Movement and Forces in Tooth Eruption

Relationship Between the Number of Rat Littermates per Dam and Mandibular Incisor Growth

The relationship between the number of littermates per dam and tooth growth of the mandibular incisor taken out of occlusion by experimental shortening was investigated. The variation in eruptive growth was statistically significant.

Effect of interrupted eruption on the enamel organ of the rat incisor

The aim of this study was to investigate the behavior of rat incisor tissues during the inhibition of tooth eruption. Twenty Sprague-Dawley rats were used in this study, and incisor eruption was inhibited by a screw pin. Animals were sacrificed 1, 3, 7 and 14 days after the start of the experiment. Cross-sections at the mesial point of the mandibular first molar and sagittal sections of the mandibular tooth germ area were examined using immunohistochemical and immunofluorescence methods. For morphometric analysis, numbers of TRAP-positive cells were calculated against the total number of cells. In cross-sections from the experimental group, dentin was thickened and pulp tissue was constricted day by day. On days 1, 3 and 7, nestin-positive cells were observed in all odontoblast cell bodies and processes, while on day 14 fewer nestin-positive cells were seen than in the control group. On day 14, the mesial area of the periodontal ligament was constricted and the number of TRAP-positive cells in the mesial area was significantly higher than in the control group. In sagittal sections, enamel formation was found to be increased on days 7 and 14. Furthermore, in the enamel matrix amelogenin was expressed more strongly than in the control group. PCNA-positive cells were significantly increased in cells of the tooth germ compared with the control group. These results suggest that inhibition of tooth eruption accelerates the apical elongation with resorption of the mesial area of the alveolar bone and stimulates cell proliferation with thickened enamel towards the apical end.

Elastic system fibers in rat incisor periodontal ligament--immunohistochemical study using sections of fresh-frozen un-demineralized tissues

The aim of this study was to examine the localization and distribution of the components of elastic system fibers in the periodontal ligament of continuously erupting rat incisors in an effort to understand the mechanism of the eruption of the tooth. Sections of fresh-frozen, un-demineralized incisors of the rat mandible were prepared for immunohistochemical localization of elastin, fibrillin-2 and microfibril-associated glycoprotein-1 (MAGP-1). The structure of the periodontal ligament was well preserved in sections of fresh-frozen tissues. At the basal region of the ligament, intense immunolabelling for fibrillin-2 and MAGP-1 was observed as dot-like structures (transversely sectioned fibers) mainly on the tooth side of the ligament close to the cementum. These dot-like structures gradually increased in number towards the incisal area and were distributed throughout the tooth side of the ligament. This pattern of distribution was the same as that of reported oxytalan fibers. Elastin-immunopositive fibers were also detected in the ligament, although the labelling was limited and distribution was sparse. In conclusion, both fibrillin-2 and MAGP-1 immunopositive fibers may serve as a scaffold for deposition of tropoelastin during elastogenesis in the periodontal ligament. They may also provide guidance for the migration of fibroblasts to the occlusive side, which generates contractile forces for the movement of the tooth for continuous eruption of incisors.

Immunohistochemical detection of matrix metalloproteinase-1 in the periodontal ligament of equine cheek teeth

The hypsodont equine cheek tooth erupts continuously throughout life. The collagen fibers of the periodontal ligament (PDL) have to remodel constantly to allow the tooth to move in an occlusal direction. Remodeling of the collagen fiber bundles needs to be well-coordinated in order to maintain functional tooth support. The aim of this study was to examine the role of matrix metalloproteinase-1 (MMP-1) in the collagen remodeling of the equine PDL under physiological conditions. Specimens containing the PDL interposed between the dental cementum and the alveolar bone were taken from nine Warmblood horses at three designated horizontal levels: subgingival, middle, and apical. The expression of MMP-1 was detected immunohistochemically. MMP-1 was found to be present in the specimens of all horses. Immunopositive fibroblasts/fibrocytes were accumulated within individual single collagen fascicles. Our results suggest that MMP-1 induced collagen degradation plays a central role in the physiological remodeling of the equine PDL. The distribution of MMP-1 positive fascicles indicates well-directed remodeling which occurs as an asynchronous process, so that only single collagen fascicles are remodeled at the same time. Due to this remodeling of one fascicle at a time, the overall anchorage of the tooth is preserved at all times.

