Fine structural observations on the mechanism of loss of attachment during experimental periodontal disease in the rat

Initial Apical Migration of Junctional Epithelium in Rats Following Application of Lipopolysaccharide and Proteases

BACKGROUND

Apical migration of junctional epithelium (JE) occurs in association with periodontal pocket formation. The aim of this study was to investigate the gingival changes occurring during apical migration of the JE following application of factors associated with inflammatory periodontal disease pathogenesis.

METHODS

Six-week-old male Wistar rats were divided into six groups: three experimental groups to investigate gingival changes following 2, 4, and 8 weeks topical application of lipopolysaccharide (LPS) and proteases and three control groups using pyrogen-free water. After 2, 4 or 8 weeks, nuclear DNA fragmentation was detected in periodontal ligament (PDL) fibroblasts using the terminal deoxynucleotidyl transferase-mediated dUTP-biotin nick end-labeling (TUNEL) method, and proliferative activities of the basal cells and fibroblasts were evaluated through expression of proliferating cell nuclear antigen (PCNA). Collagen destruction was examined histologically.

RESULTS

Gingiva treated with LPS and proteases showed an increase in PCNA-positive basal cells but not the fibroblasts. Collagen destruction was observed at 2 weeks; apical migration of the JE and TUNEL-positive fibroblasts was seen at 4 weeks.

CONCLUSIONS

Following application of LPS and proteases to rat gingival sulci, the apical migration of the JE appears to occur simultaneously with the apoptosis of PDL fibroblasts, which in turn follows proliferation of the basal cells and collagen destruction.

A study of the proliferative activity of the long junctional epithelium using argyrophilic nucleolar organizer region (AgNORs) staining

The proliferative activity of the long junctional epithelium (LJE) in rats was examined using stains for argyrophilic proteins of the nucleolar organizer region (AgNORs protein). The LJE was experimentally produced by insertion of a rubber piece between maxillary molars for 1 wk. After removal of the rubber, the length and AgNORs parameters of the LJE were measured and analyzed statistically. The LJE widely covered the apical side of the exposed root surface 4 wk after the removal. Its length was longest after 4 and 8 wk; it became shorter subsequently. The AgNORs were visible as black dots of various sizes and numbers on the sections. A high potential for proliferation was obvious in the LJE after 4 wk and was maintained until 12 wk after the removal. The AgNORs ratio on the connective tissue interface of the LJE was about twice of that of normal junctional epithelium after 4-12 wk. The proliferative activity on the root surface side was slightly increased after 4 wk. There was no significant difference in proliferative activity between the coronal and apical sides. These results suggest that the proliferative activity of the LJE is maintained continuously at a high level on the connective tissue interface supplying the epithelial cells. Basal cells proliferate at the connective tissue interface of the LJE, migrate directly to the root surface or via the apical portion and finally desquamate from the surface of the epithelium.

Stimulation of human periodontal ligament fibroblast collagenase production by a gingival epithelial cell-derived factor

To examine whether cell-to-cell interactions between human gingival epithelial cells (HGE) and periodontal ligament fibroblasts (PLF) or gingival fibroblasts (GF) take place in the periodontium, the effects on collagenase production by PLF and GF were analyzed after adding several concentrations of HGE-conditioned medium (HGE-CM) to PLF or GF culture. Collagenase production by both cell populations was stimulated by adding HGE-CM, which stimulated collagenase production by PLF to a greater extent than that by GF. The HGE-derived stimulatory factor had a molecular mass of approximately 20 kDa, and its stimulant effect was inhibited markedly in the presence of an anti-human interleukin-1 alpha (IL-1 alpha) neutralizing antibody, indicating that the factor was identical to, or antigenically cross-reactive with, IL-1 alpha. These results suggest that epithelial apical migration in the periodontium may occur after interstitial resident cells have released tissue-degrading enzymes, such as collagenase, and damaged the extracellular matrix, once a sufficient amount of IL-1 alpha-like factor for stimulating the production of proteolytic enzyme has been released by HGE in periodontal lesions.

