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Uninherited dentinogenesis imperfecta.

The rare hereditary disease, dentinogenesis imperfecta, is a disturbance of dentin formation in both the deciduous and permanent dentitions. It may be associated with osteogenesis imperfecta, though it is probably that the two diseases are carried by different genes. This association was recognized in a 19-year-old man. Dentinogenesis imperfecta had been diagnosed at the age of 6 and had been regarded as a mutation; 11 years later, an atypical form of osteogenesis imperfecta developed. The case is atypical because of the apparent absence of dentinogenesis imperfecta in the patient's family. The dental manifestations may have heralded the bone disease.

Adult

Dentinogenesis imperfecta: a case report.

Dentinogenesis imperfecta is a localized form of mesodermal dysplasia of the dentin affecting both the primary and permanent dentitions. Most previous reports on dentinogenesis imperfecta describe treatment with overdentures, which have several disadvantages. The present report describes a case of dentinogenesis imperfecta in an 11-year-old girl. A combination of restorative, prosthetic, and surgical treatment was used to resolve the condition.

Cephalometry

Unusual dentinal changes in dentinogenesis imperfecta associated with osteogenesis imperfecta. A case report.

A case is described of a boy with dentinogenesis imperfecta associated with osteogenesis imperfecta. The dentin of extracted deciduous teeth was found to show an abrupt transition to a normal tubular structure before a reversion to the more typical structure seen in dentinogenesis imperfecta. This change in the dentin appeared to have occurred in a chronologic manner. The possibilities that either a metabolic disturbance or a temporary reduced expression of the mutant gene had caused the abnormality and could account for the unusual histologic findings are discussed.

Child

Calcium ion transport kinetics during dentinogenesis: effects of disrupting odontoblast cellular transport systems.

Due to strongly discrepant results in the literature, controversy exists about the timing of the transport of Ca2+ ions to the mineralization front during dentinogenesis and the role of the odontoblasts in this transport. The present study gives evidence, by means of autoradiography as well as by a radiochemical technique, that the transport time for Ca2+ ions into the dentin mineral phase is about 10-15 min in the rat incisor. The results also show that technical factors, such as mode of tracer injection and the use of perfusion fixation, may influence the results more or less strongly. Finally, by disturbing odontoblast microtubules, involved in intracellular transport processes, and by blocking odontoblast calcium uptake channels by nifedipine and neomycin, the Ca2+ ion transport into dentin mineral was found to be strongly impaired. This may be taken as an indication that transcellular calcium transport mechanisms have a role during dentinogenesis.

Animals

[Dentinogenesis imperfecta: a structural and ultrastructural study].

Histopathology of dentinogenesis imperfecta shows a haphazard distribution of dentinal tubules as well as changes in their diameters, sometimes narrowed, sometimes widened. These tubules appear as bundles or sheaves. This kind of dentine is often similar to secondary (also called tertiary) dentine, only mantle dentine preserving a normal structure. There is a complete obliteration of the pulp chamber and an almost complete obliteration of the root canal. Through SEM, the tubules appear to be few in number, their diameters are small and their fine ramifications are intricate through all planes. An heterogenous intertubular substance can be seen. Through TEM, collagenous fibers appear to be uncalcified or incompletely calcified, with a haphazard distribution. There are wide differences in the sizes of crystals and numerous spaces appear between crystals and collagen. Differences between the ultrastructure of human dentinogenesis imperfecta and the dentine of some lower vertebrates are clearly pointed out.

Dental Cementum

Protein kinases in dentinogenesis.

