Experimental study in the dog of the non-active role of the tooth in the eruptive process

Mechanisms of tooth eruption and orthodontic tooth movement

Teeth move through alveolar bone, whether through the normal process of tooth eruption or by strains generated by orthodontic appliances. Both eruption and orthodontics accomplish this feat through similar fundamental biological processes, osteoclastogenesis and osteogenesis, but there are differences that make their mechanisms unique. A better appreciation of the molecular and cellular events that regulate osteoclastogenesis and osteogenesis in eruption and orthodontics is not only central to our understanding of how these processes occur, but also is needed for ultimate development of the means to control them. Possible future studies in these areas are also discussed, with particular emphasis on translation of fundamental knowledge to improve dental treatments.

Bone formation as a potential motive force of tooth eruption in the rat molar

The objectives of this anatomical study were to (1) determine if significant bone growth occurs in the base of the alveolar bony crypt of the first mandibular molar to move the tooth through the eruption pathway; (2) determine if the osteogenesis in the crypt correlates with the published chronological gene expression of bone morphogenetic protein-2 (BMP-2) in the dental follicle; and (3) determine chronologically and regionally the crypt bone activity. To accomplish this, the alveolar bony crypts of rat mandibular molars from postnatal days 3 to 18 were processed and examined by scanning electron microscopy (SEM). In addition, mandibles and teeth of ages 12-18 were prepared for light microscopy. SEM demonstrated that bone formation occurs in the basal (apical) portion of the alveolar bony crypt at day 3, whereas bone resorption concurrently is ongoing in the coronal region of the crypt. By day 9, the crypt is beginning to be reduced in depth as the result of basal bone formation, and by day 14, the base of the crypt immediately under the tooth is almost completely filled with bone to form the interradicular septum. At day 18, the tooth erupts as bone formation likely elevates the molar. Bone growth in the basal area of the crypt correlates with a previous study showing enhanced BMP-2 expression in the dental follicle. Thus, SEM indicates that the motive force of tooth eruption likely is bone formation at the base of the alveolar crypt and this osteogenesis may relate to BMP-2 production in the dental follicle.

Preliminary observations on increasing root length during the eruptive phase of tooth development in modern humans and great apes

Ground sections of incisors, canines, and molars were selected that showed clear incremental markings in root dentine. The sample comprised 98 Homo sapiens, 53 Pan troglodytes, and a more limited combined sample of 51 Gorilla and Pongo sections. Daily rates of root dentine formation, together with the orientation of incremental markings in roots close to the cement-dentine junction (CDJ), were used to calculate root extension rates for the first 10mm of root formed beyond the buccal enamel cervix. Modern human anterior tooth roots showed a more regular pattern of increase in root length than those in great apes. In Pan, root growth rose quickly to higher rates but then flattened off. The fastest extension rates in modern humans were in incisor roots (10-12 microm per day), followed by canines (8-9 microm per day). Extension rates in Pan rose to slightly greater values in canines ( approximately 12-14 microm per day) than in incisors ( approximately 10-11 microm per day). Molar tooth roots in both modern humans and great apes grew in a nonlinear manner. Peak rates in molars reduced from M1 to M3 (8, 7, and 6 microm per day, respectively). Like humans, root growth in Pan peaked earlier in M1s at rates of between 8 and 9 microm per day, and later in M3s at rates of 7 to 8 microm per day. The more limited data set for Gorilla and Pongo molars suggests that extension rates were generally higher than in Pan by approximately 1.0-1.5 microm per day. There were greater differences in peak extension rates, with Gorilla and Pongo extension rates being between 2.5 and 4.5 microm per day higher than those in Pan. These findings highlight for the first time that root growth rates differ between tooth types in both pattern and rate and between taxa. They provide the basis with which to explore further the potential comparative relationships between root growth, jaw growth, and the eruption process.

Expression of vascular endothelial growth factor in cultured human dental follicle cells and its biological roles

AIM

To investigate the expression of vascular endothelial growth factor (VEGF) in cultured human dental follicle cells (HDFC), and to examine the roles of VEGF in the proliferation, differentiation, and apoptosis of HDFC in vitro.

METHODS

Immunocytochemistry, ELISA, and RT-PCR were used to detect the expression and transcription of VEGF in cultured HDFC. The dose-dependent and the time-course effect of VEGF on cell proliferation and alkaline phosphatase (ALP) activity in cultured HDFC were determined by MTT assay and colorimetric ALP assay, respectively. The effect of specific mitogen-activated protein kinase (MAPK) inhibitors (PD98059 and U0126) on the VEGF-mediated HDFC proliferation was also determined by MTT assay. The effect of VEGF on HDFC apoptosis was measured by flow cytometry.

RESULTS

VEGF was transcribed and expressed in cultured HDFC. VEGF at 10-300 microg/L significantly increased HDFC proliferation and ALP activity compared to the control. Following 1, 3, 5, or 7 d of stimulation, VEGF induced a significant increase in HDFC proliferation compared with the corresponding control, while VEGF was effective at increasing ALP activity at the incubation time point of 3, 5, or 7 d. PD98059 and U0126 could attenuate the VEGF-mediated HDFC proliferation. Fewer apoptotic cells were observed in the VEGF-treated groups compared to the controls, although the difference was not statistically significant.

CONCLUSION

VEGF is expressed in cultured HDFC, and at a proper concentration range can stimulate HDFC proliferation, induce HDFC to differentiate in a "cementoblast/osteoblast" pathway and protect HDFC from apoptosis. The MAPK signaling pathway might be involved in the VEGF-mediated HDFC proliferation.

Physiologic root resorption in primary teeth: molecular and histological events

Root resorption is a physiologic event for the primary teeth. It is still unclear whether odontoclasts, the cells which resorb the dental hard tissue, are different from the osteoclasts, the cells that resorb bone. Root resorption seems to be initiated and regulated by the stellate reticulum and the dental follicle of the underlying permanent tooth via the secretion of stimulatory molecules, i.e. cytokines and transcription factors. The primary root resorption process is regulated in a manner similar to bone remodeling, involving the same receptor ligand system known as RANK/RANKL (receptor activator of nuclear factor-kappa B/ RANK Ligand). Primary teeth without a permanent successor eventually exfoliate as well, but our current understanding on the underlying mechanism is slim. The literature is also vague on how resorption of the pulp and periodontal ligament of the primary teeth occurs. Knowledge on the mechanisms involved in the physiologic root resorption process may enable us to delay or even inhibit exfoliation of primary teeth in those cases that the permanent successor teeth are not present and thus preservation of the primary teeth is desirable.

Regional differences of expression of bone morphogenetic protein-2 and RANKL in the rat dental follicle

Tooth eruption requires alveolar bone resorption and bone formation. The coronal half of the dental follicle probably mediates the bone resorption seen in the coronal region of the alveolar bony crypt, and the basal half of the follicle mediates bone growth in the basal region. We hypothesized that the expression of a gene for bone resorption--receptor activator of nuclear factor kappa B ligand (RANKL)--would be higher in the coronal than in the basal region of the follicle. Conversely, the level of expression of bone morphogenetic protein-2 (BMP-2), a gene for bone formation, would be higher in the basal region. Results obtained using laser-capture microdissection and real-time reverse transcription-polymerase chain reaction (RT-PCR) confirmed the hypothesis. Scanning electron micrographs of the bony crypt showed that the coronal area of the crypt was scalloped in appearance (bone resorption), whereas the basal area was trabecular (bone formation). Thus, the differences in bone activity at opposite poles of the crypt appear to be caused by differences in the regional expression of genes in the dental follicle and suggest a molecular mechanism whereby the dental follicle could regulate both the alveolar bone resorption and formation needed for eruption.

