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Fukaya S, Kanzaki H, Miyamoto Y, Yamaguchi Y, Nakamura Y. Possible alternative treatment for mandibular asymmetry by local unilateral IGF-1 injection into the mandibular condylar cavity: Experimental study in mice. Am J Orthod Dentofacial Orthop 2017; 152:820-829. [PMID: 29173861 DOI: 10.1016/j.ajodo.2017.05.023] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2016] [Revised: 05/01/2017] [Accepted: 05/01/2017] [Indexed: 11/29/2022]
Abstract
INTRODUCTION The purpose of this study was to investigate whether a local unilateral IGF-1 injection into the mandibular condylar cavity can induce unilateral endochondral mandibular growth without any systemic adverse effects. METHODS Seventy-five 3-week-old male Jcl:ICR mice were used in this study. The mice were divided into 2 groups: control group (n = 22) and IGF-1 group (n = 53). In the IGF-1 group, human IGF-1 was injected into the right mandibular condylar cavity, and phosphate-buffered saline solution was injected into the left cavity, 3 times per week for 10 weeks. RESULTS There was no significant difference in body weight, serum human IGF-1 concentration, and soft tissue thickness of the cheeks including the masseter muscles between the 2 groups. Unilateral IGF-1 injection induced a lateral shift of the mandible to the contralateral side, and microcomputed tomogtraphy analysis showed that unilateral IGF-1 injection induced endochondral growth in the condyle. Col2, Ihh, and Runx2 were extensively upregulated by the local unilateral IGF-1 injection in real-time reverse transcription polymerase chain reaction analysis. Proliferation marker KI67, IGF-1 signaling molecule AKT1, and chondrogenic differentiation marker Col2 were strongly expressed in the IGF-1 injected condyle by immunohistochemistry. Vital labeling showed that the distance between the labels was increased in the IGF-1 injection group compared with that of the control group. CONCLUSIONS The results verified in this study indicated that local unilateral IGF-1 injection into the mandibular condylar cavity successfully induced unilateral endochondral mandibular growth in mice without any systemic adverse effects. Thus, local unilateral IGF-1 injection into the mandibular condylar cavity could be a useful alternative for mandibular asymmetry therapy during the growth period. However, additional experimental and clinical studies will be necessary to prove the real effect of this new therapy.
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Affiliation(s)
- Sari Fukaya
- Department of Orthodontics, School of Dental Medicin, Tsurumi University, Yokohama, Japan
| | - Hiroyuki Kanzaki
- Department of Orthodontics, School of Dental Medicin, Tsurumi University, Yokohama, Japan
| | - Yutaka Miyamoto
- Department of Orthodontics, School of Dental Medicin, Tsurumi University, Yokohama, Japan
| | - Yuki Yamaguchi
- Department of Orthodontics, School of Dental Medicin, Tsurumi University, Yokohama, Japan
| | - Yoshiki Nakamura
- Department of Orthodontics, School of Dental Medicin, Tsurumi University, Yokohama, Japan.
