Phagocytosis and elimination of amelocyte debris by stratum intermedium cells in the trasitional zone of the enamel organ of the rat incisor

Role of Cell Death in Cellular Processes During Odontogenesis

The development of a tooth germ in a precise size, shape, and position in the jaw, involves meticulous regulation of cell proliferation and cell death. Apoptosis, as the most common type of programmed cell death during embryonic development, plays a number of key roles during odontogenesis, ranging from the budding of the oral epithelium during tooth initiation, to later tooth germ morphogenesis and removal of enamel knot signaling center. Here, we summarize recent knowledge about the distribution and function of apoptotic cells during odontogenesis in several vertebrate lineages, with a special focus on amniotes (mammals and reptiles). We discuss the regulatory roles that apoptosis plays on various cellular processes during odontogenesis. We also review apoptosis-associated molecular signaling during tooth development, including its relationship with the autophagic pathway. Lastly, we cover apoptotic pathway disruption, and alterations in apoptotic cell distribution in transgenic mouse models. These studies foster a deeper understanding how apoptotic cells affect cellular processes during normal odontogenesis, and how they contribute to dental disorders, which could lead to new avenues of treatment in the future.

Endocytosis and Enamel Formation

Enamel formation requires consecutive stages of development to achieve its characteristic extreme mineral hardness. Mineralization depends on the initial presence then removal of degraded enamel proteins from the matrix via endocytosis. The ameloblast membrane resides at the interface between matrix and cell. Enamel formation is controlled by ameloblasts that produce enamel in stages to build the enamel layer (secretory stage) and to reach final mineralization (maturation stage). Each stage has specific functional requirements for the ameloblasts. Ameloblasts adopt different cell morphologies during each stage. Protein trafficking including the secretion and endocytosis of enamel proteins is a fundamental task in ameloblasts. The sites of internalization of enamel proteins on the ameloblast membrane are specific for every stage. In this review, an overview of endocytosis and trafficking of vesicles in ameloblasts is presented. The pathways for internalization and routing of vesicles are described. Endocytosis is proposed as a mechanism to remove debris of degraded enamel protein and to obtain feedback from the matrix on the status of the maturing enamel.

Bone formation without lamina dura in the middle-aged and elderly: possible dependence on enamel

Bone formation below the crown of mandibular horizontal incompletely impacted third molar is frequently seen in the middle-aged and elderly. The phenomenon shows lamina dura loss without radiolucency and we hypothesized the participation of mature enamel without any influence on the environmental oral status. In order to investigate the characteristics of the phenomenon based on the presence/absence of the lamina dura and radiolucency below the crown, we studied the relationship between 58 men and 43 women with a lamina dura without radiolucency, 12 men and 8 women without a lamina dura with radiolucency, 34 men and 16 women without a lamina dura without radiolucency, and the status of teeth in the ipsilateral mandible. Subjects without a lamina dura without radiolucency were significantly older than those with a lamina dura without radiolucency in both men (P < 0.0001) and women (P <0.01), indicating different chronological causes. Men without lamina dura with radiolucency showed significantly more tooth loss than those with a lamina dura without radiolucency (P < 0.00001) and those without a lamina dura without radiolucency (P < 0.0001), indicating the influence of poor oral health. Thus, the phenomenon without a lamina dura without radiolucency may show the clinical importance of bone formation in the elderly.

Apoptosis in regressive deciduous tooth germs of Suncus murinus evaluated by the the TUNEL method and electron microscopy

Apoptosis in regressive primary (deciduous) dental primordia was examined in the embryos of Suncus murinus, which is a monophyodont. The primary tooth germs of S. murinus are temporarily formed and disappear during the embryonic period before they are calcified. Most primary tooth germs reach the bell stage and degenerate by embryonic day 22 (E22). Light microscopy on haematoxylin-eosin-stained sections revealed that intensely labelled granular substances are frequently present in the epithelial portion (enamel organs) of the deciduous tooth germs during the period from E18 to E20. The terminal deoxynucleotidyl transferase-mediated deoxyuridine triphosphate-biotin nick end labelling method, computer-assisted three-dimensional reconstructions, and electron microscopy confirmed that these variable-sized granular substances are similar to apoptotic cells or bodies. Apoptotic structures were mainly found in the primary tooth germ located on the buccal surface of the secondary (successional) tooth germ. These results lead to the conclusion that apoptosis is closely associated with the involution and disappearance of the deciduous tooth germ in S. murinus. A primary tooth germ was observed on the buccal side of all the corresponding successional tooth germs, although the buccal surface of the secondary tooth germ of third upper molar teeth developed only to epithelial thickening without mesenchymal condensation. The findings, therefore, suggest that apoptosis is responsible for disappearance of the primary dental primordia during tooth development in S. murinus.