Molar distalization with pendulum appliances in the mixed dentition: Effects on the position of unerupted canines and premolars

INTRODUCTION

The pendulum appliance allows for rapid molar distalization without the need for patient compliance. Its efficiency has been confirmed in a number of clinical studies. However, the potential interactions and positional changes between the deciduous molars used for dental anchorage and the erupted and unerupted permanent teeth have yet to be clarified when this appliance is used for molar distalization in the mixed dentition.

METHODS

Twenty-nine patients in the mixed dentition each received a modified pendulum appliance with a distal screw and a preactivated pendulum spring for bilateral distalization of the maxillary molars. The patients were divided into 4 groups based on dentition stages: patient group 1 (PG 1, n = 10) was in the early mixed dentition; patients had resorption of the distal root areas of the deciduous molars being used for dental anchorage, and the unerupted premolars were located at the distal margin of the deciduous molar root region. Based on radiographs taken before placement of the pendulum appliance, patient group 2 (PG 2, n = 10) was diagnosed as having a central location of the unerupted premolars. In the third group (PG 3, n = 4), the first premolars were already erupted and could be integrated into the dental anchorage, but the canines were not yet erupted. In the fourth group (PG 4, n = 5), the first premolars and both canines were fully erupted.

RESULTS

Statistical analysis of the measured results showed significant differences in the side effects between PG 1 and PG 2. In patients being treated with pendulum appliances, the anchorage quality of the deciduous molars that were already partially resorbed in the distal root area was comparatively reduced. Consequently, the mesial drift of the deciduous molars and incisors was increased, without impairing the extent and quality of the molar distalization. Anchorage loss in the supporting area had no direct impact on the sagittal position of the unerupted premolars in the early mixed dentition.

CONCLUSIONS

If permanent teeth have already started to erupt in the supporting area, additional space restrictions should be avoided in patients with critical topography, especially if there is little space for the unerupted canines. At this stage of the mixed dentition, premolar extraction or augmentation of the supporting area with extraoral headgear offers a therapeutic alternative to intraoral distalization appliances with exclusively dental anchorage.

Injections of osteoprotegerin and PMA delay tooth eruption

Tooth eruption requires alveolar bone resorption that is regulated by the dental follicle. This is reflected by the fact that failures of eruption often can be traced to either osteoclast deficiencies or to dental follicle abnormalities. To achieve maximal osteoclastogenesis and subsequent alveolar bone resorption for eruption, we have hypothesized that a reduction in gene expression of osteoprotegerin (OPG) in the follicle of the first mandibular molar of the rat at Day 3 is needed. To determine if OPG affects eruption, postnatal rats were injected with varying concentrations of OPG from Days 1-9 postnatally. Such studies indicated that the eruption time of the first mandibular molar was significantly delayed by 1 day or more as a result of OPG injection. Injection of phorbolmyristate acetate (PMA), an activator of protein kinase C (PKC) that in turn upregulates OPG expression, also delayed eruption by 1 day. PMA was only injected from Days 1-4 such that PKC-alpha would be increased and activated. Previous studies had shown that PKC-alpha gene expression is downregulated at the time (Day 3) that OPG expression is downregulated. In this study, using reverse transcription polymerase chain reaction techniques to examine OPG gene expression showed that PMA injection increased OPG gene expression in the dental follicle at Day 3 as compared to the controls. Thus, either injecting OPG or enhancing its expression in the follicle at Day 3 by injecting PMA delays the time of tooth eruption. Consequently, regulation of OPG production by the dental follicle likely affects the alveolar bone resorption needed for tooth eruption.

Parathyroid-hormone-related protein induces expression of receptor activator of NF-{kappa}B ligand in human periodontal ligament cells via a cAMP/protein kinase A-independent pathway

Periodontal ligament (PDL) cells play important roles in root resorption of human deciduous teeth by odontoclasts (osteoclast-like cells). However, it is unclear how PDL cells regulate osteoclastogenesis. We examined the effects of PTHrP, TGF-beta, and EGF, which are all secreted by the tooth germ, on tartrate-resistant acid-phosphatase-positive (TRAP+) cell formation using co-cultures of human PDL cells and mouse spleen cells. Only PTHrP promoted TRAP+ cell formation in co-cultures. PTHrP induced receptor activator of NF-kappaB ligand (RANKL) mRNA expression and slightly reduced osteoprotegerin (OPG) expression in PDL cells. The cAMP/PKA inhibitors Rp-cAMP, H89, and PKI did not affect PTHrP-induced TRAP+ cell formation. The PKC inhibitor, Ro-32-0432, suppressed RANKL expression in PDL cells and PTHrP-induced TRAP+ cell formation. However, this inhibitor directly modulated the number of osteoclast precursors. Thus, PTHrP induces osteoclastogenesis by increasing the relative expression level of RANKL vs. OPG in PDL cells via a cAMP/PKA-independent pathway.

ABBREVIATIONS

PTHrP, parathyroid-hormone-related protein; TGF-beta, transforming growth factor-beta; EGF, epidermal growth factor; RANKL, receptor activator of NF-kappaB ligand; OPG, osteoprotegerin; PDL, periodontal ligament; TRAP, tartrate-resistant acid phosphatase; PKA, protein kinase A; PKC, protein kinase C; MAP, mitogen-activated protein; ERK, extracellular signal-regulated kinase; cAMP, cyclic Adenosine 3'5'-Monophosphate.

Chronology and regulation of gene expression of RANKL in the rat dental follicle

Tooth eruption in the rat requires bone resorption resulting from a major burst of osteoclastogenesis on postnatal day 3 and a minor burst of osteoclastogenesis on postnatal day 10 in the alveolar bone of the first mandibular molar. The dental follicle regulates the major burst on postnatal day 3 by down-regulating its osteoprotegerin (OPG) gene expression to enable osteoclastogenesis to occur. To determine the role of receptor activator of nuclear factor-kappa B ligand (RANKL) in tooth eruption, its gene expression was measured on postnatal days 1-11 in the dental follicle. The results show that RANKL expression was significantly elevated on postnatal days 9-11 in comparison to low expression levels at earlier time-points. As OPG expression is high at this latter time-point, this increase in RANKL expression would be needed for stimulating the minor burst of osteoclastogenesis. Tumor necrosis factor-alpha enhances RANKL gene expression in vitro and it may be responsible for up-regulating RANKL in vivo. Transforming growth factor-beta1 and interleukin-1alpha also enhance RANKL gene expression in vitro but probably have no effect in vivo because they are maximally expressed early. Bone morphogenetic protein-2 acts to down-regulate RANKL expression in vitro and, in vivo, may promote alveolar bone growth in the basal region of the tooth.