Immunolocalization of integrin alpha 6 beta 4 in mouse junctional epithelium suggests an anchoring function to both the internal and the external basal lamina

The localization of the integrin alpha 6 beta 4, a transmembrane adhesion molecule associated with hemidesmosomes, was studied in mouse junctional epithelium (JE) by the use of monoclonal antibodies in indirect immunofluorescence microscopy. The results showed that the integrin a6 subunit was expressed throughout the JE and was localized to the cell membranes, including the aspects facing the internal and external basal laminae. The beta 4 subunit had a more restricted distribution. It was expressed only in cells facing the internal and the external basal laminae and had a basally polarized distribution. In other parts of gingival epithelium, both integrin subunits were mainly expressed at the basal aspects of basal epithelial cells. The basement membrane components, type IV collagen and laminin, could be detected only in the external basal lamina and in other basement membranes of gingival epithelium. The results indicate that the a6 beta 4 integrin, expressed in mouse JE, has a role in mediating the attachment of the cells to the basement membranes facing the connective tissue and the tooth.

Effects of destructive periodontitis, induced by diet, on the mechanical properties of the periodontal ligament of the mandibular first molar in golden hamsters

To examine progressive changes in the mechanical properties of the periodontal ligament in the hamster mandibular first molar with experimental periodontitis--induced by feeding a high-carbohydrate diet--load-deformation curves obtained by extracting the tooth from its socket in the dissected jaw were analyzed. The maximum shear load, elastic stiffness and failure energy in shear in the experimental groups decreased significantly during the experimental period. On the other hand, significant differences in the maximum deformation were not found between the experimental and the relevant control groups. Radiographic and histological observations showed that the alveolar bone loss and destruction of the periodontal tissues occurred at the cervical region of the tooth in the experimental animals at 8 and 12 weeks after the start of the experiment. It is suggested that the reduction of the mechanical strength of the periodontal ligament in the experimental animals may be due to the alveolar bone loss, destruction of the periodontal tissues at the cervical region--particularly on the lingual aspect--followed by a decrease in the surface area of the ligament. It is also suggested that degenerative changes in the remaining periodontal ligament occurred in hamsters with periodontal disease, causing a reduction in the mechanical strength of the ligament.

Expression of integrins in human gingiva

The distribution of the alpha 1-alpha 6 subunits of beta 1 integrins was studied by using a panel of monoclonal antibodies in indirect immunofluorescence microscopy. The results showed that the beta 1 subunit was expressed at the cell membrane of basal cells of gingival epithelium, throughout the cells of junctional epithelium (JE), and in cells of connective tissue, including endothelial cells and, more faintly, in inflammatory cells in gingival connective tissue. The alpha 4 subunit was expressed selectively in inflammatory cells, and the alpha 5 subunit was expressed in cells throughout gingival connective tissue. An overall cell membrane immunoreactivity for the alpha 2 and alpha 3 subunits was shown in basal cells of gingival epithelium and in cells of JE, corresponding to the epithelial localization of the beta 1 subunit. The alpha 6 subunit was polarized to the basal aspects of basal epithelial cells, but was also present in an overall cell surface distribution in basal cells and in cells of JE. The beta 4 integrin subunit was mainly expressed at the basal aspects of basal cells in gingival epithelium and JE. The results indicate that the alpha 2/beta 1, alpha 3/beta 1, alpha 6/beta 1, and alpha 6/beta 4 integrins are all expressed in human gingival epithelium. Of these, the alpha 6/beta 4 integrin complex is the major candidate for mediation of the attachment of epithelial cells to the basement membrane facing the connective tissue and probably also the tooth.