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Miyamoto Y, Kanzaki H, Wada S, Tsuruoka S, Itohiya K, Kumagai K, Hamada Y, Nakamura Y. Asporin stably expressed in the surface layer of mandibular condylar cartilage and augmented in the deeper layer with age. Bone Rep 2017; 7:41-50. [PMID: 28875156 PMCID: PMC5574816 DOI: 10.1016/j.bonr.2017.07.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2017] [Revised: 06/30/2017] [Accepted: 07/20/2017] [Indexed: 12/29/2022] Open
Abstract
Mandibular condylar cartilage (MCC) exhibits dual roles both articular cartilage and growth center. Of many growth factors, TGF-β has been implicated in the growth of articular cartilage including MCC. Recently, Asporin, decoy to TGF-β, was discovered and it blocks TGF-β signaling. Asporin is expressed in a variety of tissues including osteoarthritic articular cartilage, though there was no report of Asporin expression in MCC. In the present study, we investigated the temporal and spatial expression of Asporin in MCC. Gene expression profile of MCC and epiphyseal cartilage in tibia of 5 weeks old ICR mice were firstly compared with microarray analysis using the laser capture microdissected samples. Variance of gene expression was further confirmed by real-time RT-PCR and immunohistochemical staining at 1,3,10, and 20 weeks old. TGF-β and its signaling molecule, phosphorylated Smad-2/3 (p-Smad2/3), were also examined by immunohistochemical staining. Microarray analysis revealed that Asporin was highly expressed in MCC. Real-time RT-PCR analysis confirmed that the fibrous layer of MCC exhibited stable higher Asporin expression at any time points as compared to epiphyseal cartilage. This was also observed in immunohistochemical staining. Deeper layer in MCC augmented Asporin expression with age. Whereas, TGF-β was stably highly observed in the layer. The fibrous layer of MCC exhibited weak staining of p-Smad2/3, though the proliferating layer of MCC was strongly stained as compared to epiphyseal cartilage of tibia at early time point. Consistent with the increase of Asporin expression in the deeper layer of MCC, the intensity of p-Smad-2/3 staining was decreased with age. In conclusion, we discovered that Asporin was stably expressed at the fibrous layer of MCC, which makes it possible to manage both articular cartilage and growth center at the same time. Asporin gene and protein were highly expressed in mandibular condylar cartilage as compared to tibial epiphyseal cartilage. Asporin in mandibular condylar cartilage was augmented with age. TGF-β signaling is suppressed by augmented Asporin and decreased TGF-β production in mandibular condylar cartilage.
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Affiliation(s)
- Yutaka Miyamoto
- Department of orthodontics, School of Dental Medicine, Tsurumi University, 2-1-3 Tsurumi, Tsurumi-ku, Yokohama 230-8501, Kanagawa Pref., Japan
| | - Hiroyuki Kanzaki
- Department of orthodontics, School of Dental Medicine, Tsurumi University, 2-1-3 Tsurumi, Tsurumi-ku, Yokohama 230-8501, Kanagawa Pref., Japan
| | - Satoshi Wada
- Department of orthodontics, School of Dental Medicine, Tsurumi University, 2-1-3 Tsurumi, Tsurumi-ku, Yokohama 230-8501, Kanagawa Pref., Japan
| | - Sari Tsuruoka
- Department of orthodontics, School of Dental Medicine, Tsurumi University, 2-1-3 Tsurumi, Tsurumi-ku, Yokohama 230-8501, Kanagawa Pref., Japan
| | - Kanako Itohiya
- Department of orthodontics, School of Dental Medicine, Tsurumi University, 2-1-3 Tsurumi, Tsurumi-ku, Yokohama 230-8501, Kanagawa Pref., Japan
| | - Kenichi Kumagai
- Department of Oral and Maxillofacial Surgery, School of Dental Medicine, Tsurumi University, 2-1-3 Tsurumi, Tsurumi-ku, Yokohama 230-8501, Kanagawa Pref., Japan
| | - Yoshiki Hamada
- Department of Oral and Maxillofacial Surgery, School of Dental Medicine, Tsurumi University, 2-1-3 Tsurumi, Tsurumi-ku, Yokohama 230-8501, Kanagawa Pref., Japan
| | - Yoshiki Nakamura
- Department of orthodontics, School of Dental Medicine, Tsurumi University, 2-1-3 Tsurumi, Tsurumi-ku, Yokohama 230-8501, Kanagawa Pref., Japan