Eruptive tooth movement — the current state of knowledge

How the dentition erupts, and what controls it, is fundamental to almost all aspects of clinical dentistry, yet the mechanisms behind this have not yet been fully elucidated. When the process continues into space that has been created through toothwear or tooth loss, problems in placing restorations can be encountered. This review examines the possible mechanisms of tooth eruption. Differences between processes in animals and humans are highlighted. The limitations of conclusions drawn from animal studies are then discussed with reference to human dental conditions. The differing forms of overeruption in humans are described and the treatment options for overerupted teeth, including prevention of the situation arising, are provided with a discussion of the quality of the evidence base behind these.

In vivo expression of RANKL in the rat dental follicle as determined by laser capture microdissection

Tooth eruption is a localized event in which many of the genes required for eruption are expressed in the dental follicle. A major function of the follicle is to recruit mononuclear cells for osteoclastogenesis such that the alveolar bone can be resorbed. Osteoclastogenesis is primarily regulated by receptor activator of nuclear factor-kappa B ligand (RANKL), colony-stimulating factor-one (CSF-1) and osteoprotegerin (OPG). In the rat first mandibular molar, osteoclastogenesis is maximal at day 3 and CSF-1 is maximally expressed in the follicle at this time whereas OPG expression is reduced. Whether or not RANKL is expressed in vivo in the follicle is controversial, however. It is critical to determine this because others have shown that in partially-rescued mice null for RANKL, teeth do not erupt. This suggests that RANKL should be expressed in the follicle for eruption to occur. Thus, to precisely determine if RANKL is expressed in the follicle in vivo, laser capture microdissection (LCM) was used to excise dental follicle tissue from frozen sections followed by RNA isolation and RT-PCR. The results show that RANKL is expressed in the dental follicle at days 1-9 postnatally. The technique was confirmed by controls showing that LCM isolates of the follicle, and alveolar bone, express OPG. Also, LCM isolates of alveolar bone were positive for RANKL. Thus, RANKL has now been shown to be expressed in the follicle and it is probable that interactions between it, CSF-1 and OPG regulate locally the osteoclastogenesis needed for tooth eruption.

Influence of aging on tooth eruption: experimental canine mandibular allograft

PURPOSE

Aging is clinically related to tooth eruption; however, there are no known studies that have elucidated the relationship. We examined whether tooth eruption would occur normally in a mature subject.

MATERIALS AND METHODS

Using vascularized composite tissue mandibular transplantation, we extracted portions of immature mandibles including the tooth germs from young beagle dogs and placed them into unrelated immature and mature beagle dogs. We then examined eruption of the lower first molar in the grafted mandibular bone and compared the results clinically, radiographically, and histologically.

RESULTS

Normal tooth eruption was observed in the transplanted mandibles in the young dogs. In the mature dogs, eruption from the gingiva was delayed, whereas that from alveolar bone occurred normally in the transplanted mandibles. Further, the whole crown was covered with a cap of gingival tissue in the mature dogs, although this cap was not gingival overgrowth.

CONCLUSIONS

Tooth eruption is influenced by some unknown factors related to aging. Apparently, apoptosis did not occur in the connective tissues between the reduced enamel epithelia and oral epithelia that overlay the teeth in the mature subjects.

The effect of partial damage to the enamel-related periodontium combined with root resection on eruption of the rat incisor eruption

Previous work has indicated that the enamel-related periodontium (ERP) has a role in the eruptive process of the rat lower incisor. By combining partial damage of this tissue with resection of the odontogenic organ, we examined the effect of the damage on subsequent incisor eruption. The connective tissue of the enamel-related periodontium was regenerated in less than 2 weeks, showing morphology close to normal. The injured part of the enamel organ was neither regenerated nor repaired, and a cement-like tissue, continuous with the true acellular cement, was formed on the denuded enamel. Before tooth exfoliation, the operated teeth erupted at a slower rate compared with root-resected and sham-operated incisors, probably because of the absence of a substantial part of the enamel organ due to surgical damage. As with the coronal dental follicle and the enamel organ in rat molars, the enamel-related periodontium and the enamel organ of rat incisors may have some control on their eruptive process.

In vivo expression of classic PKC isoforms in the rat dental follicle as related to tooth eruption

Activation of protein kinase C (PKC) can upregulate tooth eruption molecules such as osteoprotegerin (OPG) and vascular endothelial growth factor (VEGF). In this study, we examined the in vivo gene expression of classic isoforms of PKC in the dental follicle of postnatal rats. The expression level of PKC-alpha was significantly reduced at day 3 followed by a gradual return to day 1 level, a profile similar to OPG expression. The expression of PKC-beta was the lowest at day 1 followed by elevated levels from day 3 to day 11. Expression of PKC-beta is positively correlated with the expression of overall VEGF and VEGF120. The expression level of PKC-gamma was relatively steady in the postnatal days. Injection of a PKC activator, phorbol 12-myristate 13-acetate (PMA), at late postnatal days, slightly accelerated first mandibular molar eruption. This study suggests that PKC isoforms may be involved in the regulation of tooth eruption.

Development of a novel mouse osteoclast culture system including cells of mandibular body and erupting teeth

Osteoclasts are multinucleated cells with the specialized function of resorbing calcified tissues. These cells develop from hemopoietic cells of the monocyte-macrophage lineage with the support of osteoblasts/stromal cells. Tooth eruption is a vertical movement of teeth via creation of an eruption pathway in and through the alveolar bone. The precise cellular and molecular determinants of tooth eruption are not yet clear, and a cell culture system that can reproduce the activity of osteoclast formation during tooth eruption is expected to be a useful tool to clarify the mechanism of eruption pathway formation. To this end, mandibular bodies, including incisors and molars, were isolated from 9- to 11-day-old mice undergoing active tooth eruption. Primary cells were obtained from mandibular bodies by enzymatic digestion and cultured in alphaMEM containing 15% FBS without any cytokine or growth factor or hormone in the culture (AFT culture, for alveolar bone, dental follicle, and tooth). A progressive increase in the number of tartrate-resistant acid phosphatase-positive multinucleated osteoclastic cells was observed in AFT culture. The osteoclastic cells generated were immunopositive for cathepsin K and calcitonin receptor, and formed resorption pits when cultured on dentine slices. Parathyroid hormone-related protein (PTHrP), expressed by the enamel organ of tooth, is reported to be an essential factor in creation of the eruption pathway. To verify this point, cells were isolated from mandibular bodies from which all teeth and dental follicles had been removed and cultured similarly (A culture, for alveolar bone). Osteoclastic cells were not formed and PTHrP production was hardly detected in the medium of A culture, in contrast to the high level of PTHrP in AFT culture. Since our previous study demonstrated that neonatal homozygous PTHrP-knockout mice show impaired osteoclastogenesis around tooth germs, AFT culture was performed by using this sample to examine whether this culture system can reproduce the status of osteoclastogenesis observed in vivo. The result showed that none of the osteoclastic cells were generated from cells of homozygous mice. We here report a novel mouse osteoclast culture system that reproduces the activity of osteoclast formation around erupting teeth without addition of any cytokine or growth factor or hormone to the medium. Histological examination of various transgenic and mutant mice now offers valuable findings on studies of tooth eruption and the present culture system using these animals would be a powerful tool in clarifying the cellular and molecular mechanisms of eruption pathway formation.

