membranes. Based on this biochemical conservation of protein in the human species, the temporospatial expression patterns were established in the craniofacial skeleton at the same ages. Comparative analysis was performed in teeth and bones from early morphogenesis to terminal cell differentiation and extracellular biomineralization. The data show the potential implication of 1,25D3-MARRS in the heterogeneous cell population including ameloblasts, odontoblasts, osteoblasts, and osteoclasts. The epithelial-mesenchymal cascade related to odontogenesis was coincident with a sequence of up- and down-regulation of immunoreactive 1,25D3-MARRS. Biomineralization was associated with a striking up-regulation in the adjoining secretory cells in all tissues. Finally, osteoclasts appeared also to express the 1,25D3-MARRS during these early phases of bone modeling. Previously obtained data of the nuclear vitamin D receptor (VDR) expression and this study on 1,25D3-MARRS suggest the existence of cross-talk between the genomic and nongenomic pathways during human development.

Ameloblasts↗

Restorative pulpal and repair responses.

BACKGROUND: Each year, about 90 million new restorations are placed in the United States and 200 million are replaced. Controversy surrounds the pulpal reactions and frequency of bacterial microleakage associated with common restorative materials. The authors investigated and compared pulpal reactions to different types of restorative materials. METHODS: Two hundred seventy-two teeth with standardized rectangular Class V unexposed cavities were restored with resin-based composite bonded to dentin; resin-based composite bonded to enamel; resin-modified glass ionomers, or RMGI; amalgam lined with zinc polycarboxylate, or ZnPC; amalgam lined with calcium hydroxide, or Ca(OH)2; or zinc oxide-eugenol, or ZnOE. Teeth were extracted for orthodontic reasons between 20 and 381 days later. The authors categorized pulpal responses according to standards set by the Federation Dentaire Internationale and the International Organization for Standardization. Bacteria were detected using Brown-Brenn-stained sections. Pulpal responses were evaluated using histomorphometric analysis and analysis of variance statistics. RESULTS: The results showed that RMGI was the best material for preventing bacterial microleakage, and resin-based composite bonded to enamel was the worst. In regard to minimizing pulpal inflammatory activity, ZnOE was the best material and resin-based composite bonded to enamel was the worst. In terms of maximizing odontoblast survival beneath deep cavity preparations, Ca(OH)2, was the best material and RMGI was the worst. CONCLUSIONS: The results show that bacterial microleakage, pulpal injury and repair responses varied widely with different restorative materials. CLINICAL IMPLICATIONS: The authors recommend that RMGI be used to restore teeth with cavities that are shallow to moderate in depth, with the floor of deep cavities being lined with Ca(OH)2 before the teeth are restored with RMGI.

Adolescent↗

Side population cells isolated from porcine dental pulp tissue with self-renewal and multipotency for dentinogenesis, chondrogenesis, adipogenesis, and neurogenesis.

Dental pulp has the potential to form dentin as a regenerative response to caries. This regeneration is mediated by stem/progenitor cells. Thus, stem cell therapy might be of potential utility in induction of reparative dentin. We isolated side population (SP) cells from dental pulp based on the exclusion of the DNA binding dye Hoechst 33342 by flow cytometry and compared its self-renewal capacities and multipotency with non-SP cells and primary pulp cells. The cumulative cell number of the SP cells was greater than the non-SP cells and primary pulp cells. Bmi1 was continuously expressed in SP cells, suggesting longer proliferative lifespan and self-renewal capacity of SP cells. Next, the maintenance of the multilineage differentiation potential of pulp SP cells was investigated. Expression of type II collagen and aggrecan confirmed chondrogenic conversion (30%) of SP cells. SP cells expressed peroxisome proliferator-activated receptor gamma and adaptor protein 2, showing adipogenic conversion. Expression of mRNA and proteins of neurofilament and neuromodulin confirmed neurogenic conversion (90%). These results demonstrate that pulp SP cells maintain multilineage differentiation potential. We further examined whether bone morphogenetic protein 2 (BMP2) could induce differentiation of pulp SP cells into odontoblasts. BMP2 stimulated the expression of dentin sialophosphoprotein (Dspp) and enamelysin in three-dimensional pellet cultures. Autogenous transplantation of the Bmp2-supplemented SP cells on the amputated pulp stimulated the reparative dentin formation. Thus, adult pulp contains SP cells, which are enriched for stem cell properties and useful for cell therapy with BMP2 for dentin regeneration.

Adipogenesis↗

Transient expression of heat shock protein (Hsp)25 in the dental pulp and enamel organ during odontogenesis in the rat incisor.