The immunohistochemical localization of Bax and Bcl-2 and their relation to apoptosis during amelogenesis in developing rat molars

Bax and Bcl-2 are members of a family of intracellular, membrane-associated proteins that regulate programmed cell death. It has been suggested that, when Bax predominates, programmed cell death is accelerated and the apoptosis inhibitory activity of Bcl-2 is suppressed. The present study was undertaken to immunohistochemically (IHC) localize Bax and Bcl-2 in the cells of the enamel organ during amelogenesis in rat molars. Also, apoptotic cells were detected by TUNEL staining. The IHC intense localization of Bcl-2 and light staining for Bax in the pre-ameloblasts suggest that apoptosis is inhibited in the proliferating pre-ameloblasts. This is consistent with an absence of TUNEL staining for apoptosis in these cells. However, in the late secretory and transition ameloblasts, and adjacent stratum intermedium, evidence of apoptosis of the ameloblasts was observed. Bax and Bcl-2 were co-localized in the proximal ends of late secretory, transition and early maturation-stage ameloblasts, but immunoreactivity for Bax markedly increased in the proximal ends of late secretory and transition ameloblasts, while the Bcl-2 staining appeared to be lighter. This suggests that Bax antagonized Bcl-2 function, limiting the ability of Bcl-2 to prolong cell survival. In the early maturation stage, Bax staining faded while the immunoreactivity for Bcl-2 increased. Evidence of distinct apoptosis was reduced in the early maturation stage ameloblasts. When related to the occurrence of apoptosis during amelogenesis, the relative intensity of expression of Bax and Bcl-2 changed in a pattern consistent with that observed in other cell lines. This indicates that these proteins play essential roles in the process of amelogenesis, as predicted by their proposed mechanisms of action in the control of apoptosis.

Cellular and chemical events during enamel maturation

This review focuses on the process of enamel maturation, a series of events associated with slow, progressive growth in the width and thickness of apatitic crystals. This developmental step causes gradual physical hardening and transformation of soft, newly formed enamel into one of the most durable mineralized tissues produced biologically. Enamel is the secretory product of specialized epithelial cells, the ameloblasts, which make this covering on the crowns of teeth in two steps. First, they roughly "map out" the location and limits (overall thickness) of the entire extracellular layer as a protein-rich, acellular, and avascular matrix filled with thin, ribbon-like crystals of carbonated hydroxyapatite. These initial crystals are organized spatially into rod and interrod territories as they form, and rod crystals are lengthened by Tomes' processes in tandem with appositional movement of ameloblasts away from the dentin surface. Once the full thickness of enamel has been formed, ameloblasts initiate a series of repetitive morphological changes at the enamel surface in which tight junctions and deep membrane infoldings periodically appear (ruffle-ended), then disappear for short intervals (smooth-ended), from the apical ends of the cells. As this happens, the enamel covered by these cells changes rhythmically in net pH from mildly acidic (ruffle-ended) to near-physiologic (smooth-ended) as mineral crystals slowly expand into the "spaces" (volume) formerly occupied by matrix proteins and water. Matrix proteins are processed and degraded by proteinases throughout amelogenesis, but they undergo more rapid destruction once ameloblast modulation begins. Ruffle-ended ameloblasts appear to function primarily as a regulatory and transport epithelium for controlling the movement of calcium and other ions such as bicarbonate into enamel to maintain buffering capacity and driving forces optimized for surface crystal growth. The reason ruffle-ended ameloblasts become smooth-ended periodically is unknown, although this event seems to be crucial for sustaining long-term crystal growth.