PDGF BB and bFGF stimulate DNA synthesis and upregulate CSF-1 and MCP-1 gene expression in dental follicle cells

CSF-1 and MCP-1, released by dental follicle cells, stimulate the influx of monocytes into the follicle sac and enhance the formation of osteoclasts that, in turn, resorb alveolar bone for the eruption pathway. PDGF and bFGF, released by cells adjacent to the follicle or by activated monocytes, are prime candidates that may regulate CSF-1 and MCP-1 gene expression. The present study demonstrates that PDGF and bFGF are mitogens for dental follicle cells and stimulate CSF-1 and MCP-1 mRNA, but with different time course kinetics. Peak induction of CSF-1 mRNA was observed at 6-8h, while maximal MCP-1 induction was observed at 2h. These findings suggest that MCP-1 is an early chemotactic signal for monocytes and that subsequent release of CSF-1 may act synergistically with MCP-1 to enhance monocyte influx. Further understanding of the molecular mechanisms by which cytokines regulate CSF-1 and MCP-1 may lead to more effective treatment regimens for disorders associated with abnormal tooth eruption.

Apoptosis in the connective tissues of the periodontal ligament and gingivae of rat incisor and molar teeth at various stages of development

Apoptosis in the periodontal connective tissues was studied using the TUNEL technique, supported by electron microscopy. For 16 rats (aged 3, 8, or 104 weeks), nuclear fragmentation was assessed using the TUNEL technique (for 4 of the animals aged 8 weeks, incisor eruption was experimentally increased by trimming of teeth to the gingival margin--unimpeded eruption). A further 8 rats (aged 8 and 104 weeks) were employed for electron microscopy. For the incisor, prior to aging, and regardless of eruptive behavior (i.e., for both impeded and unimpeded incisors), there was little evidence of apoptosis in the periodontal ligament or gingival connective tissues. For the molar, apoptosis was also not usually detected when the teeth were erupting or in the mature, erupted state. In the aged animals, however, there was a marked increase in apoptosis (as assessed by the TUNEL technique) within the periodontal ligament and gingivae of both the molars and incisors (where eruption rates also increased). Nevertheless, electron microscopy indicated that significant numbers of apoptotic cells were only in the incisor periodontium. These findings are not consistent with the view that the periodontal fibroblasts provide a component of the force(s) responsible for eruption.

The effects of aging on the eruptive behavior of the mandibular incisor in male rats

Several studies have highlighted the lack of age changes in the extracellular matrix of the periodontal ligament, but more needs to be known about cellular and functional changes (including the effects upon eruption). For this study, impeded and unimpeded eruption rates were measured over a 2-week period for the mandibular incisors of a group of 24-month-old rats. The technique used for measuring eruption was similar to that described by Bryer [15]. Both impeded and unimpeded eruption rates were found to be significantly increased (p < .01) compared with those obtained from a group of rats aged 8 weeks. These changes might be related to changes in the mechanism(s) responsible for the generation of the eruptive force(s) or to changes in the resistance of the tissues to such forces.

Regulation of osteoprotegerin gene expression in dental follicle cells

Colony-stimulating factor-one (CSF-1) and parathyroid-hormone-related protein (PTHrP) down-regulate osteoprotegerin (OPG) gene expression in the dental follicle of the rat first mandibular molar. To examine this regulation at the signal transduction level, we treated cultured dental follicle cells with either phorbolmyristate acetate (PMA) or dibutyryl cyclic AMP (dbcAMP) to activate either protein kinase C (PKC) or protein kinase A (PKA). Our results demonstrate that PMA up-regulates OPG gene expression and down-regulates the expression of CSF-1 and the PTHrP receptor (PTHrP-R). Conversely, dbcAMP down-regulates OPG expression and up-regulates CSF-1 and PTHrP-R expression. Immunostaining shows that PMA also increases the steady-state levels of protein. Thus, treatment with agents that affect protein kinase activity also enhance the steady-state mRNA and protein levels of OPG, as well as decreasing the mRNA levels of CSF-1 and PTHrP-R. The PKC-alpha isoform may be critical in OPG regulation because PKC-alpha gene expression is enhanced by PMA and reduced by either CSF-1 or PTHrP.

Exposure to oral uranyl nitrate delays tooth eruption and development

The risk of oral exposure to uranium potentially involves the population at large. Tooth eruption and development are ongoing processes that begin during fetal development and continue until the age of 18 y. Since one of the mechanisms involved in tooth eruption is bone formation and it is well documented that uranium inhibits bone formation, the aim of the present work was to study the effect of oral administration of uranyl nitrate (UN) on tooth eruption and development. Wistar rats aged 1 and 7 d were orally administered a single dose of 90 mg kg(-1) body weight of uranyl nitrate. Two age matched groups received an equal volume of saline and served as controls. The animals were killed at 7 and 14 d of age, respectively. Mandibles were resected and processed to obtain bucco-lingual sections oriented at the level of the mesial root of the first mandibular molar, and histomorphometric studies were performed. Results showed that an acute high dose of uranyl nitrate delays both tooth eruption and development, probably due to its effect on target cells.

Expression of tumour necrosis factor-alpha in the rat dental follicle

Tooth eruption requires the presence of the dental follicle, a loose connective tissue sac that surrounds each unerupted tooth. The follicle appears to regulate many of the cellular and molecular events of eruption, including the formation of osteoclasts needed to resorb alveolar bone to form an eruption pathway. To that end, the expression of the tumour necrosis factor-alpha (TNF-alpha) gene was examined in the dental follicle as a possible regulator of osteoclastogenesis. TNF-alpha was expressed slightly in the dental follicle of the first mandibular molar of the rat beginning at day 3 postnatally, but maximal expression was seen at day 9, a time that correlates with a slight burst of osteoclast formation seen at day 10 postnatally. In vitro, TNF-alpha was not expressed constitutively in the follicle cells but incubating them with interleukin 1alpha resulted in a strong expression of TNF-alpha after only 0.5h. TNF-alpha itself enhanced monocyte chemotactic protein 1 (MCP-1) and vascular endothelial growth factor (VEGF) gene expression. It also slightly decreased the expression of osteoprotegerin after 3-h incubation but this returned to the control level at 6h. MCP-1 and VEGF could aid in recruiting mononuclear cells (osteoclast precursors) to the dental follicle. In addition to the potential role of TNF-alpha in tooth eruption, this study suggests that the periodontal ligament derived from the dental follicle might have the capacity to synthesize TNF-alpha, and thereby contribute to the destructive events of periodontitis.