Humoral immune response to active root resorption with a murine model

A depression in autoantibody titers to tooth root antigens has been shown to coincide with active root resorption in the dog. Since a murine model would facilitate immunologic studies of root resorption because of the availability of syngeneic and immunodeficient strains, the objectives of this study were to develop a quantitative mouse model for root resorption and to determine if a similar drop in tooth root autoantibodies coincides with active root resorption in this species. Uniform areas of necrosis were created in the periodontal ligaments of lower incisors of 36 male Swiss albino mice by inserting a cryoprobe through a skin incision (-80 degrees C; 5 minutes). Contralateral incisors served as controls. At 0, 3, 5, 7, 10, 14, and 21 days; six mice were killed, and blood and incisors were collected. Relative surface areas of root resorption were quantified with micrographs taken at a standardized position, tilt, and magnification with a scanning electron microscope. Serum autoantibody titers were determined with an enzyme-linked immune sorbent assay with antigen prepared from a 5 mol/L guanidine-HCl-EDTA (pH 5.0) extract of incisor roots that were harvested from syngeneic mice. ANOVA and the paired Student t test were used to compare data at the various time points. No root resorption was evident on control teeth. Localized lesions on treated teeth were found to be of significant size between 7 and 14 days (p less than 0.05), but most of these erupted into the mouth by 21 days.(ABSTRACT TRUNCATED AT 250 WORDS)

Resorption of the mouse incisor after the application of cold to the periodontal attachment apparatus

In order to study in detail the processes leading to the resorption and ankylosis of teeth after trauma, the effects of cold application on the periodontal tissues were studied in the mouse. Liquid nitrogen was applied locally to the outer surface of the lower jaw which resulted in a freezing of the incisor and its surrounding tissues. The healing processes in the damaged periodontal ligament and the accompanying phenomena of ankylosis and dental root resorption were investigated histologically at both the light and electron microscopic levels. As a result of cold application, the cells in the periodontal ligament were killed. After a few days, the ligament started to be repopulated with cells like fibroblasts and macrophages. From 3 days on, mineral crystallites were deposited along the cementum covering the lingual, mesial, and lateral surfaces of the incisor, finally resulting in a 4-6 micron thick layer. During the period of 7-12 days following cold application, this layer of mineralized material started to be phagocytosed and degraded, presumably by mononuclear cells. Finally, extensive root resorption and some ankylosis between the tooth and the alveolar bone were observed. In the resorbed areas, cells were seen which could not be distinguished from osteoclasts. In some instances, their ruffled border was in close apposition with each of the three mineralized tissues--dentin, cementum, and alveolar bone. It is hypothesized that the deposition and subsequent phagocytosis of mineralized material along the root surface may be an important factor in the initiation of dental root resorption.

A study of epithelial odontogenic residues in the pig

Formation of the junctional epithelium was studied by routine light microscopy in the molar teeth of commercially slaughtered pigs. It was found that the process whereby the reduced enamel epithelium (REE) contributed to the junctional epithelium formation corresponded largely with changes in man previously described by Schroeder and Listgarten (Monographs in Developmental Biology, Vol. II, Basel, S. Karger, 1971). The configuration of the marginal rests of Malassez (ROM) and their relationship to the junctional epithelium and REE was similarly studied by means of true serial sections. It was found that the ROM in that portion of the periodontium below the alveolar crest formed a well defined network of epithelial strands, but the network became more poorly defined and diverged away from the surface of the cementum as the cementoenamel junction was approached. The coronal border of this network ultimately became continuous with the REE by means of a relatively few vertical strands of epithelium. The possibility that the presence of epithelial residues in the periodontium may contribute to pocket formation and the potential effects of its configuration and continuity with the junctional epithelium are speculatively considered.

