Movement of fibroblasts in the periodontal ligament of the mouse incisor is related to eruption

Creeping attachment: A literature review

OBJECTIVE

Mucogingival surgery has been widely applied in clinics. An interesting phenomenon after mucogingival surgery is the coronal migration of gingival margin, which is described as "creeping attachment." The goal of this review is to summarize the characteristics, significance, mechanism, and manifestation of the creeping attachment after mucogingival surgery and to describe the factors associated with its occurrence.

OVERVIEW

A total of 82 relevant articles were included in the literature review. The characteristics and significance of the creeping attachment after mucogingival surgery were analyzed. The mechanism of the creeping attachment was explored. Different manifestations of and factors associated with creeping attachment were summarized.

CONCLUSIONS

Creeping attachment may occur to obtain additional root coverage after the healing of various mucogingival surgeries. However, this coverage is not always complete nor entirely predictable.

CLINICAL SIGNIFICANCE

Creeping attachment plays an important role in the prognosis of mucogingival surgeries. This review will help clinicians get a thorough recognition and understanding of this phenomenon.

Histological evidence for a dynamic dental battery in hadrosaurid dinosaurs

The first histological study of an entire hadrosaurid dental battery provides a comprehensive look at tooth movement within this complex structure. Previous studies have focused on isolated teeth, or in-situ batteries, but this is the first study to examine an entire dental battery of any dinosaur. The absence of direct tooth-to-tooth contact across the entire battery and a unique arrangement of the dental tissues in hadrosaurids led us to compare their teeth with the ever-growing incisors of mammals. The similarity in the distributions of tissues along the incisor, coupled with continuous eruption, make for helpful comparisons to hadrosaurid teeth. The mammalian ever-growing incisor can be used as a model to extrapolate the soft tissue connections and eruptive mechanisms within the hadrosaurid dental battery. Serial sections across the adult dental battery reveal signs of gradual ontogenetic tooth migration. Extensive remodeling of the alveolar septa and the anteroposterior displacement of successive generations of teeth highlight the gradual migration of tooth generations within the battery. These eruptive and ontogenetic tooth movements would not be possible without a ligamentous connection between successive teeth and the jaws, underscoring the dynamic nature of one of the most unique and complex dental systems in vertebrate history.

Resolving stem and progenitor cells in the adult mouse incisor through gene co-expression analysis

Investigations into stem cell-fueled renewal of an organ benefit from an inventory of cell type-specific markers and a deep understanding of the cellular diversity within stem cell niches. Using the adult mouse incisor as a model for a continuously renewing organ, we performed an unbiased analysis of gene co-expression relationships to identify modules of co-expressed genes that represent differentiated cells, transit-amplifying cells, and residents of stem cell niches. Through in vivo lineage tracing, we demonstrated the power of this approach by showing that co-expression module members Lrig1 and Igfbp5 define populations of incisor epithelial and mesenchymal stem cells. We further discovered that two adjacent mesenchymal tissues, the periodontium and dental pulp, are maintained by distinct pools of stem cells. These findings reveal novel mechanisms of incisor renewal and illustrate how gene co-expression analysis of intact biological systems can provide insights into the transcriptional basis of cellular identity.

α11β1 integrin-mediated MMP-13-dependent collagen lattice contraction by fibroblasts: evidence for integrin-coordinated collagen proteolysis

We have previously determined that integrin α11β1 is required on mouse periodontal ligament (PDL) fibroblasts to generate the force needed for incisor eruption. As part of the phenotype of α11(-/-) mice, the incisor PDL (iPDL) is thickened, due to disturbed matrix remodeling. To determine the molecular mechanism behind the disturbed matrix dynamics in the PDL we crossed α11(-/-) mice with the Immortomouse and isolated immortalized iPDL cells. Microarray analysis of iPDL cells cultured inside a 3D collagen gel demonstrated downregulated expression of a number of genes in α11-deficient iPDL cells, including matrix metalloproteinase-13 (MMP-13) and cathepsin K. α11(-/-) iPDL cells in vitro displayed disturbed interactions with collagen I during contraction of attached and floating collagen lattices and furthermore displayed reduced MMP-13 protein expression levels. The MMP-13 specific inhibitor WAY 170523 and the Cathepsin K Inhibitor II both blocked part of the α11 integrin-mediated collagen remodeling. In summary, our data demonstrate that in iPDL fibroblasts the mechanical strain generated by α11β1 integrin regulates molecules involved in collagen matrix dynamics. The positive regulation of α11β1-dependent matrix remodeling, involving MMP-13 and cathepsin K, might also occur in other types of fibroblasts and be an important regulatory mechanism for coordinated extracellular and intracellular collagen turnover in tissue homeostasis.

The oxytalan fibre network in the periodontium and its possible mechanical function

The biomechanical character of the periodontal ligament (PDL) is crucial in its response to functional and orthodontic forces. Collagen has been the primary subject of investigations in this field. Several studies, however, indicate that oxytalan fibres, which belong to the elastic fibre family, also contribute to the biomechanical character and behaviour of the PDL. In order to elucidate this, we have evaluated the available literature on the oxytalan fibre network within the PDL and supra-alveolar tissues with respect to development, morphology and distribution, and response to mechanical stimulation. To this end, we have combined the classical histological studies with more recent in vitro studies. Oxytalan fibres develop simultaneously with the root and the vascular system within the PDL. A close association between oxytalan fibres and the vascular system also remains later in life, suggesting a role in vascular support. Mechanical loading of the PDL, through orthodontic force application, appears to induce an increase in the number, size, and length of oxytalan fibres. In line with this, in vitro stretching of PDL fibroblasts (PDLFs) results in an increased production of fibrillin, a major structural component of the microfibrils that make up oxytalan fibres. The available data suggest a mechanical function for oxytalan, but to date experimental data are limited. Further research is required to clarify their exact mechanical function and possible role in orthodontic tooth movement.