Cellular, molecular, and genetic determinants of tooth eruption

Tooth eruption is a complex and tightly regulated process that involves cells of the tooth organ and the surrounding alveolus. Mononuclear cells (osteoclast precursors) must be recruited into the dental follicle prior to the onset of eruption. These cells, in turn, fuse to form osteoclasts that resorb alveolar bone, forming an eruption pathway for the tooth to exit its bony crypt. Some of the molecules possibly involved in the signaling cascades of eruption have been proposed in studies from null mice, osteopetrotic rodents, injections of putative eruption molecules, and cultured dental follicle cells. In particular, recruitment of the mononuclear cells to the follicle may require colony-stimulating factor-one (CSF-1) and/or monocyte chemotactic protein-1 (MCP-1). Osteoclastogenesis is needed for the bone resorption and may involve inhibition of osteoprotegerin transcription and synthesis in the follicle, as well as enhancement of receptor activator of NF kappa B ligand (RANKL), in the adjacent alveolar bone and/or in the follicle. Paracrine signaling by parathyroid-hormone-related protein and interleukin -1 alpha, produced in the stellate reticulum adjacent to the follicle, may also play a role in regulating eruption. Osteoblasts might also influence the process of eruption, the most important physiologic role likely being at the eruptive site, in the formation of osteoclasts through signaling via the RANKL/OPG pathway. Evidence thus far supports a role for an osteoblast-specific transcription factor, Cbfa1 (Runx2), in molecular events that regulate tooth eruption. Cbfa1 is also expressed at high levels by the dental follicle cells. This review concludes with a discussion of the several human conditions that result in a failure of or delay in tooth eruption.

Inhibition of osteoclastogenesis by the secretion of osteoprotegerin in vitro by rat dental follicle cells and its implications for tooth eruption

Tooth eruption requires the presence of the dental follicle, a loose connective tissue sac that surrounds each unerupted tooth. Early postnatally in the rat, the follicle secretes colony-stimulating factor-1 (CSF-1) and monocyte chemotactic protein-1 (MCP-1), chemotactic molecules that are probably responsible for the recruitment of mononuclear cells. These cells, in turn, fuse to form osteoclasts, which are required for alveolar bone resorption to form an eruption pathway. Recent studies have shown that the osteoprotegerin (OPG) gene is expressed in the dental follicle, but in the first mandibular molar of the rat, that expression is reduced at day 3, the time of maximal osteoclast numbers on the alveolar bone. Inhibition of OPG expression at this time would allow osteoclast formation/activation. To determine if the dental follicle cells do secrete OPG that inhibits osteoclastogenesis, spleen cell cultures were established and soluble osteoclast differentiation factor (ODF) and CSF-1 added to some of them to promote osteoclast formation. In other cultures, dental follicle cells were added in an insert, such that they did not touch the spleen cells. Using a quantitative, tartrate-resistant acid phosphatase (TRAP) assay, it was shown that ODF and CSF-1 promoted osteoclastogenesis in the spleen cell cultures, but the addition of the follicle cells inhibited this and returned the TRAP activities to those seen in cultures of spleen cells only. Adding anti-OPG to these cultures, however, negated the effect of the follicle cells, demonstrating that OPG was the inhibitory molecule secreted by those cells. The follicle cells also immunostained for OPG, confirming that they synthesize OPG. These findings, coupled with those of other studies which show that the periodontal ligament (a derivative of the dental follicle) also secretes OPG, indicate that, except for the period of time in tooth eruption, where osteoclast formation is needed to form an eruption pathway, secretion of OPG would be the norm, presumably to prevent resorption of alveolar bone and subsequent disruption of the periodontal ligament.

Cellular events at the onset of physiological root resorption in rabbit deciduous teeth

For elucidation of how physiological root resorption of deciduous teeth is initiated, the cellular events that occur surrounding the root of rabbit deciduous teeth before and at the onset of physiological root resorption were observed by means of light and electron microscopy. In addition, the cytodifferentiation of odontoclasts during the initial phase of this root resorption was evaluated by histochemical staining of tartrate-resistant acid phosphatase (TRAP) activity as a marker odontoclasts and their precursors. The present investigation was focused on the physiological root resorption of the deciduous lower second molar of rabbits from Day 0-5 postnatally. At birth, the deciduous molar had not erupted yet, and no TRAP-positive cell could be found surrounding the tissue adjacent to the root of the deciduous tooth. TRAP-positive mononuclear cells were initially detected in the coronal portion of the dental follicle of the permanent tooth at Day 1 postnatally. Ultrastructurally, these mononuclear cells had moderate numbers of mitochondria and short-strand rough endoplasmic reticulum, as well as scattered free ribosomes throughout their cytoplasm. TRAP-positive mononuclear cells then appeared in the cementoblast layer immediately adjacent to the surface of the deciduous roots. These mononuclear cells projected cytoplasmic extensions between the cementoblasts and made contact with the cementum. At that time, cell-cell contact was frequently observed between these mononuclear cells and cementoblasts. During 3-5 days postnatally, the number of TRAP-positive multinucleate odontoclasts on the root surface gradually increased. They had well-developed ruffled borders and made typical resorption lacunae on the root surface of the deciduous tooth. During this early postnatal period, neither inflammatory cells nor necrotic tissue could be observed surrounding the deciduous root. This study demonstrates that the dental follicle of the permanent tooth as well as the connective tissue adjacent to the deciduous root might play important role in site- and time-specific recruitment, development, and activation of odontoclasts before and at the onset of physiological root resorption.

A mechanism of noncontinuous supraosseous tooth eruption

Numerous theories have been propounded to explain the various aspects of tooth eruption, but no general consensus exists about some of the underlying mechanisms that govern these aspects. An important unresolved issue is the source of the motive forces that displace teeth. We proposed that supraosseous eruptive forces are generated by tooth socket distortions caused by functional jaw deformations. Previous studies used basic equations of static equilibrium to demonstrate that the concomitant stretching of the oblique periodontal ligament (PDL) fibers give rise to forces that may cause supraosseous tooth eruption. For a more rigorous and expanded analysis, we applied the finite element method (FEM). Three functional loads were considered, but the FEM calculations strongly suggested that all jaw deformations contribute to tooth extrusion. It was also demonstrated that the PDL fiber disruptions that are likely to occur with increased stretching can provide a mechanism to stabilize the erupted position.

Effects of dexamethasone on tooth eruption in rats: differences in incisor and molar eruption

A requirement for tooth eruption is the resorption of alveolar bone. Because bone resorption is stimulated by dexamethasone both in vivo and in vitro, dexamethasone 21-phosphate, a soluble form of dexamethasone, was injected into rats to determine its effect on tooth eruption. Such dexamethasone injections accelerate the time of intra-osseous eruption in rat incisors but do not accelerate the eruption time of rat molars when injected into rats. The injections of dexamethasone 21-phosphate also accelerate the time of eyelid opening in the postnatal rats, as well as retarding growth, as measured by body weight. These effects of dexamethasone 21-phosphate parallel the effects of epidermal growth factor injections, including the absence of an effect on molar eruption. This suggests that the molecular signals for the initiation of tooth eruption (i.e., onset of bone resorption) differ between rat incisors and molars. Given that rat incisors are teeth of continuous eruption whereas rat molars are teeth of limited eruption, as are human teeth, care must be taken in extrapolating results derived from rat incisors to human dentition. In vitro, dexamethasone has no effect on the gene expression of either osteoprotegerin or epidermal growth factor in dental follicle cells derived from molars. Because osteoprotegerin expression during normal tooth eruption is transitorily inhibited early postnatally in the molar dental follicle to allow osteoclast formation, the absence of inhibition of its expression by dexamethasone could explain why dexamethasone does not accelerate eruption in molars.