The expression of heat shock protein (Hsp) 25 during odontogenesis in the dental pulp and enamel organ of rat incisors was investigated by immunocytochemistry and confocal microscopy. In the process of dentin formation, immature odontoblasts first exhibited Hsp 25-immunoreactivity, and increased in immunointensity with the advance of their differentiation. In the dental pulp, in contrast, intense immunoreaction in the mesenchymal cells became weak or negative in parallel with the progress of cell differentiation. The immunoreaction for Hsp 25 in the enamel organ revealed a characteristic stage-related alteration during amelogenesis. In secretory ameloblasts, the immunoreaction for Hsp 25 was found throughout their cell bodies, intense reactivity being located near the proximal and distal terminal webs. At the maturation stage, ruffle-ended ameloblasts (RA) consistently showed Hsp 25-immunoreactivity throughout the cell bodies, whereas smooth-ended ameloblasts (SA) lacking a ruffled border were weak in immunoreaction at the distal cytoplasm. Other cellular elements of the enamel organ were negative. The subcellular localization of Hsp 25-immunoreactivity in this study appeared essentially identical to that of actin filaments as demonstrated by confocal microscopy using rhodamine-labeled phalloidin. These immunocytochemical data suggest that the Hsp 25 molecule is involved in reinforcement of the cell layer following cell movement during odontogenesis and in the formation and maintenance of the ruffled border of RA.

Actins↗

The distribution of nerves in human deciduous and permanent teeth.

Human permanent teeth without caries, obtained from 10-16 year old males and females and noncarious human deciduous teeth in which roots remained intact or were only poorly resorbed, were studied histologically. The distribution of sensory nerves in deciduous teeth were compared with that in permanent teeth by means of the silver-nitrate technique. 1. In radicular pulp, the sensory nerve fiber bundles accompany blood vessels in the axial area and several nerve single-fibers occur in the peripheral area of the pulp. 2. The subodontoblastic nerve plexus is formed in or beneath the cell-rich zone of the coronal pulp, and further, the marginal nerve plexus is built up near the pulpo-predentinal border. 3. The nerve fibers entering the predentin can be classified into 3 types by their courses. In the first type, nerve fibers pass directly toward the calcification front along the dentinal tubules in the predentin. In the second type, nerve fibers run obliquely or transversely in the predentin. The transversal fibers form a plexus-like structure by dividing and interlacing at various levels of predentin. The third type nerve fibers pass along the dentinal tubules in the predentin and, after reaching the predentino-dentinal border, reverse the odontoblast layer, thus forming a looped course. 4. There is no essential difference between the nerve supply in the deciduous and in the permanent teeth, but the nerves in the deciduous teeth are less dense in distribution and lower in amount than in the permanent teeth. Moreover, a typical marginal nerve plexus, which occurs constantly in the permanent teeth, is only occasionally found in the deciduous teeth; and no nerve fiber was observed to penetrate into the calcified dentin in the deciduous teeth. This finding seems to account for the fact that the deciduous teeth are less sensitive than their permanent successors.

Adolescent↗

Pulpal evaluation of two adhesive systems in rat teeth.

Formocresol is the agent most frequently used with pulpotomies in primary teeth, but its use is currently under discussion in regard to its possible toxic effects. Some current works suggest the use of dentinal adhesives in cavities with minimal dentinal thickness and even in small pulpal exposures. Our objective was to evaluate pulpal response to the application of two dentinal adhesives Syntac and Prime & Bond NT in pulpal exposures in rat teeth. Sprague Dawley rats were used, male, 150 to 200 gm in weight. The maxillary first molar, left and right, was employed in each case, a total of twelve teeth. Duration of the study was 45 days. Sections were evaluated using a light microscope in order to determine pulpal response to the two adhesives. In both groups the persistence of chronic inflammation was associated with the absence of dentinal bridges in the affected specimens. Areas of necrosis and absence of regularity of the odontoblastic layer could also be seen.

Animals↗

Gene therapy for dentin regeneration with bone morphogenetic proteins.

