Cholera toxin and dibutyryl cyclic-AMP stimulate the growth of epithelial cells derived from epithelial rests from porcine periodontal ligament

Determination of potential cellular proliferation in the odontogenic epithelia of the dental follicle of the asymptomatic impacted third molars

PURPOSE

The aim of this study is to determine the proliferative potentials of dental follicles (DF) of radiographically asymptomatic impacted third molar teeth by using Ki-67 and mini-chromosome maintenance protein 2 (MCM-2) proliferation markers, and to discuss whether there is any necessity for the removal of all impacted third molars by detecting the potential of the developing cysts and tumors of its DF.

MATERIALS AND METHODS

This study involved 59 DF of 54 patients referred for clinically and radiographically asymptomatic lower impacted third molars. Thirteen healthy gingiva tissues obtained during the impacted third molar operation in 13 patients served as a control group. DF widths on periapical radiographs below 2.5 mm were included in the study. The epithelial and mesenchymal components of DF were examined histologically. All specimens were stained with periodic acid Schiff, Alcian blue, and mucin for the evaluation of mucous cell prosoplasia. Epithelial cell proliferation was determined by using immunohistochemical labeling.

RESULTS

The histologic examinations showed 11.9% mucous cell prosoplasia, 55.9% squamous metaplasia, 15.3% glandular epithelium, and 33.9% inflammation. Ki-67 expression was found to have higher values than MCM-2 expression in controls 6.15 (3.18) and 10.53 (5.77) and in DF 4.46 (1.39) and 5.89 (2.89), respectively. The expression of both proliferation markers in the basal epithelial cells, mucous, and squamous epithelium and inflammatory cells were statistically significant (P < .01).

CONCLUSION

The results of this study indicate that the odontogenic epithelium in DF of asymptomatic impacted third molars might be actively proliferating and may be an indicator for the differentiation potential of DF. It would also seem that the inflammation observed in the mesenchymal components of DF up-regulate the cell turnover of odontogenic epithelium and lead to proliferation. Based on these observations, we support prophylactic removal of impacted third molars.

Quiescent epithelial cell rests of Malassez can differentiate into ameloblast-like cells

Epithelial cell rests of Malassez (ERM) are quiescent epithelial remnants of Hertwig's epithelial root sheath (HERS) that are involved in the formation of tooth roots. After completion of crown formation, HERS are converted from cervical loop cells, which have the potential to generate enamel for tooth crown formation. Cervical loop cells have the potential to differentiate into ameloblasts. Generally, no new ameloblasts can be generated from HERS, however this study demonstrated that subcultured ERM can differentiate into ameloblast-like cells and generate enamel-like tissues in combination with dental pulp cells at the crown formation stage. Porcine ERM were obtained from periodontal ligament tissue by explant culture and were subcultured with non-serum medium. Thereafter, subcultured ERM were expanded on 3T3-J2 feeder cell layers until the tenth passage. The in vitro mRNA expression pattern of the subcultured ERM after four passages was found to be different from that of enamel organ epithelial cells and oral gingival epithelial cells after the fourth passage using the same expansion technique. When subcultured ERM were combined with subcultured dental pulp cells, ERM expressed cytokeratin14 and amelogenin proteins in vitro. In addition, subcultured ERM combined with primary dental pulp cells seeded onto scaffolds showed enamel-like tissues at 8 weeks post-transplantation. Moreover, positive staining for amelogenin was observed in the enamel-like tissues, indicating the presence of well-developed ameloblasts in the implants. These results suggest that ERM can differentiate into ameloblast-like cells.

Upregulation of Basic Fibroblast Growth Factor in Human Periapical Lesions

Basic fibroblast growth factor is one of a class of heparin-binding growth factors that stimulates endothelial cell proliferation and migration in vitro and angiogenesis in vivo. The purpose of this study was to investigate the expression of basic fibroblast growth factor in chronic periapical lesions of endodontic origin. Ten chronic inflammatory periapical lesions were examined using immunohistochemical staining. The experimental control group consisted of four specimens of uninflamed periodontal ligament tissue. Two independent observers graded the staining intensity for basic fibroblast growth factor. An immunopositive, cytoplasmic, and nuclear reaction for basic fibroblast growth factor, with varying degrees of upregulation was observed in all 10 chronic periapical lesions. We speculate that the formation of granulation tissue and the activation of epithelial cell rests in chronical apical lesions might be associated with a local rise in the tissue level of basic fibroblast growth factor. Therefore, this growth factor could play an important role in the pathogenesis of chronic apical periodontitis and periapical cysts.