Nuclear DNA fragmentation during postnatal tooth development of mouse and hamster and during dentin repair in the rat

The TUNEL (transferase-mediated, dUTP-biotin nick end labeling) method for in situ labeling of DNA strands was utilized to localize DNA fragmentation in cells involved in tooth formation in the neonatal mouse and hamster. Positive reactions for the presence of DNA fragments were obtained in some epithelial cells of the cervical loop region of incisors, late secretory, transitional and early maturation stage ameloblasts, stratum intermedium cells and in shortened ameloblasts just before eruption. Also, cells of the periodontal ligament of the continuously erupting incisors stained positive shortly before eruption. Odontoblasts were negative but became strongly positive during the formation of physiological osteodentin at the tip of developing incisors. Osteodentin matrix and the surfaces of unerupted enamel and cementum just prior to eruption stained for DNA fragments as well. DNA fragmentation could be elicited in odontoblasts and underlying pulpal tissues of mature erupted molars after mechanical injury to the odontoblast processes during cavity preparation. We conclude that, in rodents, DNA fragmentation and cell death are biological processes which take place in a variety of cells involved in formation of teeth. The TUNEL staining technique is a simple but powerful tool to examine the fate of cells and tissues undergoing either programmed cell death (apoptosis) or fragmentation of nuclear DNA induced by external factors leading to pathological changes.

DNA localization in nuclear fragments of apoptotic ameloblasts using anti-DNA immunoelectron microscopy: programmed cell death of ameloblasts

Ameloblasts responsible for tooth enamel formation are classified into two different phases: secretion and maturation. At the transition between these secretion and maturation stages, a considerable number of cells die. In this study, we examined the morphology of degenerating ameloblasts by conventional electron microscopy, and DNA cleavage in degenerating ameloblast nuclei by the in situ terminal transferase assay. The results suggest that apoptosis (programmed cell death) in ameloblasts, including DNA ligation is induced at the transitional stage. The nuclear fragments, chromatin condensation and DNA relocation in apoptotic nuclei were examined quantitatively by post-embedding anti-DNA immunogold electron microscopy and the in situ terminal transferase assay combined with electron microscopy. Numerical analysis revealed that immunogold labeling density in the condensed chromatin of apoptotic nuclei was comparable on the average to that in the perinuclear heterochromatin of normal nuclei, and that individual apoptotic nuclear fragments exhibited highly variable to that of normal heterochromatin, to fragments with densities twice as high as that of normal heterochromatin. The in situ terminal transferase assay combined with electron microscopy detected DNA ends exposed by ultrathin sectioning as well as DNA cleavage by a putative endonuclease. In conclusion, the state of the DNA, including its ligation and degeneration, changes gradually during chromatin condensation and nuclear fragmentation of apoptosis.

Morphology of the enamel organ in the miniature swine

In recent years, the dentition of the pig has been increasingly used as a model for the study of amelogenesis. Indeed, much of our current knowledge on enamel formation derives from biochemical and physicochemical analyses of the organic and inorganic components, respectively, of porcine enamel. As an extension of this previous work, and as the first step in our attempt to correlate known enamel matrix and mineral changes with adjacent enamel organ morphology, the present study was undertaken to provide a description of the morphological events occurring in the enamel organ during porcine amelogenesis. Two-week-old miniature swine (minipigs) were fixed by vascular perfusion with glutaraldehyde, the deciduous teeth present at this age were embedded in Epon resin and sectioned, and the cells of the enamel organ at each of the various developmental stages of amelogenesis were examined by light and transmission electron microscopy. In many respects, the morphology of the porcine enamel organ was similar to that previously described in other mammalian species. On the other hand, several particularities were noted and these are discussed in the context of available data correlating cell ultrastructure with putative function during enamel formation.

Fine structural changes and lysosomal phosphatase cytochemistry of ameloblasts associated with the transitional stage of enamel formation in the rat incisor

Trimetaphosphatase (TMPase) and cytidine-5'-monophosphatase (CMPase) were used as lysosomal markers in the transitional ameloblasts (TA) to investigate the distribution of lysosomal structures and to correlate the cytochemical findings with the ultrastructural features of these cells. Of particular interest were the cytochemical and morphological changes which occur as the ameloblasts approach the maturation stage of enamel formation. The sequence of changes observed provides a basis for designation of three regions of the transitional zone (early and late TA and modulating ameloblasts). In the early TA region, the cells decreased in height and contained phagic vacuoles as well as numerous TMPase and CMPase reactive structures. Late transitional ameloblasts had invaginations at their distal ends as well as membrane-bound structures, both filled with fine granular material. Dense bodies, phagic vacuoles, and other elements of the lysosomal system were enzyme reactive. Modulating ameloblasts lacked the phagic vacuoles but exhibited large numbers of multivesicular bodies, vesicles, and secretory granules. Their distal ends were morphologically altered indicating a change towards ruffle- or smooth-ended varieties of maturation ameloblast. In the former, increased granular material was observed within cell membrane invaginations and associated membrane-bound structures. In the latter, intercellular spaces widened and were filled with granular material. The present cytochemical findings of an extensive lyosomal system in transitional ameloblasts confirm the function of those cells in reducing the secretory ameloblast population and in the selective elimination of their protein-synthesizing organelles. Furthermore, this extensive lysosmal system and the present morphological findings are consistent with a potential role for transitional ameloblasts in contributing to the marked loss of enamel protein known to occur during maturation.