Recent advances in stem cell biology and gene therapy technology have provided the great potential of adult stem cells for therapeutic use in regeneration of lost tissue due to diseases including cancer, trauma, and even caries. Dental pulp tissues harbor mesenchymal stem/progenitor cells and have potential to regenerate and/or repair dentin-pulp complex after injury such as caries. There are two main methods, in vivo and ex vivo gene therapy. In in vivo gene therapy the healing potential of pulp tissue is enhanced by genes inducing dentin directly applied on the exposed/amputated dental pulp. In ex vivo gene therapy, pulp stem/progenitor cells transfected with some therapeutically proven genes to induce differentiation into odontoblasts which are transplanted on the exposed/amputated pulp. In the inflamed pulp under deep caries or trauma, possibly due to the limited supply of pulp stem/progenitor cells, it might be useful to apply cell-based ex vivo gene therapy compared to in vivo gene therapy. Before clinical use of ex vivo gene therapy for dentin regeneration in endodontics, there is a need for establishment of isolation, identification and expansion of the pulp stem cells. A safe and efficient gene delivery system also needs to be optimized. In this review we provide an overview of our current knowledge in the biology and function of adult pulp stem cells. This is followed by a discussion of the challenges of translating basic cellular and molecular biology of differentiation of pulp stem cells to safe and efficient gene therapy for dentin regeneration.

Bone Morphogenetic Proteins↗

An electron microscopic study of ectomesenchymal contacts in rat incisors.

In order to clarify connections between epithelium and mesenchymal tissue in the early stage of odontogenesis, the formation of ectomesenchymal contacts and the presence of coarse-textured material at the interface between ameloblasts (AMs) and odontoblasts (ODs) on growing rat incisors were studied by electron microscopy. The presecretory zone was classified into five regions according to the ultrastructure of each preameloblast (PA). The region where collagen fibrils could be observed was designated PZ-2, the region where predentin existed PZ-3, the region where the basal lamina began to disappear PZ-4, and the region where the basal lamina had disappeared PZ-5. In PZ-2, the cytoplasmic processes of PAs penetrated the basal lamina and reached the dental papilla cells. In some locations, ectomesenchymal contacts were also observed, in which the cytoplasmic processes of the PAs were in contact with those of the preodontoblasts (POs). In PZ-3, the distal cytoplasm contained large amounts of type-1 vesicles, and secretory granules. In the distal membrane of the PA, membrane invaginations containing fibrillar structures were visible. Also in some areas, the cytoplasmic processes at the distal ends of the PAs invaded the predentin. In the predentin, a large amount of coarse-textured material, considered to be the precursor of the enamel matrix, was observed. In PZ-3, a large number of cytoplasmic processes extended into the predentin, while in PZ-4, microvillus-like processes extended from the distal ends of the PAs, showing a high frequency of ectomesenchymal contact. It was suggested that secretory activity of the PAs was induced after ectomesenchymal contact had been accomplished, but that the PAs did not undergo morphological change into secretory ameloblasts.

Ameloblasts↗

Reaction of the human dental pulp to silver amalgam restorations. The modifying effect of treatment with calcium hydroxide.

Cavities were prepared in 43 bicuspid teeth using two general categories of cavity depth. In the "deep" cavities the bottom was placed in the inner third of the dentin. In the "intermediate depth" cavities the bottom was positioned in the middle third of the dentin. The bottom of the cavities was either rubbed with calcium hydroxide, covered with calcium hydroxide, or left unlined before filling according to the wet amalgam technique. The teeth were extracted after 1 week and examined histologically. All cases, except 2 with deep and 1 with intermediate depth rubbed cavities, showed local vascular dilatation in the pulp underneath the cavity. In addition, all teeth with deep unlined cavities showed inflammatory cells as did 1 with an intermediate depth unlined cavity. There were fewer displaced odontoblast nuclei in the dentin in the calcium hydroxide-treated groups. The milder reactions in the rubbed or covered groups are probably due to the restrictive effect by calcium hydroxide on penetration of amalgam components. In the teeth with deep cavities there were only minor differences between the ones which had been rubbed and those which had been covered with calcium hydroxide.

Calcium Hydroxide↗

A comparative histologic study of the pulp-dentinal interface in undemineralized and demineralized tooth sections.

This study examines cellular differences between undemineralized and demineralized tooth sections. The material comprised unerupted and partly erupted third molars. After fixation for 24 h, 10- to 15-microns ground sections were prepared from half of the tooth, using a cutting-grinding system. The sections were compared with demineralized routine sections from the other half of the tooth. Undemineralized sections showed a better capacity for preserving the tissue integration. Especially between the odontoblast layer and the predentin a low frequency of disjunctions or tears were noted. At this level of examination fixation quality and vacuole frequency (intra-cellular spaces) did not show any differences between the two methods.

Cell Membrane↗

The effect of two sucrose diets on formation of dentin and predentin in growing rats.