Relationship between the tooth eruption and regional blood flow in angiotensin II-induced hypertensive rats

OBJECTIVE

The mechanism of action of vasoactive drugs on tooth movement is unknown. The purpose of the present study was to measure simultaneously the axial movement of the mandibular incisor, regional blood flow at the base of the incisor, and systemic arterial blood pressure in angiotensin II-induced hypertensive rats to determine the possible cause of tooth displacement.

DESIGN

The measurements were made under artificial respiration with halothane anaesthesia. In the experimental animals, 2.5 microg of angiotensin II in 1 ml of Ringer's solution was infused at 0.83 ml/h for 12 h from the femoral vein. In the control animals, only Ringer's solution was infused.

RESULTS

Angiotensin II caused an increase of the mean arterial blood pressure from 86 to 119 mm Hg, and decreases of the eruption rate from 667 to 494 microm/24 h and the regional blood flow from 262 to 214 mV. There was a positive correlation between the eruption rate and regional blood flow, and a negative correlation between the blood pressure and regional blood flow.

CONCLUSION

These results suggest that angiotensin II caused constriction of the peripheral vascular smooth muscle resulting in an increase of arterial blood pressure and a decrease of regional blood flow, followed by a decrease of fluid volume and then a reduction of either the pressure within the socket or of the eruptive force. We assume that the regional vascular pressure within the socket plays an important role in determining the position of the rat incisor.

The effects of intrusive loading on axial movements of impeded and unimpeded rat incisors: estimation of eruptive force

Axial movements of impeded and unimpeded rat mandibular incisors were measured following application and removal of intrusive loads of 1, 2, 5, 10 and 20 mN in a stepwise order at intervals of 1h on erupting teeth. The tooth movements were recorded by a displacement detector under artificial respiration with halothane anaesthesia. The loading and unloading procedures brought about the tooth movements in two steps: an initial rapid movement immediately after application or removal of the load and a subsequent slow and gradual movement. The initial rapid intrusive or extrusive tooth movements were significantly greater in the unimpeded than in the impeded teeth at the same load. The forces to stop extrusive tooth movements, estimated from the formula of regression lines showing correlations between the intrusive loads from 0 to 5 mN and tooth movements (microm/30 min), were 4.2 mN in the impeded and 2.9 mN in the unimpeded incisors. We suggest that repeated shortenings of the rat incisor did not cause an increase in the eruptive force and that changes in the resistance of the periodontal ligament predominantly regulate the axial movement of the rat incisor.

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.

A comparison between a conventional optical method and image-analysis for measuring the unimpeded eruption rate of the rat mandibular incisor

The impeded/unimpeded eruption rates of the rat incisor have been much studied. The most commonly used optical microscopic method, which has inherent weaknesses, was compared here with an image-analysis method to measure the eruption rate of the mandibular incisor. The study also evaluated the incisal edge as a reference point for the measurement of the unimpeded eruption rate, and the frequency of shortening the mandibular incisor. The image-analysis method was found to be a simple and reliable technique that could replace the optical method. There was no significant difference between the data from the two methods; their kappa coefficients were similar at the 0.99 level. It was concluded that shortening the incisor in the measurement of the unimpeded eruption rate should be done at least every 48 h, and that the incisal edge of the shortened incisor can be used as the reference point for that measurement.

Biomechanical behaviour of bovine temporomandibular articular discs with age

The purpose was to evaluate age-associated changes in the creep and restoration properties of bovine temporomandibular joint (TMJ) discs under and after sustained tensile stress. Forty discs were obtained from 7- and 10-year-old cattle, referred to as the adult and mature adult groups, respectively. Tension of 1.0 MPa was applied and sustained for 20 min to specimens from ten right discs and of 1.5 MPa to specimens from ten left discs. After the period of tension for the study of creep, the specimens were removed from the tension devices and their restoration observed for 20 min. For comparative purposes the relevant results for a young adult group were recruited from data on 3-year-old bovine TMJ discs reported in a previous study on viscoelastic properties. In all the specimens the time-dependent creep curves showed a marked change in strain during the initial 5 s, but the elastic moduli at the onset of stress were significantly larger in the mature adult group than in the other groups. After 20-min creep, the strains were decreased in relation to the age of the specimen and were significantly smaller in the mature adult than in the young adult. With regard to regional differences, the medial specimens exhibited significantly smaller strains than the central ones in all three age groups. Furthermore, the residual strains after 20-min restoration also decreased slightly with age. It is concluded that the bovine TMJ disc becomes stiff and acquires the capacity to recover from continuous deformation during growth and maturation. These findings suggest that the TMJ disc can modify its viscoelasticity in order to withstand extrinsic functional stresses.