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Narimiya T, Wada S, Kanzaki H, Ishikawa M, Tsuge A, Yamaguchi Y, Nakamura Y. Orthodontic tensile strain induces angiogenesis via type IV collagen degradation by matrix metalloproteinase-12. J Periodontal Res 2017; 52:842-852. [PMID: 28393366 DOI: 10.1111/jre.12453] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/14/2017] [Indexed: 12/30/2022]
Abstract
BACKGROUND AND OBJECTIVE During orthodontic tooth movement (OTM), periodontal ligament (PDL) is remodeled dynamically, which requires sufficient blood supply for the regeneration of PDL. However, little is known about the remodeling of blood vessels during OTM. In this study, we hypothesized that the orthodontic tensile strain upregulates matrix metalloproteinase-12 (MMP-12) expression in the tension zone and induces angiogenesis via degradation of type IV collagen (Col-IV) in vascular endothelial basement membrane during the early stage of OTM. MATERIAL AND METHODS Temporal and spatial MMP-12 expression in the tension zone of PDL, during the early stage of OTM, were examined by immunohistochemistry in rats. Continuous tensile strain was applied to cultured human immortalized PDL cell lines (HPL cells) and MMP-12 expression was examined in vitro. Colocalization of MMP-12 and Col-IV in vivo were examined by immunohistochemistry. To investigate whether MMP-12 produced by HPL cells could degrade Col-IV, recombinant Col-IV was incubated in the culture supernatants of HPL cells. Intact Col-IV in vitro was also examined by western blot analysis. Finally, the changes in blood vessels in the PDL were examined by micro-computed tomography analysis with perfused contrast agents and by conventional histological analysis. RESULTS Orthodontic tensile strain induced MMP-12 expression in PDL cells in vivo and in vitro. Immunohistochemistry revealed that MMP-12-positive cells were observed adjacent to the Col-IV-positive tubular area in the tension zone of PDL. MMP-12 in culture supernatant of HPL cells degraded recombinant Col-IV, and specific MMP-12 inhibitor blocked the Col-IV degradation. Micro-computed tomography analysis and conventional histological analysis demonstrated that the areas of blood vessels were increased in the tension zone of the PDL after OTM. CONCLUSION We discovered that the orthodontic tensile strain upregulates MMP-12 expression in the tension zone of PDL and induces angiogenesis via degradation of Col-IV in the vascular endothelial basement membrane.
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Affiliation(s)
- T Narimiya
- Department of Orthodontics, School of Dental Medicine, Tsurumi University, Yokohama, Kanagawa, Japan
| | - S Wada
- Department of Orthodontics, School of Dental Medicine, Tsurumi University, Yokohama, Kanagawa, Japan
| | - H Kanzaki
- Department of Orthodontics, School of Dental Medicine, Tsurumi University, Yokohama, Kanagawa, Japan
| | - M Ishikawa
- Department of Orthodontics, School of Dental Medicine, Tsurumi University, Yokohama, Kanagawa, Japan
| | - A Tsuge
- Department of Orthodontics, School of Dental Medicine, Tsurumi University, Yokohama, Kanagawa, Japan
| | - Y Yamaguchi
- Department of Orthodontics, School of Dental Medicine, Tsurumi University, Yokohama, Kanagawa, Japan
| | - Y Nakamura
- Department of Orthodontics, School of Dental Medicine, Tsurumi University, Yokohama, Kanagawa, Japan
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Thennavan A, Sharma M, Chandrashekar C, Hunter K, Radhakrishnan R. Exploring the potential of laser capture microdissection technology in integrated oral biosciences. Oral Dis 2016; 23:737-748. [DOI: 10.1111/odi.12578] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2016] [Revised: 08/10/2016] [Accepted: 08/24/2016] [Indexed: 12/19/2022]
Affiliation(s)
- A Thennavan
- Department of Oral Pathology; Manipal College of Dental Sciences; Manipal Karnataka India
| | - M Sharma
- Pacific Academy of Higher Education and Research (PAHER) University; Udaipur Rajasthan India