The effect of two high-sucrose diets on dentinal caries, dentin formation, and the predentin width was studied in Sprague-Dawley rats. Rats were weaned at the age of 3 weeks and for 4 weeks fed a non-cariogenic commercial rat food (R36) for control, a high-sucrose Stephan-Harris (S-H) diet, or a new high-sucrose (sR36) diet in which most of the barley and wheat flour of the control R36 diet were replaced by sucrose. The areas of dentinal caries, the areas of dentin formation, and the width of predentin and dentin were quantified. Both high-sucrose diets induced dentinal caries, and both reduced dentin formation and increased the width of predentin compared with the control diet. Moreover, rats fed the S-H high-sucrose diet showed significantly greater progression of caries and reduction of dentin formation relative to rats fed the new high-sucrose diet, sR36. The high-sucrose diet thus was a substrate for caries-inducing microbes and a significant, but possibly not the exclusive, substrate for host modulation of odontoblast function.

Animals↗

The distribution of cellular retinoic acid-binding protein I (CRABPI) and cellular retinol-binding protein I (CRBPI) during molar tooth development and eruption in the rat.

The distribution of cellular retinoic acid-binding protein (CRABPI) and cellular retinol binding protein (CRBPI) was studied in a series of prenatal and early postnatal rats, covering the main stages of development and eruption of the molar teeth. CRABPI positive cells were found in the mesenchymal cells of the dental follicle from the cap stage and in the dental papilla from the early bell stage. In the dental papilla, CRABPI positive cells were situated adjacent to the enamel organ in the cervical loop region and in the subodontoblastic region. Newly formed odontoblasts were CRABPI positive for a short period of time. The enamel organ was CRBPI and CRABPI negative, except for the presence of CRABPI positive cells in the internal enamel epithelium over the tip of cusps and in parts of the stratum intermedium. During root formation, CRABPI positive cells were found in the developing periodontal ligament, in the dental papilla adjacent to the epithelial root sheath and in the subodontoblastic zone. During crown formation, CRBPI positive cells were mainly localized to the mesenchymal cells of the dental papilla during the cap stage of crown development. The periosteum of the developing mandible contained CRABPI positive cells while some osteoclasts appeared to show a weak but positive reaction to CRBPI. The findings were considered in terms of the possible significance of retinoid-binding proteins during tooth and bone development.

Aging↗

C-CAM expression in odontogenesis and tooth eruption.

The distribution of the cell adhesion molecule C-CAM was analyzed during tooth development, eruption and formation of the junctional epithelium in rat molars by immunohistochemistry and in situ hybridization. C-CAM could not be detected during odontogenesis until the late bell stage; then only the mRNA was demonstrated in the odontoblasts and ameloblasts. Prior to eruption, a local increase in C-CAM (mRNA and protein) was observed in the reduced enamel epithelium. During eruption, high C-CAM levels were seen in the fusion zone between the oral epithelium and the reduced enamel epithelium. In the adult rat, C-CAM remained strongly expressed in the junctional epithelium. Our study indicates that C-CAM may play a role in odontogenesis and during formation of the epithelial structures involved in tooth eruption and formation of the junctional epithelium.

Ameloblasts↗

Regulation of bone sialoprotein gene transcription by steroid hormones.

During the initial formation of bone, dentine and cementum in tooth morphogenesis, fully differentiated osteoblasts, odontoblasts and cementoblasts express bone sialoprotein (BSP), a mineralized tissue-specific acidic glycoprotein that has been implicated in the nucleation of hydroxyapatite crystal growth. The expression of BSP is regulated by steroid hormones that modulate mineralized tissue formation. Thus, the transcription of the BSP gene is induced by glucocorticoids in association with osteoblast differentiation and glucocorticoids also stimulate the expression of BSP in differentiated osteoblasts. In contrast, however, vitamin D3 suppresses bone formation and abrogates the expression of BSP. Our studies, using the osteoblastic cell lines ROS 17/2.8 and UMR 106-06, have revealed that the glucocorticoid (10(-8) M dexamethasone; dex) effect on BSP mRNA involves both direct and indirect pathways. To determine the molecular basis of the direct pathway on transcriptional regulation of the BSP we have isolated and characterized the promoter regions of both the human and rat BSP genes. The promoters are characterized by a highly conserved region (BSP box) encompassing the immediate promoter region, which includes a unique inverted TATA box overlapped by a putative (DR3) vitamin D3 response element (VDRE). Possible glucocorticoid response elements are present approximately 1 kb and approximately 1.4 kb further upstream. Transient transfection analysis of chimeric constructs linked to a luciferase reporter gene have shown Dex-stimulated expression in constructs that include one or both GREs, whereas vit D3 suppresses expression in a short construct that includes the VDRE.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