Eruption pattern of autotransplanted premolars visualized by radiographic color-coding

Eruption patterns and root growth were visualized with the use of a new technique, radiographic color-coding, for comparison of the development of autotransplanted premolars with contralateral control teeth. Rates of eruption and root growth were studied. The eruption pattern and rate was assessed relative to the first molar. Maximum rates were found to occur between 30 and 60 days after transplantation. There were no significant differences between transplants and their contralaterals. Two distinct categories of eruption patterns were demonstrated. One group showed a tendency toward an initial rate of transplant eruption that was somewhat faster than that of the contralaterals. The other group showed initially retarded eruption. Possible explanations were discussed. Because no significant differences between the transplants and the contralaterals were observed, it was concluded that autotransplantation is a sound treatment option for substitution of missing teeth, at least from a tooth development point of view.

A role for TNF in bone resorption of deciduous molars in human beings

In this study, tumor necrosis-alpha was sampled from the gingival crevice of human deciduous molars; this was compared with values measured from the crevice of those deciduous molars missing a permanent successor, and from the crevice of deciduous ankylosed molars. Tumor necrosis-alpha was harvested from the gingival crevice with magnetic microspheres coated with tumor necrosis-alpha antibodies. The amount of bead-bound tumor necrosis-alpha was quantified with the use of an enzyme-linked immunosorbent assay. One hundred seven sites (from 41 patients) were sampled; for each patient, the normal value was compared with either the molars missing a permanent successor or ankylosed value. The tumor necrosis-alpha levels were 1.6 times higher from the crevice of ankylosed deciduous molars when compared with normal deciduous molars and 2.6 times higher from the crevice of sites with a molar missing a permanent successor. The mean and standard error mean distribution of tumor necrosis-alpha expressed as picograms was: normal molars 91 pg (standard error mean +/- 20), ankylosed molars 150 pg (standard error mean +/- 31), and missing permanent successor 236 pg (standard error mean +/- 67). Analysis of variance showed the difference among the 3 means was close to attaining significant difference (F [2.104] = 2.7905, P =.066). Multiple comparison procedures indicated that the mean for molars missing a permanent successor and the normal groups were significantly different, P =.05. The results of this study suggest tumor necrosis-alpha values are elevated in the gingival crevice of deciduous molars with ankylosis and where the permanent tooth bud is congenitally missing.

The effects of local trauma to the enamel-related periodontal tissues in the eruption of the rat incisor

The periodontal tissues related to enamel (PTE) of the rat incisor comprise a connective tissue derived from the dental follicle and the enamel organ with its successive stages of development. Localized damage to these tissues in rat lower incisors was done surgically in three ways: with an endodontic file introduced into the labial periodontal space through either (i) its basal or (ii) its incisal extremities, or (iii) by the partial removal of the mandibular lower border, at the level of the molar teeth, together with the introduction of an endodontic file into the incisal part of that space. The lesions in the molar region of the PTE produced first a variable period of retarded eruption, and, depending upon their extent or degree were followed by a cessation of the eruptive movement and, in the majority of the operated teeth, a recovery of the normal eruption rate before the end of the experiment (17 weeks after surgery). Access to the PTE through the basal portion of the socket was erratic, but when the tissues were damaged produced similar effects. Effects on eruption of lesions produced through the alveolar crest were minimal or even absent. Localized injury to the periodontal ligament of either lower or upper incisors did not produce similar effects on tooth eruption. The dental follicle and the enamel organ of teeth of limited growth when their crown is completed are similar to the PTE in the molar region of continuously growing rodent incisors. In teeth of limited growth these tissues play an essential part in the intraosseous stage of eruption. The results here suggest that the PTE may also have a role in the supraosseous stage of eruption, which is continuous in teeth such as rat incisors due to the presence of a continuously functioning odontogenic organ.

Eruption disturbances of the first and second permanent molars: results of treatment in 43 cases

Impaction or retention of first and second permanent molars is an uncommon condition with diverse therapeutic approaches. To ascertain the success rate of different treatment possibilities, a retrospective study was made of 25 patients with a total of 43 permanent molars with eruption disturbances. In most cases, the nonerupted teeth were mandibular second molars (65%), followed by maxillary second molars (21%). Their position, degree of impaction (inclusion), clinical features, repercussion on the neighboring teeth, type of treatment, and outcome were evaluated. Infraocclusion was often associated with malposition of neighboring teeth, as well as extrusion and infraocclusion of opposing teeth. Due mostly to a delay in the diagnosis of the condition, an acceptable final position of the nonerupted molar was obtained in only 8 of 13 conservatively treated second molars. In order to prevent this situation, radiographic examination (ideally during the early mixed dentition period) and early diagnosis of eruption disturbances of permanent first and second molars are recommended, particularly when considering that these anomalies are associated with a high rate of occlusal disturbances that may require orthodontic correction.

Implications for tooth eruption of the effect of interleukin-1alpha on nuclear factor-kappaB gene expression in the rat dental follicle

Tooth eruption is a localized event and a cascade of molecular signals generated in the dental follicle and stellate reticulum appears to initiate its onset. Consequently, mononuclear cells are recruited into the follicle and, in turn, fuse to become osteoclasts needed to resorb the alveolar bone to form an eruption pathway. One of the transcription factors involved in the sequence of molecular signalling may be nuclear factor (NF)kappaB. This study shows that NFkappaB is expressed and synthesized by cultured dental follicle cells. Moreover, its transcription, activation and translocation were enhanced by interleukin (IL)-1alpha, a potential eruption molecule. The enhancement of transcription of the NFkappaB gene by IL-1alpha was blocked by a tyrosine-specific kinase inhibitor, suggesting that the enhancement may require the phosphorylation of the NFkappaB complex. In vivo, NFkappaB is maximally expressed in the dental follicle of the rat first mandibular molar at day 3 postnatally, the age at which there is a peak influx of mononuclear cells into the follicle. Thus, a transcription factor apparently required for eruption (NFkappaB) is present in the tissue required for eruption, the dental follicle, and its gene expression is maximal at a critical time in eruption.

Mandibular canine tooth impaction in a young dog--treatment and subsequent eruption: a case report

Extraction of an embedded supranumerary incisor tooth and surgical exposure of the crown of an impacted left mandibular canine tooth were performed in a 5 month-old Doberman Pinscher dog. Six months following surgery, the canine tooth was fully erupted and in normal occlusion. A review of tooth eruption in the dog is provided.

Tooth eruption molecules enhance MCP-1 gene expression in the dental follicle of the rat

Tooth eruption is a localized developmental event that requires the presence of the dental follicle, a loose connective tissue sac that surrounds each tooth. Early postnatally in the first mandibular molar of the rat there is an influx into the follicle of mononuclear cells (monocytes) which, in turn, fuse to form osteoclasts that resorb the bone to form an eruption pathway. The chemoattractant that may attract the mononuclear cells to the follicle to initiate the cellular events of eruption is monocyte chemotactic protein-one (MCP-1). MCP-1 is secreted by the dental follicle cells and its gene is expressed maximally at an early postnatal age, correlating with the monocyte influx into the follicle. In this study, we show that other potential tooth eruption molecules--EGF, IL-1alpha, TGF-beta1 and CSF-1--all enhance the expression of the MCP-1 gene in the cultured dental follicle cells. In vivo, injections of IL-1alpha or EGF also enhance the gene expression of MCP-1 in the follicle with maximal enhancement occurring in the early postnatal days. Thus, there appears to be a redundant function of the different tooth eruption genes to ensure that the MCP-1 gene is expressed. In turn, expression of MCP-1 may be critical for recruiting the monocytes to the dental follicle to initiate the cellular events of tooth eruption.