A histological study of root-resected and root-transected rat incisors when eruption ceases, shortly before they are exfoliated from the socket

Resection of the odontogenic region or root transection of normal (impeded) rat lower incisors showed that eruption ceased from 1 to 13 weeks when the base of the resected teeth (87.5%) or of the distal segment of the transected ones (86%) reached the alveolar-crest region. When the operated teeth reached the crestal region, the enamel-related periodontal tissues were absent and the periodontal ligament (PDL) was the only periodontal tissue that remained. The PDL of the crestal region may be considered as mature PDL, showing a length of approx. 5-6 6 mm at the mesial face of the tooth, 4-5 mm at lingual face and 1 mm at distal face; from these limits towards the apical end of the socket the PDL becomes gradually immature. The mature PDL seems not to have a role in the process of tooth eruption. Several factors can be suggested to explain the more frequent retention, at the crestal region of the socket, of impeded rather than unimpeded incisors submitted to the same procedures. The connective tissue that develops between the base of the tooth and the bone that fills the alveolus may have more time to organize itself in impeded than in unimpeded teeth, which erupt at a faster rate; this tissue could support and retain the impeded operated teeth longer than the unimpeded ones. The decrease in the mechanical properties of the PDL in the unimpeded condition may ease the traumatic effects and lead to exfoliation. Eruption might be stopped by the increase in occlusal forces, per unit area of root surface, as the root becomes shorter; this effect is likely to be greater in impeded than unimpeded teeth.

Changes in the shape and orientation of periodontal ligament fibroblasts in the continuously erupting rat incisor following removal of the occlusal load

One of the main theories which attempts to explain the phenomenon of tooth eruption suggests that periodontal ligament (PDL) fibroblasts move actively and pull the tooth with them out of its socket. To find further support for this theory, we determined the changes in the shape and orientation of PDL fibroblasts induced by a transition from impeded to unimpeded eruption. We measured nuclear area, elongation (length-to-width ratio), and orientation (angulation in relation to the eruption axis) of PDL fibroblasts in impeded (functionally loaded) and unimpeded (hypoloaded) rat incisors. The mean cross-sectional nuclear area did not differ between fibroblasts in the two groups. In contrast, unimpeded eruption resulted in a marked increase in the mean nuclear elongation (from about 2 to 2.56) and a significant increase in the mean nuclear orientation (from 25.6 to 14.0 degrees). Bivariate analysis suggested that these changes occurred in the same cells. Analysis of nuclear elongation and orientation at various distances from the cementum toward the alveolar bone revealed a profile of both parameters, such that cells located 20 to 80 microns away from the cemental surface were more elongated and more frequently oriented toward the eruption axis, while cells at 0 to 20 and 80 to 100 microns were more round/oval and had a greater angulation with the eruption axis. These findings, together with other observations of changes in cell number, number of microtubules, and migration velocity which occur on the shift to unimpeded eruption, support the theory of active movement of PDL fibroblasts as an important component of tooth eruption.

A rationale for a simplified occlusal design in restorative dentistry: historical review and clinical guidelines

An occlusal contact pattern in which the number of occlusal contacts has been substantially reduced as compared with traditional schemes is described. Concepts that may have had a justification in balanced occlusions have been needlessly transferred to anterior disclusion mechanics. No natural dentition presents occlusal contacts as described in many texts and yet stability is established. The temporomandibular joint does present structural changes that should be accounted for when an occlusal anatomy is designed. The force vectors that are active on teeth are not directed along the longitudinal axes of the roots only, and thus occlusal contact locations will not determine the direction of functional forces. The stability of the teeth on the arch depends primarily on the forces of eruption from the periodontium and the balance between the resting pressures of the muscles of the cheeks and the tongue. The mechanics of the stomatognathic system are not as accurate as their counterpart on an articulator. The variability of the guiding surfaces inherent to the temporomandibular joints should be incorporated into an occlusal design. Occlusal contacts that do not fulfill a justifiable purpose may be eliminated, and the number of contacts may be reduced to one per tooth.