- Department of Oral Pathology; ITS Dental College; Hospital and Research Center; Greater Noida India
| | - C Chandrashekar
- Department of Oral Pathology; Manipal College of Dental Sciences; Manipal Karnataka India
| | - K Hunter
- School of Clinical Dentistry; The University of Sheffield; Sheffield UK
| | - R Radhakrishnan
- Department of Oral Pathology; Manipal College of Dental Sciences; Manipal Karnataka India
- School of Clinical Dentistry; The University of Sheffield; Sheffield UK
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Tsuge A, Noda K, Nakamura Y. Early tissue reaction in the tension zone of PDL during orthodontic tooth movement. Arch Oral Biol 2016; 65:17-25. [PMID: 26828679 DOI: 10.1016/j.archoralbio.2016.01.007] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2015] [Revised: 11/09/2015] [Accepted: 01/16/2016] [Indexed: 11/16/2022]
Abstract
OBJECTIVE The aim of the study was to examine the early tissue reaction in the tension zone of periodontal ligament (PDL) during orthodontic tooth movement. DESIGN Upper first molars of rats were moved buccally with fixed appliances. The PDL in the tension zone was examined histologically, immunohistochemically and at a molecular level after 24h, 3 days and 7 days. RESULTS After 24h of orthodontic force loading, the periodontal space appeared considerably expanded. The periodontal fibers were stretched between the bone and the root. Three days after loading, the expanded periodontal space had slightly narrowed, the periodontal fiber arrangement was relaxed, and the blood vessels did not appear elongated. A considerable layer of osteoid was formed on the bone surface. The total cross-sectional areas of the PDL in experimental groups were significantly larger than control group. The total cross-sectional areas of the blood vessels were not significantly different among the groups. Significantly high expressions of IL-1β and PTX3 were characteristically observed not only in the endothelial cells and cells around the blood vessel, but also in fibroblasts throughout the PDL of the tension zone 24h after orthodontic force loading. Three and 7 days after loading, these showed tendencies to return to control levels. CONCLUSIONS The present results suggest that the early reaction in the tension zone of the PDL during tooth movement consists of two phases: first, inflammation and second, rapid recovery and renovation of the PDL with bone formation.
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Affiliation(s)
- A Tsuge
- Department of Orthodontics, Tsurumi University School of Dental Medicine, Japan.
| | - K Noda
- Department of Orthodontics, Tsurumi University School of Dental Medicine, Japan
| | - Y Nakamura
- Department of Orthodontics, Tsurumi University School of Dental Medicine, Japan
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Mori Y, Chung UI, Tanaka S, Saito T. Determination of differential gene expression profiles in superficial and deeper zones of mature rat articular cartilage using RNA sequencing of laser microdissected tissue specimens. Biomed Res 2015; 35:263-70. [PMID: 25152035 DOI: 10.2220/biomedres.35.263] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Superficial zone (SFZ) cells, which are morphologically and functionally distinct from chondrocytes in deeper zones, play important roles in the maintenance of articular cartilage. Here, we established an easy and reliable method for performance of laser microdissection (LMD) on cryosections of mature rat articular cartilage using an adhesive membrane. We further examined gene expression profiles in the SFZ and the deeper zones of articular cartilage by performing RNA sequencing (RNA-seq). We validated sample collection methods, RNA amplification and the RNA-seq data using real-time RT-PCR. The combined data provide comprehensive information regarding genes specifically expressed in the SFZ or deeper zones, as well as a useful protocol for expression analysis of microsamples of hard tissues.