Confocal laser scanning microscopic study [corrected] of tartrate-resistant acid phosphatase-positive cells in the dental follicle during early morphogenesis of mouse embryonic molar teeth

Tartrate-resistant acid phosphatase (TRAPase)-positive cells were examined during the early morphogenesis of mouse mandibular first molar teeth, using a simultaneous azo dye-coupling technique and confocal laser scanning microscopy (CLSM). CLSM of paraffin-embedded sections revealed that cells exhibiting TRAPase fluorescence appeared along the marginal region of the condensed dental mesenchyme, not yet the dental follicle, at embryonic day 12 (E12). The follicle was recognized histologically as a population of fibroblastic cells in tooth organs at E14, and TRAPase-positive cells were localized among the follicular cells. Light-microscopic observations of microsliced thick sections showed the overall morphology of the TRAPase-positive cells. A few positive cells of E13 tooth organs were oval, and the intense reaction products of TRAPase revealed complex processes on positive cells in E14 tooth organs. Three-dimensional fluorescent images of TRAPase-positive cells using microsliced sections and CLSM showed their unique morphology of long processes with small spine-like projections at E14. Thus, TRAPase-positive cells appeared in the region of the prospective follicle at the bud stage (E12 and 13) before the formation of the follicle proper. In addition, the formation of the follicle and the appearance of TRAPase-positive cells with unique morphology were correlated in their developmental stage (E14). The findings suggest that the TRAPase-positive cells may be involved in the formation of the dental follicle in early tooth morphogenesis.

Gene expression of growth and differentiation factors-5, -6, and -7 in developing bovine tooth at the root forming stage

Growth and differentiation factors (GDF)-5, -6, and -7 are members of the bone morphogenetic protein (BMP) family. Previous studies suggest their importance in bone development and in tendon/ligament morphogenesis. The cells of the dental attachment apparatus, cementum, periodontal ligament, and alveolar bone proper are derived from the dental follicle proper. In this study, we investigated the expression of GDF-5, -6, and -7 genes in tissues of the bovine incisor tooth germ at the root forming stage. The results demonstrate distinct expression of GDFs in both the dental follicle and the odontoblast layer. While GDF-5 and -6 mRNAs were expressed in both the dental follicle and the odontoblast layer, GDF-7 mRNA expression was detected only in the dental follicle. These results indicate that GDFs, expressed in the bovine tooth germ including the dental follicle, may be potent regulatory molecules in the development of the dental attachment apparatus.

In vivo effect of interleukin-1 alpha on colony-stimulating factor-1 gene expression in the dental follicle of the rat molar

Interleukin-1 alpha (IL-1 alpha) acts in vitro to enhance the gene expression of colony-stimulating factor-1 (CSF-1) of dental follicle cells. Because the dental follicle is required for tooth eruption and because CSF-1 appears to be a key molecule in initiating eruption, it was the aim of this study to determine if IL-1 alpha could enhance the expression of the CSF-1 gene in the dental follicle in vivo. To determine this, rats were injected with IL-1 alpha at different ages postnatally and the total RNA was isolated from the dental follicles of the first mandibular molars. Reverse transcription-polymerase chain reaction showed that IL-1 alpha enhanced the expression of CSF-1 in the follicle. Thus, IL-1 alpha may play a part in the cascade of molecular signals that initiate eruption by its effect upon the CSF-1 gene.

Colony-stimulating factor-1 and monocyte chemotactic protein-1 chemotaxis for monocytes in the rat dental follicle

Tooth eruption requires the influx of mononuclear cells (monocytes) into the dental follicle to form osteoclasts that resorb the alveolar bone to form an eruption pathway. Candidate molecules to attract these monocytes are colony-stimulating factor-1 (CSF-1) which is produced in the dental follicle, and monocyte chemotactic protein-1 (MCP-1), which is known to be a chemoattractant for monocytes. Using reverse transcription-polymerase chain reaction techniques, it was shown that the follicle cells of the first mandibular molar of the rat transcribe MCP-1 with maximal expression in vivo at day 3 postnatally, the time of peak expression of CSF-1 as well. This is also the day of peak influx of monocytes into the follicle. To determine if these molecules that were produced by the dental follicle were chemotactic, a chemotactic assay using a mouse monocyte cell line was conducted. CSF-1 or MCP-1 alone were found to be chemotactic for the monocytes and conditioned medium from the cultured follicle cells also was chemotactic. Incubating the conditioned medium with antibodies against either CSF-1 or MCP-1 reduced the chemotaxis. The results demonstrate that both CSF-1 and MCP-1 produced by the dental follicle are chemotactic for monocytes and that these chemoattractants might be responsible for the influx of monocytes into the follicle necessary to initiate tooth eruption.

Tooth eruption through autogenous and xenogenous bone transplants: a histological and radiographic evaluation in beagle dogs

The effect of implanting autogenous and xenogenous (Bio-Oss) bone transplants into metabolically active sites within beagle dog mandibles during permanent premolar tooth eruption was examined. Ten 14-week-old beagles were used. Before commencing the radiographic experiments, metal bone markers were placed in the caudal margin of the mandible at the age of 10 weeks. The deciduous first and third molar teeth were extracted and their sockets over the permanent second and fourth premolars were implanted with autogenous particulate enchondral iliac crest bone, autogenous particulate membraneous mandibular body bone, xenogenous bovine anorganic bone mineral spongiosa granules (1-2mm3) (Bio-Oss, Geistlich Pharma, Switzerland) of left empty. The third premolar served as control site. Standardized oblique lateral radiographs were taken once a week. A number of coordinates of defined points and structures were determined by means of a coordinate digitizing system. Animals were killed 4, 10 and 16 weeks after bone transplantation for histological examination of the transplantation sites. All premolars showed no delay in eruption or disruption of crown and root development. On histology, the Bio-Oss particles were not resorbed or integrated in the alveolar bone but were pushed forward into the gingiva. We have demonstrated that there is on difference in the eruption curve of the permanent premolars in the four groups (ANOVA P > 0.5) and that bone transplantation has no inhibitory effect on eruption (ANOVA P > 0.3) and crown development of the underlying permanent premolar but that Bio-Oss does not have the same resorbable or integrating capability as autogenous bone grafts.