Ultrastructure of granular materials in rat incisor enamel organ at early maturation stage

With scanning electron microscopy, globules were seen in inter-cellular spaces between ameloblasts with ruffled borders and papillary cells at early maturation stage. Numerous globules were located on longitudinal folds between parallel ridges on the sides of ameloblasts, but only a few in the papillary layer. In previously-scanned specimens sectioned for transmission electron microscopy, the globules were composed of finely granular material. Vacuoles containing material identical to extra-cellular granules were observed in intra-cellular portions of the ameloblasts and papillary cells.

Effect of developmental stage of explants on further in-vitro development of hamster molars

With morphometrical and biochemical methods the in-vitro development of 1-4-day-old 2nd maxillary molars was studied up to 10 days and compared with previously reported in-vivo development. Incorporation of [3H]-thymidine and increase in dry weight were used as biochemical parameters for cell proliferation and growth respectively specific alkaline phosphatase activity and uptake of 45Ca as the measure for mineralization. In explants of 2-4-day-old hamsters, formation of dentine and enamel matrix was consistent: both mineralized. These explants attained stages beyond enamel matrix formation, possibly the transitional stages of amelogenesis. The amounts of matrices produced appeared to be related to the final size the explants attained. Best in-vitro development histologically was in explants of 2 and 3-day-olds. Thus in-vitro development was qualitatively similar to in vivo.

Structural changes induced by tetracycline in secretory ameloblasts in young rats

The effects of tetracycline hydrochloride (TC) on secretory ameloblasts in mandibular incisors and first molars in young rats were investigated. The pathogenesis of the TC-induced changes was examined in light and electron microscopes 6, 12, 24 and 96 h after a single intraperitoneal injection of a high dose of TC (200 mg TC/kg body wt.) into 4-d-old animals. Secretory ameloblasts from non-injected animals served as controls. Cellular changes were observed in all teeth 6 h after injection. The changes increased with the postinjection period and after 96 h they were so severe that they were considered irreversible. The incipient changes of the ameloblasts comprised altered structure and location of the mitochondria, succeeded by dilated cisternae of endoplasmic reticulum arranged in short curled formations. Later on, distorted Golgi complexes were observed. Secretory granules appeared in various numbers in the Golgi zone and in the Tomes' processes. In severely affected ameloblasts the cell nuclei showed an increased content of chromatin. Autophagic vacuoles and extracellular membrane bound fragments with cellular remnants were frequent, indicating death of some of the ameloblasts. Areas of stippled secretory material were observed along the formative enamel front and in extracellular spaces between the ameloblasts. In the 96-h group calcified bodies with a varying content of crystals were scattered between the cells. Incisors and the molars displayed similar patterns of structural changes of the secretory ameloblasts; however, the changes developed earlier and became more severe in the molars.

Physiological cell death of secretory ameloblasts in the rat incisor

The migration of the ameloblasts in the continuously erupting incisors of the rat is accompanied by cell loss. Ameloblasts degenerate near the mesial and lateral cemento-enamel junctions in the secretory zone and in the middle two thirds of the region of postsecretory transition, degeneration being most marked where these areas merge. These findings support the hypothesis that the prism decussation in the enamel results from alternating transverse rows of secretory ameloblasts sliding past each other whilst elaborating their rods. The distribution of the degenerating cells suggests, however, that the sliding cell rows are not exactly transverse but arcuate, with the opening facing incisally. The progress of structural alterations of the nuclei in the degenerating ameloblasts appears to follow the pattern earlier described in vinblastine-damaged ameloblasts.

Ameloblasts: secretory and resorptive functions

The sequence of steps which an ameloblast passes through in forming enamel appears remarkably similar in amphibian and man. Despite considerable improvements in understanding the early events in the life cycle that lead to the intracellular synthesis and secretion of enamel matrix by the cell, little is known about the cell's functional role at later stages of the life cycle when the extracellular enamel matrix undergoes classical maturation in becoming fully mineralized.