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Affiliation(s)
- Yoshifumi Mori
- Sensory & Motor System Medicine, Faculty of Medicine, University of Tokyo
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Abstract
OBJECTIVE The aim of this study was to determine the impact of standard methods for processing decalcified highly mineralized tissues on RNA yield and quality from microdissected samples. DESIGN Rat mandibles were fixed with either formalin-based or ethanol-based fixatives, decalcified in 20% ethylenediaminetetraacetic acid solution for 15 days, and embedded in paraffin. Transversal sections of the molars were mounted on membrane glass slides for laser capture microdissection. Unfixed frozen liver samples were used as controls to determine the impact of fixatives, decalcification and paraffin embedding on RNA integrity and recovery after sample preparation, and laser microdissection. Total RNA was obtained from periodontal ligament and fresh-frozen liver; RNA quality was assessed by Bioanalyzer, and 5 ng of total RNA was used for cDNA synthesis followed by gene expression analyses by polymerase chain reaction using 3 sets of primers for glyceraldehyde 3-phosphate dehydrogenase. RESULTS Data analysis demonstrated that all fixed samples presented some level of RNA fragmentation as compared with fresh-frozen samples (P<0.05). Samples fixed with Protocol (10% formalin) showed the least RNA fragmentation as compared with other fixatives (P<0.05), and biologically useful RNA was extracted even from microdissected samples with a minimum RNA Integrity Number of 1.5. Moreover, RNA fragments up to 396 bp were assayable by reverse transcriptase-polymerase chain reaction, although short-targeted fragments as 74 bp were more consistently amplified. CONCLUSIONS Although variable levels of RNA fragmentation should be expected, gene expression analysis can be performed from decalcified paraffin-embedded microdissected samples, with the best results obtained for short-targeted fragments around 70 bp.
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Sun JX, Horst OV, Bumgarner R, Lakely B, Somerman MJ, Zhang H. Laser capture microdissection enables cellular and molecular studies of tooth root development. Int J Oral Sci 2012; 4:7-13. [PMID: 22422086 PMCID: PMC3412663 DOI: 10.1038/ijos.2012.15] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Epithelial-mesenchymal interactions (EMIs) are critical for tooth development. Molecular mechanisms mediating these interactions in root formation is not well understood. Laser capture microdissection (LCM) and subsequent microarray analyses enable large scale in situ molecular and cellular studies of root formation but to date have been hindered by technical challenges of gaining intact histological sections of non-decalcified mineralized teeth or jaws with well-preserved RNA. Here,we describe a new method to overcome this obstacle that permits LCM of dental epithelia,adjacent mesenchyme,odontoblasts and cementoblasts from mouse incisors and molars during root development. Using this method,we obtained RNA samples of high quality and successfully performed microarray analyses. Robust differences in gene expression,as well as genes not previously associated with root formation,were identified. Comparison of gene expression data from microarray with real-time reverse transcriptase polymerase chain reaction (RT-PCR) supported our findings. These genes include known markers of dental epithelia,mesenchyme,cementoblasts and odontoblasts,as well as novel genes such as those in the fibulin family. In conclusion,our new approach in tissue preparation enables LCM collection of intact cells with well-preserved RNA allowing subsequent gene expression analyses using microarray and RT-PCR to define key regulators of tooth root development.
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Nomura Y, Ishikawa M, Yashiro Y, Sanggarnjanavanich S, Yamaguchi T, Arai C, Noda K, Takano Y, Nakamura Y, Hanada N. Human periodontal ligament fibroblasts are the optimal cell source for induced pluripotent stem cells. Histochem Cell Biol 2012; 137:719-32. [DOI: 10.1007/s00418-012-0923-6] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/21/2012] [Indexed: 12/20/2022]
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Choi JW, Arai C, Ishikawa M, Shimoda S, Nakamura Y. Fiber system degradation, and periostin and connective tissue growth factor level reduction, in the periodontal ligament of teeth in the absence of masticatory load. J Periodontal Res 2011; 46:513-21. [PMID: 21762408 DOI: 10.1111/j.1600-0765.2011.01351.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND AND OBJECTIVE The periodontal ligament (PDL), which is interposed between the alveolar bone and roots, supports teeth against mechanical stress. Periostin and connective tissue growth factor (CTGF) might play essential roles in maintaining PDL fiber integrity under mechanical stress. However, this relationship has not been studied at the protein and gene levels. Therefore, the aim of this study was to assess the PDL fiber system without masticatory load to determine the structural changes in the PDL in the absence of mechanical stress. MATERIAL AND METHODS The study included 45 Wistar male rats (12 wk of age) whose upper-right first molars were relieved from occlusion for 24 h, 72 h, 7 d or 21 d. The PDL was examined histologically, and changes in the gene and protein levels of periostin and CTGF were investigated. RESULTS The PDL space width was reduced significantly. Histologically, an initial reduction in the fiber number and thinning of PDL fibers were observed, followed by disarrangement of the PDL fibers and their attachments to the alveolar bone; finally, the PDL fibers lost their meshwork structure. Real-time RT-PCR results revealed sharp down-regulation of the periostin and CTGF mRNA levels at 24 and 72 h, respectively, which continued throughout the experiment. Immunohistochemical analysis revealed that periostin localized to both the cellular elements and the extracellular matrix, whereas CTGF localized only to the cellular elements. Periostin and CTGF immunoreactivities became very weak without masticatory load. CONCLUSION In the absence of mechanical stress, the PDL fiber system undergoes degradation concomitantly with a reduction in the periostin and CTGF levels in the PDL.