Localization and expression of CSF-1 receptor in rat dental follicle cells

Colony-stimulating factor-1 (CSF-1) accelerates tooth eruption in rats and is localized in the dental follicle, a loose connective tissue sac that is necessary for eruption to occur. CSF-1 enhances the cellular events that occur in the follicle prior to eruption--namely, an influx of monocytes into the follicle early post-natally to form the osteoclasts needed to resorb bone for the eruption pathway. Because CSF-1 levels are at a peak at day 3 post-natally, and because CSF-1 has an autocrine effect on its own gene expression, the question remains as to what causes the subsequent decline in CSF-1 protein and mRNA after day 3 post-natally. To determine if the autocrine effect is inhibited through the CSF-1 receptor, analysis of the CSF-1 receptor mRNA levels in cultured dental follicle cells reveals that high concentrations of CSF-1 reduce the gene expression of the CSF-1 receptor. Interleukin 1 alpha, a molecule that enhances CSF-1 gene expression, has no effect on CSF-1 receptor mRNA levels. Immunostaining for the CSF-1 receptor protein shows that it is present in the dental follicle early post-natally and is either absent or greatly reduced by day 10 post-natally. Earlier studies showed that the mRNA levels of the CSF-1 receptor also parallel this time course. Thus, the above results suggest that the feedback inhibition of the autocrine effect of CSF-1 on its own expression is through the effect of CSF-1 inhibiting the translation and transcription of its receptor. In turn, these molecular interactions possibly regulate the cellular events that occur in the follicle prior to and during eruption.

Immunostaining and transcriptional enhancement of interleukin-1 receptor type I in the rat dental follicle

Interleukin-1alpha (IL-1alpha) enhances the gene expression of colony-stimulating factor-one (CSF-1) in dental follicle cells. In turn, CSF-1 appears to be a critical molecule in stimulating the cellular events of eruption that require the presence of the follicle. Chronologically, the maximal transcription and translation of CSF-1 in the follicle occurs early postnatally, followed by a decline later. Thus, in this study, immunostaining for the interleukin-1 receptor type I (IL-1RI) was used to determine if it paralleled the CSF-1 localization and chronology. The results showed that IL-1RI is primarily localized in the dental follicle, with maximal immunostaining early postnatally and a greatly reduced staining by day 10. In conjunction with this, molecules that enhance the gene expression of IL-1alpha epidermal growth factor (EGF) and transforming growth factor-beta1 (TGF-beta1) were also shown to enhance the expression of IL-1RI, but IL-1alpha did not increase the gene expression of IL-1RI. After injections of EGF at different times postnatally the mRNA of IL-1RI increased over comparable controls. Between days 2 and 5 the IL-1RI mRNA in the follicle decreased. In combination the results suggest that, as the expression of IL-1alpha is enhanced in the stellate reticulum either by EGF or TGF-beta1, these two molecules could also enhance the expression of IL-1RI in the dental follicle such that more receptors would be available to respond to the increased IL-1alpha secreted. The maximal presence of the receptors (IL-1RI) in the dental follicle early postnatally, followed by their subsequent decline, parallels the rise and fall of CSF-1 in the follicle. Thus, regulation of the IL-1RI and IL-1RI gene expression might be a means of regulating changes in CSF-1 in the follicle.

Tooth eruption: theories and facts

The mechanisms of tooth eruption (i.e., the answer to the question of how and why teeth erupt) has been a matter of long historical debate. This review focuses on human and other mammalian teeth with a time- and spacewise limited period of eruption and analyzes recent observations and experimental data on dogs, rats, primates, and humans in a framework of basic biological parameters to formulate a guiding theory of tooth eruption. Acknowledging basic parameters (i.e., that teeth move in three-dimensional space, erupt with varying speed, and arrive at a functional position that in inheritable) eliminates a number of previously held theories and favors those that accommodate basic parameters, such as alveolar bone remodeling in association with root elongation, with possible correction factors in the form of cementum apposition and periodontal ligament formation. We have critically analyzed, summarized, and integrated recent findings associated with preeruptive movements of developing teeth, the intraosseous stage of premolar eruption in dogs, molar eruption in rodents, and premolar and molar eruption in primates. The variable speeds of eruption are particularly important. We conclude with basic principles of tooth eruption--that is, the type of signals generated by the dental follicle proper, the conditions under which teeth are moved and the clinical understanding to be derived from this knowledge.

In vivo and in vitro effects of epidermal growth factor on its receptor gene expression in rat dental follicle cells

Epidermal growth factor receptor (EGFR) is known to be localized early postnatally in the follicle of rat mandibular molars and to decline later. Here, EGFR mRNA present early postnatally in the follicle was revealed by in situ hybridization and reverse transcription-polymerase chain reaction. Injections of epidermal growth factor (EGF) enhanced the expression of EGFR mRNA but not EGF mRNA through day 5 postnatally in the follicle. By day 7 postnatally, the amount of EGFR mRNA was dramatically reduced and EGF injection at that time or later did not enhance its expression. Cultured dental follicle cells were also shown to contain both EGFR mRNA and EGF mRNA, but only EGFR mRNA expression was enhanced after incubation of the cells with EGF. The EGFR mRNA was apparently translated, because the cultured cells could be immunostained for EGFR. This enhancement of EGFR mRNA in the dental follicle cells by EGF may be a necessary prelude to the mitogenic effect of EGF on the cultured cells because incubating the dental follicle cells in EGF over 6 days resulted in almost a doubling in their number as compared to controls. These results indicate that the tissue necessary for eruption to occur, the dental follicle, contains EGFR mRNA in the early postnatal days. In turn, this mRNA is enhanced by EGF, a molecule known to accelerate eruption if injected early postnatally. Whether or not the mitogenic effect of the EGF on the cultured dental follicle cells is a mechanistic factor that contributes to the subsequent tooth eruption is unknown.

Bone surface morphology reflects local skeletal metabolism

The metabolic activity of bone cells is faithfully reflected in the surface topography of mineralized bone surfaces, and this can be easily detected by scanning electron microscopy (SEM). Forming bone surfaces exhibit knobby projections which represent foci of mineralization, resorbing surfaces are scalloped, and resting surfaces undergoing neither activity are smooth, as shown by Boyde and Hobdell 25 years ago. These phenomena are illustrated in vivo by tooth eruption, a local activity in alveolar bone where resorption and formation are polarized around an erupting tooth, and osteopetrosis, a metabolic bone disease characterized by a congenital reduction or absence of bone resorption. The ability to analyze bone metabolism over large areas of the skeleton by SEM offers a convenient and powerful microscopic technique to assess regional and global bone cell activity in an era where the investigative focus is increasingly molecular.

Transcription and translation of CSF-1 in the dental follicle

The dental follicle, a loose connective tissue sac which surrounds the unerupted tooth, is required for eruption to occur. Injection of colony-stimulating factor-1 (CSF-1) will accelerate molar eruption in rats, as well as stimulate tooth eruption in osteopetrotic rats. Utilizing in situ hybridization and reverse- transcription polymerase chain-reaction techniques, we show here that CSF-1 mRNA is present in vivo in the dental follicle of the first mandibular molar of the rat. Analysis of the molars from day 0 through day 10 post-natally demonstrates that the maximal expression of CSF-1 mRNA is at day 3 post-natally. Immunostaining also reveals that the CSF-1 mRNA is translated, with immunostaining for the CSF-1 itself, being heavy in early post-natal days and absent by day 9 postnatally. In view of the fact that there is a maximal influx of mononuclear cells (monocytes) into the dental follicle at day 3 post-natally--an influx which increases the numbers of osteoclasts needed to form a tooth eruption pathway--it is probable that the maximal expression of CSF-1 mRNA by day 3 post-natally contributes to this monocyte influx. Thus, this study establishes a relationship among a molecule (CSF-1), cell (monocyte), and tissue (dental follicle) that appear to play a major role in tooth eruption.