On the effect of vinblastine on ameloblasts of rat incisors in vivo. 2. Protracted effect on secretory ameloblasts. A light microscopical study

The effects of vinblastine sulphate at a dosage of 0.2 mg per 100 g body weight on the secretory ameloblasts of rat incisors were studied 3, 6 and 24 hours and 3 and 7 days after administration of the drug. The vinblastine affected the secretion profoundly, caused a reduction in size of the cells and death of many ameloblasts. Most of the surviving ameloblasts restored initially-induced loss of polarity. Many also resumed secretion and deposition of enamel matrix. The Tomes' processess were extremely sensitive to vinblastine and all matrix deposited after administration of the drug appeared abnormal in structure. Ameloblasts not resuming secretory activity were less than half the size (height) of normal cells. In some areas all the ameloblasts were destroyed with the exception of a varying number of surviving ameloblasts parts consisting only of a nucleus and a small amount of cytoplasm. The ameloblasts which had re-established secretory activity, and most of the ameloblasts which had not, retained their ability to transform into transporting ameloblasts. Large amounts of ameloblast debris present 3 and 6 hours after administration of the vinblastine were effectively engulfed and digested by the cells of the striatum intermedium within 24 hours.

Quantitative analysis of cell turnover in the enamel organ of the rat incisor. Evidence for ameloblast death immediately after enamel matrix secretion

During renewal of the enamel organ in the rat incisor cohorts of epithelial cells are transported sequentially through presecretory, secretory and maturation zones to the gingival margin where the life cycles of these cells terminate. This process was examined kinetically by determining the absolute flux of cells within each of these zones of amelogenesis. It was found that the efflux of ameloblasts, stratum intermedium and papillary layer cells from the presecretory zone was about equal to the efflux plus expected growth within the secretory zone. However, between the secretory and maturation zones about 50% more ameloblasts entered the maturation zone than were required to account for the egress at the gingival margin and the expected growth. Since there was no similar imbalance between these zones for papillary layer cells, it was concluded that this discrepancy must represent a 50% reduction in the size of the ameloblast population during the maturation stage of amelogenesis. It was calculated that a little over 25% of the loss occurred immediately at the start of maturation within the region of postsecretory transition and the remaining 25% of the loss occurred throughout the subsequent regions of the maturation zone. In addition to the kinetic analysis graphic reconstructions, or surface maps, of ameloblast nuclei were prepared. These maps illustrated the characteristics of ameloblast nuclear packing within the three zones of amelogenesis and they provided quantitative confirmation that as ameloblasts progress through the maturation zone, there is a loss of cells in an amount predicted by the kinetic analysis.

Ultrastructural studies on rat skin autografts

The epidermis of rat skin autografts was studied during the first 14 days of the healing period using light and electron microscopy. Patches of necrotic cells were found on the second and third days while the major part of the cells only showed minor changes from normal skin. At the ultrastructural level the last mentioned cells showed changes, comprising wrinkling of nuclear envelope, aggregation of chromatin, irregular and swollen mitochondria, appearance of different types of vacuoles and a reduction in size and number of keratohyalin granules. These changes were most pronounced on the third day after transplantation. After 8 days only minor changes from the normal epidermis were found and after 14 days the epidermis of skin autografts exhibited a complete healing and regeneration.

Cellular renewal in the enamel organ and the odontoblast layer of the rat incisor as followed by radioautography using 3H-thymidine

Renewal of the cell populations of the incisor was studied in 100 gm male rats injected with a single dose of 3H-thymidine and sacrificed at various times from one hour to 32 days after injection. Radioautographs showed that a cohort of labeled cells within the enamel organ, odontoblast layer, and pulp was carried passively with the erupting incisor from the apical end towards the gingival margin where the life cycle of these cells was terminated. Labeled cells in the upper and lower incisor, although traversing different absolute lengths, were found in approximately the same functional stage of their life cycle at similar times after the injection. Thus, by one and on-half days labeled ameloblasts began inner enamel secretion and, by eight days (upper) or nine days (lower), complement outer enamel secretion. By 32 days labeled ameloblasts had traversed the entire enamel maturation zone and were located at the gingival margin. Labeled odontoblasts followed closely the movement of labeled ameloblasts. The mean rate of ameloblast migration was 567 mum/day on the upper incisor and 651 mim/day on the lower. For the odontoblasts this rate was 55 mum/day (upper) and 631 mum/day (lower). Finally, it was found that as the rat age, the duration of the life cycle for epithelial and pulp cell populations of the incisor increased because of growth within the lonitudinal axis of the tooth. It was concluded that the apical end of the incisor literally "grows backward" in the bony socket, and hence, the duration of the life cycle becomes greater simply because it takes cells longer to physically reach the gingival margin.