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Affiliation(s)
- J W Choi
- Department of Oral Anatomy I, School of Dental Medicine, Tsurumi University, Tsurumi-ku, Yokohama, Japan.
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Abstract
Laser capture microdissection (LCM) allows for the microscopic procurement of specific cell types from tissue sections that can then be used for gene expression analysis. According to the recent development of the LCM technologies and methodologies, the LCM has been used in various kinds of tissue specimens in dental research. For example, the real-time polymerase-chain reaction (PCR) can be performed from the formaldehyde-fixed, paraffin-embedded, and immunostained sections. Thus, the advance of immuno-LCM method allows us to improve the validity of molecular biological analysis and to get more accurate diagnosis in pathological field in contrast to conventional LCM. This paper is focused on the presentation and discussion of the existing literature that covers the fields of RNA analysis following LCM in dentistry.
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HSPA1A is upregulated in periodontal ligament at early stage of tooth movement in rats. Histochem Cell Biol 2010; 134:337-43. [DOI: 10.1007/s00418-010-0737-3] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/17/2010] [Indexed: 01/11/2023]
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Oikawa T, Nomura Y, Arai C, Noda K, Hanada N, Nakamura Y. Mechanism of active eruption of molars in adolescent rats. Eur J Orthod 2010; 33:221-7. [PMID: 20651045 DOI: 10.1093/ejo/cjq053] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
The mechanism of active eruption of molars was examined in 36 male adolescent Wistar rats. Histological, histochemical [tetracycline (TC) labelling and alkaline phosphatase (ALP) activity], and immunohistochemical [transforming growth factor (TGF)-β1, -β2, and -β3] investigations were conducted of the rat molar areas. Real-time reverse transcription-polymerase chain reaction (RT-PCR) for mRNA of TGF-β was performed on the periodontal ligament (PDL) dissected out by laser capture microdissection. TC labelling lines showed that a considerable amount of bone formation occurred in the alveolar crest region, apical region, and intraradicular septum, indicating that the maxillary molars had moved downward. However, the periodontal fibres revealed a regular arrangement (alveolar crest, horizontal and oblique fibres) during the experimental period. This suggests that new formation of alveolar crest fibres and rearrangement of the periodontal fibres occurred in the PDL. ALP activity was intense on the bone surface and in the PDL. TGF-β1 was also detected in osteoblasts and fibroblasts but less so in cementoblasts. Real-time RT-PCR also demonstrated significant expression of mRNA of TGF-β1 in the PDL, indicating that TGF-β1 was involved in active eruption. These results suggest that active eruption occurs in adolescent rats and can be managed by TGF-β1.
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Affiliation(s)
- Takashi Oikawa
- Department of Orthodontics, School of Dental Medicine, Tsurumi University, Yokohama, Japan.
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