Protein modifications such as phosphorylation and dephosphorylation are known to control several cell functions including regulation of the cell cycle, signal transduction and enzyme activation/inactivation. Bone and dentin contain highly phosphorylated anionic proteins that appear to be involved in the regulation of mineralization. This study was designed to identify and characterize the enzyme(s) responsible for phosphorylation (kinases) of dentin phosphoprotein (DPP) during dentinogenesis. DPP-protein kinase activity was demonstrated in a crude homogenate of dental pulp and odontoblast cells. In parallel studies, oligonucleotides to conserved amino acid sequences present in the active site of kinases were constructed and used to screen a lambda-gt11 tooth organ cDNA library. Several cDNA clones were isolated, the size of the insert determined by PCR (polymerase chain reaction) amplification, and in situ hybridization was used to determine cellular localization during tooth organ development. Preliminary evidence provides additional molecular determinants involved with candidate kinases responsible for DPP phosphorylation and dentinogenesis.

Animals

Repair dentinogenesis following transplantation into normal and germ-free animals.

UNLABELLED: The purpose of this study was to investigate the dentinogenesis of dental pulp tissue following transplantation and during regeneration in normal and germ free animals, as well as in vitro experiments. EXPERIMENTS: (1) Partial and complete exposure of dental pulp in germ free rats by removing the enamel and dentin of molars. (2) The central portion of rat incisor which consisted of pulp and pulp chamber were autografted into various tissues. (3) Explants of rat pulp tissue were cultured on dentin matrix. (4) Resin bonding agent, 4-META/MMA-TBB-O (Superbond), was placed directly on surgically-exposed dental pulp. RESULTS: (1) Dentin bridge formation was recognized at 5 days after operation in germ free rat. (2) The cut surface of the transplant exhibited dentin bridge at 7 days after implantation, and the thickness of the newly formed dentin increased gradually thereafter up to 30 days. (3) Cultured pulp cells had high alkaline phosphatase activity and bone- or dentin-like hard tissue was synthesized on the dentin matrix in vitro. (4) Dentin bridge formation was evident on the surgically-exposed dental pulp even after application of Superbond. From these results, it is suggested that pulp tissue has a high activity of dentinogenesis both in vivo and in vitro and 3 days is enough for pulp cells to express the odontoblast phenotype when inflammatory factors are not present.

Animals

Molecular control of dentinogenesis: a reaction.

This paper represents an invited reaction to three papers presented at the International Conference on Pathobiology of the Dentin/Pulp Complex, June, 1991. Repair dentinogenesis following transplantation into normal and germs free animals are correlated with results elucidating the expression of dentin phosphoproteins, collagen, and osteocalcin. The importance of transcription and translation controls of dentin matrix components are discussed and reviewed. In addition, possible implications of a molecular chaperone protein, Hsp47, in controlling dentinogenesis is introduced. Future research directions are developed and include: (a) identification of odontoblast precursors; (b) delineation of markers for odontoblasts at varying degrees of differentiation; (c) characterization of environmental conditions leading to odontoblast differentiation; (d) determination of the nature of repair and regenerated tissues; (e) elucidation of transcription and translation control factors, and (f) mapping the human genome for dentin matrix constituents.

Collagen

Dentin phosphoprotein in dentin development: implications in dentinogenesis imperfecta.

Dentin phosphoprotein (DPP, phosphophoryn) is the major non-collagenous protein component of the dentin extracellular matrix. This highly acidic phosphorylated protein is solely expressed by ectomesenchymal-derived odontoblast cells of the tooth organ. Previous biochemical studies have suggested the absence of this protein associated with the human genetic disease dentinogenesis imperfecta (DGI) Types I and II. However, due to the normal degradation of human DPP during dentin maturation, it has not been possible to establish if these reported differences were due to changes in DPP expression or secondary degradation rates in DGI affected versus normal teeth. Recently, we have taken both a molecular and biochemical approach to address this problem. Molecular studies have utilized genetic linkage studies performed on several multi-generation informative DGI kindreds. These studies have determined linkage between DGI Types II and III and two markers localized to the long arm of human chromosome 4 in the region 4q11-4q21. The strategy used in our study was to map the DPP gene locus to the long arm of human chromosome 4, in the same region as DGI, using a DPP oligonucleotide probe and somatic hybrid cell lines. The results indicate DPP is not localized to any region of human chromosome 4. Our data indicates that a mutation within the DPP gene locus is not associated with DGI Types II or III. This data is supported by the identification of human DPP (95 kDa) within the dentin extracellular matrix of molars isolated from an affected DGI type II patient using a mouse anti-DPP antibody. However, this does not exclude the possibility that enzymes associated with DPP post-translational modifications (ie. phosphorylation or degradation) might be responsible for this genetic disease.