Accelerated eruption of rat lower incisor. Relationship between impeded and unimpeded eruption rates, rate of attrition, tooth length, and production of dentin and enamel

The present investigation studies the effects of persistently cutting one lower rat incisor out of occlusion. Within four days, the rate of eruption of the cut (unimpeded) incisor increased to 216% and that of the uncut (impeded) contralateral to 136% of the baseline rate. While the former remained high, the latter decreased gradually to about 90% within three weeks. The rate of attrition of the impeded incisor increased to 233% of the baseline rate within two days, then fell abruptly, and remained at a slightly lower level than the rate of eruption. Accordingly, the length of the erupted part of the impeded incisor decreased initially, but increased gradually after about four days. Measurements made on SEM micrographs of the series of transverse tooth segments obtained when cutting the incisor out of occlusion, showed that growth-related increase in mesiodistal tooth width was arrested from the 10th segment, dentin thickness decreased gradually to about 50% in the 12th segment, and enamel thickness, after an initial increase, decreased to about 80% in the 11th segment. The present study provides experimental evidence that accelerated eruption affects morphogenesis and histogenesis of the rat lower incisor. An impeded incisor, especially the contralateral, may not serve as an ideal control.

Granule proteins of the dental follicle and stellate reticulum inhibit tooth eruption and eyelid opening in postnatal rats

Electron-dense granules within cells of the dental follicle and stellate reticulum of rat mandibular molars can be isolated; their major components are 167 and 200 kDa proteins. Injecting these granule proteins into postnatal rats results in a delay of incisor eruption and eyelid separation. These inhibitory effects were most pronounced with the 167 kDa protein (a delay of 3 days in incisor eruption and of 2 days in eyelid opening) and were opposite to the stimulatory effects of epidermal growth factor. Thus, these granules may play an inhibitory part in tooth eruption.

Relationship between enamel formation and eruption rate in rat mandibular incisors

The relationship between the formation of dental enamel and tooth eruption was investigated. Rat mandibular incisor eruption rate was accelerated by maintaining incisors out of occlusion. Rate of eruption, enamel thickness, secretory zone length and matrix breakdown were measured. Eruption rate increased by 120% in experimental teeth but enamel secretion increased by only 90%. There were no obvious differences between control and experimental teeth in final enamel thickness or in the molecular weight distribution of the enamel matrix proteins.

The pattern and control of eruptive tooth movements

Assumptions about eruptive tooth movements based on experience with adolescents may not be applicable to all ages. The eruptive process can be subdivided into six phases--three profunctional stages of individual tooth eruption (follicular growth, pre-emergent eruptive spurt, and postemergent eruptive spurt) and three postfunctional stages of the eruption of the entire dentition (juvenile occlusal equilibrium, circumpubertal occlusal eruptive spurt, and adult occlusal equilibrium). Differences in tooth-eruption rates in each of these phases result from variations in systemic and local factors. A series of working hypotheses which incorporate recent research into a theoretical explanation of the control of eruption during each stage is presented. Prior to emergence, the force of eruption may influence the rate of bone resorption and later of gingival remodeling, but the resorptive processes occur independently and are the rate-limiting factors in pre-emergent eruption. After emergence, intermittent occlusal loading disrupts the generative or adaptive mechanisms of the periodontal ligament so that eruption slows. The light continuous forces from resting tongue pressure also are significant influences on tooth eruption during periods of rapid facial growth. Cellular adaptation of the alveolar bone and gingiva plays an important role in the control of tooth eruption in the adult.

Interactions between thyroxine, hydrocortisone and cyclophosphamide in their effects on the eruption of the rat mandibular incisor

The effects on the unimpeded eruption rates of the rat mandibular incisor of daily doses of thyroxine (0.5 mg/kg) and hydrocortisone (12.5 mg/kg) and of a single injection of cyclophosphamide (40 mg/kg), either alone or in combination, were studied over approximately 15 days. Both the thyroxine and hydrocortisone alone produced increases in eruption, whereas a decrease was recorded with cyclophosphamide alone. When thyroxine was combined with hydrocortisone, the increase in eruption rate was greater than that with thyroxine or hydrocortisone alone. When cyclophosphamide was combined with hydrocortisone, there was no difference compared with cyclophosphamide alone. These results obtained with drug combinations are consistent with eruption having a multifactorial basis.