The rests of Malassez and chronic marginal periodontitis

The structure of the rests of Malassez and the relationship which they bear to the junctional epithelium in the marginal region of pigs' molars was investigated. A 3-dimensional picture of the marginal rests and their relationship to the junctional epithelium was built up by means of standardized photomicrographs made from serial sections. In teeth involved in chronic marginal inflammation, the rests in this region appeared to form a continuous network and we confirmed the original suggestion of Grant & Bernick that, at frequent intervals, the junctional epithelium"... seemed to be continuous with the epithelial rests in the upper third of the root...". If the anatomical relationship of the rests in man resembles that seen in the pig and they form a continuous network communicating at intervals with the junctional epithelium, this relationship must inevitably lead to speculation about the effects of any potential for reactive proliferative equivalent to that which is frequently seen in the apical region. It is possible that the rests might be acting as the "thin end of the wedge", augmenting and facilitating apical migration of the junctional epithelium during the pathogenesis of the periodontal pocket.

Identification of a cathepsin b-like protease in the crevicular fluid of gingivitis patients

Crevicular fluid from gingivitis patients contains significant levels of a cysteine protease which was characterized as the lysosomal protease cathepsin B, as judged by substrate specificity, thiol dependence, pH optimum, kinetic parameters, pH stability, and inhibitor sensitivities. A highly-sensitive fluorometric assay procedure was used to establish the mean level of cathepsin B activity for 25 gingivitis patients.

Oral implantation of Bacteroides asaccharolyticus and Eikenella corrodens in conventional hamsters

Oral implantation of Bacteroides asaccharolyticus 381-R' and Eikenella corrodens 1073S-R, which are highly resistant to streptomycin, was examined in conventional hamsters. The hamsters' first molars were ligatured with cotton threads preimmersed in bacterial suspensions. Bacterial inoculation was performed daily for 1 week, followed by a single weekly inoculation for 7 more weeks. Hamsters were fed Keyes' diet no. 2000 or ordinary powdered diet. Bacterial recovery, gingival histological changes, and immunological response were checked 2, 5, and 8 weeks after the daily serial inoculation. B. asaccharolyticus 381-R' was recovered from all hamsters during the experiment (6.7 X 10(6) to 6.3 X 10(8) colony-forming units). E. corrodens 10735-R was recovered from the hamsters fed Keyes' diet no. 2000 throughout the experimental period (2.4 X 10(5) to 1.2 X 10(6) colony-forming units), but not in the group fed the ordinary powdered diet. The histological changes in gingival tissues at the second week showed no differences among the control group, the B. asaccharolyticus-inoculated group, and the E. corrodens-inoculated group. However, by the eighth week, the inflammation persisted only in the bacteria-inoculated groups, especially in the B. asaccharolyticus-inoculated group. A relatively increased serum antibody titer was also observed in the B. asaccharolyticus-inoculated group, but not in the E. corrodens-inoculated group. These findings indicate that B. asaccharolyticus 381-R' and E. corrodens 1073S-R can be implanted in hamsters' oral cavity with the aid of cotton thread ligature. It was also suggested that B. asaccharolyticus may have some pathogenic role in the destruction of periodontal tissue in hamsters.

Current concepts of the dentogingival junction: the epithelial and connective tissue attachments to the tooth

This review leads to a concept in which the tissues of the dentogingival junction are dynamic rather that static. Even when they are pathologic, they can be reconstituted by repair. Both their cellular and extracellular components exhibit a high rate of turnover. Some of the cells are specialized for specific functions, such as attachment formation, and do not generate additional cells, but generative pools are always nearby. The cells are capable of movement and of positional change. The junctional epithelium can advance and retract. The cuticle width is alterable. The entire tissue is capable of regeneration after wounding. This dynamic group of tissues is well adapted for the healing of direct injuries produced during mastication. The tissues do remarkably well, over long periods, in their response to periodontal disease, whether due to direct bacterial or toxic damage, or to indirect damage via the migration of inflammatory cells into the lesion. The tissues show a capacity for repair and regeneration following the elimination of plaque formation and the resultant resolution of the inflammatory infiltrate. The complete story is not yet developed. The past 60 years are replete with fine contributions by distinguished workers. Additional contributions continue to be made. The inheritance from our predecessors has been used well and our expanded knowledge in this area now serves as the conceptual framework for further study.