Animals

Type II collagen defect in two sibs with the Goldblatt syndrome, a chondrodysplasia with dentinogenesis imperfecta, and joint laxity.

We report on a syndrome of spondylo-epimetaphyseal dysplasia, dentinogenesis imperfecta, and ligamentous hyperextensibility in two sibs born to nonconsanguineous parents. This chondrodysplasia was characterized by severe shortness of stature and an osteoporosis without fractures. Electron microscopic examination of the cartilage documented large vacuoles of dilated rough endoplasmic reticulum within the cytoplasm of chondrocytes. Gel electrophoresis of pepsin-soluble collagen extracted from cartilage demonstrated the presence of type II collagen chains with an abnormal mobility. Prolyl and lysyl hydroxylations were slightly increased. The abnormal molecules melted at a higher temperature than the normal ones. CNBr peptide mapping of type II collagen showed an altered electrophoretic migration of peptides CB 11, CB 8, and CB 10,5 whereas CB 9,7 looked normal. In addition, two small non-collagenous proteins isolated from cartilage were not found in an age-matched control individual but were detected in a normal newborn infant. The quantitation of proline-labelled collagen synthesized by dermal fibroblasts demonstrated a 50% reduction of total collagen. This decrease essentially affected the amount of extracellular type I collagen, which was secreted less efficiently than in control cells. Nevertheless, type I collagen chains behaved normally on 5% polyacrylamide gels. The reduced mRNA levels of alpha 1I and alpha 2I chains might reflect either a transcriptional defect or a decreased stability of mRNA transcripts. We suggest that the association of both pathological chondrocytes producing altered collagen type II and decreased synthesis of type I could be responsible for this peculiar phenotype. The overmodification of alpha 1II CNBr peptides is consistent with the presence of a single-base substitution in the COL2A1 gene. Whether there is a direct causal relationship between the type II collagen defect and the underexpression of type I collagen will require clarification.

Abnormalities, Multiple

The effect of vincristine on dentinogenesis in the rat incisor.

A preliminary report on the histomorphologic effects of vincristine on rat incisor dentinogenesis is presented. Niche-like areas of osteodentin and a faint incremental line in the dentin were the main derangements observed after single injections of the drug. The severity of the lesions was dose-dependent.

Animals

Investigation of the role of Von Korff fibers during murine dentinogenesis.

The existence and significance of Von Korff fibers during early dentinogenesis are still very controversial. The purpose of the present study was to re-examine the questions of the existence, nature and significance of Von Korff's fibers using light microscopy and immunohistochemistry. Specimens were obtained from 3 days-old CD-I mice and mandibles were carefully dissected under constant irrigation and immediately fixed in 10% neutral buffered formalin for light microscopy. Sections were treated or not with collagenase prior to silver staining. For immunohistochemistry, specimens were fixed in 95% ethanol and embedded in paraffin. Sections were reacted with goat anti-human-bovine type I or type III collagen and a rhodamine (RITC) labelled rabbit anti-goat IgG was then reacted as a secondary antibody. Slides were then examined under a Zeiss II photomicroscope equipped with epifluorescence. Our results have confirmed the presence of argyrophilic material concentrated at the periphery of the dental papilla and stretching from the subodontoblastic layer to the future dentino enamel junction. The distribution of type III collagen was very similar to the distribution of the silver staining at the cervical loop area. Type I collagen distribution was different and concentrated in areas where odontoblasts were fully differentiated. Our study showed that Von Korff fibers are not artefactual. We have established the presence of an apical compartment containing type I collagen fibers and a basal compartment containing type III collagen to explain the image of continuous silver staining crossing the entire thickness of the odontoblast layer.