A quantitative comparison of the ultrastructure of the periodontal ligaments of impeded and unimpeded rat incisors

The periodontal ligaments of impeded and unimpeded rat mandibular incisors were examined to find structural correlates for the known functional differences between the tissues. The structures quantified were fibroblasts (area and membrane length, endoplasmic reticulum, mitochondria, microtubules, lysosomes, intracellular collagen profiles, intercellular contacts), oxytalan fibres, collagen fibrils and ground substance. The only changes seen on rendering a tooth unimpeded were an increase in the number of microtubules within the fibroblasts, an increase in the number of simplified desmosomes between the fibroblasts and a decreased amount of ground substance within the extracellular matrix. The results show that it is possible for a connective tissue to undergo marked changes in function, turnover and biomechanical properties without major structural changes.

The adaptation of a two-compartment cell renewal system to external demands. A study of the rat incisor inner enamel epithelium

The inner enamel epithelium (IEE) covers the labial tooth aspect as a one cell layer which, when cut sagittally, appears as a longitudinal cell column extending from the tooth origin toward the periphery. Following sudden tooth shortening, the IEE responds by an increased cell production which later declines below normal values. The perturbation affects all cell kinetic parameters; the progenitor compartment, which initially increases, diminishes in size toward end of the experiment. The cell cycle transition times, which initially decline, rise toward the end of the experiment. The mean normal daily cell production rate of 70 cell % (i.e. 70 cells are produced by 100 progenitors) increases to 111 cell % and then declines to a low of 51 cell %. The IEE response typifies the behavior of other cell renewal systems such as intestinal epithelium and epidermis.

Inner enamel epithelium cell production rates

Crowning of all four rat incisors slows down their eruption rate, leading to a diminution of cell production by the inner enamel epithelium (IEE). The production rate by 100 progenitor cells is dominated as production rate %. The normal IEE in rats weighing 200 g produces daily 67 cells %. In the crowned incisor this rate drops to 15 cells % while during accelerated eruption rate and IEE cell production rate remains unchanged and an eruption of 6-4 mum reflects a production of 1 cell % by the IEE. A method which relates labelled cell displacement along the IEE with its cell production rate is described and its applicability to other cell renewal systems discussed.

The rodent incisor tooth proliferon

The rodent incisor tooth is the site of five cell populations proliferating in harmony: amelocytes, odontocytes, pulp cells, endothelial cells and the periodontal ligament. Their proliferating regions are located in the apex tip, where the various cells originate. Cells displaced from the tooth origin at the apex toward the periphery, mature to perform their specified function. The proliferative events in the tooth are summarized in a conceptual model of the incisor proliferon. The proliferon is an oriented structure with an origin and periphery. It consists of four basic elements: parenchyma, connective tissue, blood vessels and nerve fibres, all interacting continuously. All four are indispensable in the definition of the proliferon.

Eruption rates of human upper third molars

Human maxillary third molars have been observed to have maximum rates of eruption of approximately 1 mm/2 mo. Rates of less than 1 mm/6 mo have also been recorded. Maximum rates of eruption were associated with spacing of the dentition. Passive eruption in the form of gingival recession is an important factor resulting in the exposure of the clinical crown.

Role of attrition and occlusal contact in the physiology of the rat incisor: VIII. Tooth length and occlusal plane as regulating factors of eruption and attrition rates

Occlusal pressure has been recognized as an efficient regulator of eruption rate in rat incisors. An abnormal level of the occlusal plane, as determined by incisor length, exhibits a selective regulatory influence on eruption and attrition rates in an attempt to reestablish normal conditions.

Effect of fluoride on eruption rates of rat incisors

The addition of either 25 or 100 ppm fluoride to the drinking water of Wistar rats produced a banded appearance on the mandibular incisors but had no significant effect on the impeded or unimpeded eruption rates of the incisors.

Role of attrition and occlusal contact in the physiology of the rat incisor. II. Diurnal rhythm in eruption and attrition

Rates of eruption and of attrition were measured on impeded and unimpeded rat incisors at 6 AM and 6 PM. The rhythm of unimpeded eruption and attrition was diurnal. The rates increased during the night, as do rates of other physiologic processes in the nocturnal animal. When eruption was impeded however, this rhythm was reversed by the inhibiting force of occlusal contact.