Regulatory mechanisms of periodontal regeneration

The periodontal ligament, located between the cementum and the alveolar bone, has a width ranging from 0.15 to 0.38 mm. Regeneration and homeostasis of the periodontal ligament are highly significant functions in relation to periodontal therapy, tooth transplantation or replantation, and orthodontic tooth movement. The purpose of this review is to discuss the regulatory mechanisms of regenerative and homeostatic functions in the periodontal ligament based on currently published studies and also on our own experimental data. We consider the capability of the ligament tissue to promote or to suppress calcification in connection with bone and cementum formation and the maintenance of the periodontal ligament space. Also discussed are the involvement of the periodontal ligament tissue in the regenerative ability, cell proliferation, growth and differentiation factors, extracellular matrix proteins, homeostatic phenomena, function of Malassez epithelial rests, tooth movement, or occlusal loading. Regulatory mechanisms for regeneration and homeostasis of the periodontal ligament are hypothetically proposed.

Detection of epidermal growth factor receptor in inflammatory periapical lesions

Epithelial cell proliferation is often observed in periapical lesions of endodontic origin. The mechanisms which stimulate the epithelial cell rests of Malassez to proliferate are not understood fully. Fifteen inflammatory periapical lesions (10 granulomas and five cysts) obtained from periapical surgery and six additional periapical lesions (four granulomas and two cysts) collected from extracted teeth were examined using immunohistochemical staining and 125I-EGF (epidermal growth factor) binding assay to detect the presence of epidermal growth factor receptor. The results indicated that the periapical lesions without epithelial cell proliferation had a weak immunoperoxidase staining or low specific binding of 125I-EGF. In contrast, the periapical lesions with epithelial cell proliferation and cyst formation exhibited a strong immunoperoxidase staining in the epithelial cells or high specific binding of 125I-EGF.

Expression of epidermal growth factor receptors by odontogenic jaw cysts

The expression of epidermal growth factor receptor (EGFr) by odontogenic epithelium was studied in odontogenic cysts (n = 35), ameloblastoma (n = 6), and periapical granulomas containing proliferating epithelial rests of Malassez (n = 7) using a panel of monoclonal antibodies to EGFr (clone E30, F4 and C11) known to react with formalin-fixed, paraffin-embedded sections. Odontogenic epithelium in all specimens demonstrated immunoreactivity with all three antibodies. Clone E30 consistently gave the most intense, membrane located staining pattern of the three antibodies tested. Generally, staining of epithelial cells progressively diminished with movement away from the basal cell layers toward the most superficial layers of cystic lining or centre of epithelial rests and tumour islands. Developmental odontogenic cysts (odontogenic keratocysts, n = 13; dentigerous cysts, n = 11) and ameloblastoma (follicular type, n = 5; unicystic type, n = 1) expressed a higher level of EGFr staining than inflammatory cysts (radicular cysts, n = 11) and the proliferating epithelial rests in periapical granulomas. However, foci of weak EGFr staining of odontogenic keratocyst lining, similar to that seen in radicular cysts, were found in areas associated with inflammation. In addition, epithelial rests not associated with inflammatory cell infiltrates exhibited stronger reactivity for EGFr than proliferating rests within periapical granulomas. These results indicate that the level of EGFr expression by odontogenic cysts and rests is related to the presence of inflammation within adjacent connective tissue and that there is no detectable difference in receptor expression between developmental cysts and ameloblastoma.

Long-term cultivation of canine keratinocytes

The growth characteristics and morphology of canine keratinocytes grown in vitro were studied. Keratinocytes from canine oral mucosa, ear skin, and ventral abdominal skin were grown in culture either as explants or as dispase/trypsin-derived suspensions in the absence of a feeder cell layer. Cholera toxin and epidermal growth factor were essential to the successful long-term growth and propagation of the cells during multiple passages. Keratinocytes from all tissue sources, either as primary cultures or subcultivated for up to 10 passages, had growth characteristic and morphology similar to that reported in other species. The use of cultured canine keratinocytes should provide a suitable model for comparative in vitro studies of the pathogenesis of dermatologic diseases.