Animals

Calcium transport in dentinogenesis. An experimental study in the rat incisor odontoblast.

Since cellular calcium transport mechanisms during biological calcification are less known, a series of experiments were performed by in vivo as well as in vitro methodologies in the dentinogenically active rat incisor. By means of micro-electrode technique, the pH and pCa (calcium ion activity) in predentin in situ were found to be 7.0 and 2.9, respectively. It was concluded that there exists a Ca2+ion concentrating mechanism over the odontoblast layer in direction towards the mineralization front. The kinetics of this calcium flow was determined in vivo by radiotracer technique. The time for 45Ca2+ uptake into the dentin mineral phase was determined to 10-15 min. Transmembraneous Ca2+ ion pumps and channels in odontoblasts were further analyzed. The resting membrane potential of rat incisor odontoblasts was determined to -24 mV. Using ion-specific mini-electrode technique as well as fluorescence spectrophotometry, calcium channels, Ca(2+)-ATPase and Na+/Ca2+ antiports, responsible for cellular Ca2+ uptake and extrusion, were identified in the odontoblast plasma membrane. Dissected odontoblasts were subjected to subcellular fractionation. An electrophoretic uniporter and a Na2+/Ca2+ exchanger, for Ca2+ release and uptake, respectively, were demonstrated in mitochondria, whereas a Ca(2+)-ATPase was present in the microsomal fraction. Mitochondria, microsomes and whole, digitonin-permeabilized odontoblasts, were able to maintain a steady state Ca2+ activity at pCa = 6.4-6.6 in vitro. In rats treated with colchicine, the incorporation of 45Ca2+ into dentin mineral was severely altered. Similarly, administration to rats of specific calcium channel blockers strongly inhibited 45Ca2+ incorporation. Together, the results indicate that a transcellular pathway is a major route for Ca2+ ion transport during dentinogenesis, and that this may be under a relatively strict cellular control.

Animals

Trimetaphosphatase activity in rat incisor odontoblasts during early dentinogenesis.

The ultrastructural localization of trimetaphosphatase activity have been investigated in early stages of dentinogenesis in the rat incisor. Extracellular reactive structures were present in between the odontoblasts during early secretion and absent later on. Tubular lysosomes were observed for the first time in odontoblasts and seemed to be involved with other elements of the lysosomal system in endocytosis of extracellular substances.

Acid Anhydride Hydrolases

Hereditary dentinogenesis imperfecta: a treatment program using an overdenture.

The aim of treatment in cases of dentinogenesis imperfecta is to improve the esthetic appearance and maintain the oral masticatory apparatus in a healthy and functional state. In the growing child, it was decided to maintain the teeth for as long as possible under an overdenture, until such time when a permanent prosthetic solution can be decided upon.

Child

Dentin extracellular matrix and dentinogenesis.

The formation of dentin involves secretion of matrix proteins by odontoblasts, prior to the deposition of apatite crystals. These matrix proteins probably play a role in transformation of predentin to dentin. The physical and chemical properties of dentin collagen, similar to those of bone, are especially adapted for binding matrix proteins and as a grid for mineral deposition. Phosphophoryns, polyanionic, and dentin-specific proteins are secreted at the mineralization front and are involved in some way in the mineralization process of circumpulpal dentin. Dentin sialoprotein is specifically made by odontoblasts and pulp cells and may be in the family of bone proteins known to promote cell attachment. Several proteins originally isolated from bone are also found in dentin and are expressed by odontoblasts. Although the mechanisms of dentinogenesis have not been elucidated, detailed studies of dentin matrix proteins should give valuable insights into this process.

Collagen