SPARC/osteonectin functions to maintain homeostasis of the collagenous extracellular matrix in the periodontal ligament

Expression of secreted protein acidic and rich in cysteine (SPARC)/osteonectin, a collagen-binding matricellular protein, is frequently associated with tissues with high rates of collagen turnover, such as bone. In the oral cavity, expression of SPARC/osteonectin has been localized to the periodontal ligament (PDL), a collagen-rich tissue with high rates of collagen turnover. The PDL is critical for tooth position within the alveolar bone and for absorbing forces generated by chewing. To characterize the function of SPARC/osteonectin in PDL, SPARC/osteonectin expression in murine PDL was evaluated by immunochemistry at 1, 4, 6, and >18 months. Highest levels of SPARC/osteonectin were detected at 1 and >18 months, with decreased levels associated with adult (4-6 months) PDL. To determine whether the absence of SPARC/osteonectin expression influenced cellular and fibrillar collagen content in PDL, PDL of SPARC-null mice was evaluated using histological stains and compared with that of wild-type (WT). Our results demonstrated decreased numbers of nuclei in PDL of SPARC-null mice at 1 month. In addition, decreased collagen volume fractions were found at 1 and >18 months and decreases in thick collagen fiber volume fraction were detected at 4, 6, and >18 months in SPARC-null PDL. The greatest differences in cell number and in collagen content between SPARC-null and WT PDL coincided with ages at which levels of SPARC/osteonectin expression were highest in WT PDL, at 1 and >18 months. These results support the hypothesis that SPARC/osteonectin is critical in the control of tissue collagen content and indicate that SPARC/osteonectin is necessary for PDL homeostasis.

A Role for α11β1 Integrin in the Human Periodontal Ligament

We previously demonstrated a role for α11β1 integrin in periodontal ligament (PDL)-driven tooth eruption in the mouse. To explore a possible role for α11β1 in the human periodontium, we have characterized the expression and function of α11 in human PDL tissue, in human PDL fibroblasts (hPDLF), and in human gingival fibroblasts (hGF). α11 expression was detected in PDL tissue, in hPDLF, and in hGF cells. Platelet-derived growth factor-BB and insulin-like growth factor II stimulated contraction of collagen lattices by both types of fibroblasts. α2 integrin blocking antibodies and the use of α11 siRNA demonstrated a role for both α2β1 and α11β1 in collagen lattice remodeling. Analysis of the proximal ITGA11 promoter from persons with chronic periodontal disease failed to reveal any polymorphism. Analysis of our data shows that α11β1 is a major collagen receptor on cultured human PDL cells and implies that it is also functionally important in the PDL in vivo.

Physiology and pathology of collagen receptors

Just before the transition from pre-genomic to the post-genomic era, the two latest members of the mammalian integrin family were identified. These integrins, which were named alpha10beta1 and alpha11beta1, are both collagen receptors and are related. Rather than being twins, they can be regarded as close cousins. They both belong to the subfamily of integrins that contain an I-domain in the alpha subunit. This domain is also the part that endows these integrins with the capacity to bind the GFOGER sequence in collagens. In the current review, we summarize and update the current knowledge about the in vitro and in vivo functions of these integrins.

Alpha11 beta1 integrin-dependent regulation of periodontal ligament function in the erupting mouse incisor

The fibroblast integrin alpha11beta1 is a key receptor for fibrillar collagens. To study the potential function of alpha11 in vivo, we generated a null allele of the alpha11 gene. Integrin alpha11(-/-) mice are viable and fertile but display dwarfism with increased mortality, most probably due to severely defective incisors. Mutant incisors are characterized by disorganized periodontal ligaments, whereas molar ligaments appear normal. The primary defect in the incisor ligament leads to halted tooth eruption. alpha11beta1-defective embryonic fibroblasts displayed severe defects in vitro, characterized by (i) greatly reduced cell adhesion and spreading on collagen I, (ii) reduced ability to retract collagen lattices, and (iii) reduced cell proliferation. Analysis of matrix metalloproteinase in vitro and in vivo revealed disturbed MMP13 and MMP14 synthesis in alpha11(-/-) cells. We show that alpha11beta1 is the major receptor for collagen I on mouse embryonic fibroblasts and suggest that alpha11beta1 integrin is specifically required on periodontal ligament fibroblasts for cell migration and collagen reorganization to help generate the forces needed for axial tooth movement. Our data show a unique role for alpha11beta1 integrin during tooth eruption.

Effects of human relaxin on orthodontic tooth movement and periodontal ligaments in rats

INTRODUCTION

The rate-limiting step in orthodontic treatment is often the rapidity with which teeth move. Using biological agents to modify the rate of tooth movement has been shown to be effective in animals. Relaxin is a hormone present in both males and females. Its main action is to increase the turnover of fibrous connective tissues. Thus, relaxin might increase the amount and rate of tooth movement through its effect on the periodontal ligament (PDL). The purpose of this study was to measure the effect of relaxin on orthodontic tooth movement and PDL structures.

METHODS

Bilateral orthodontic appliances designed to tip maxillary molars mesially with a force of 40 cN were placed in 96 rats. At day 0, the animals were randomized to either relaxin or vehicle treatment. Twelve rats in each group were killed at 2, 4, 7, and 9 days after appliance activation. Cephalograms were taken at appliance placement and when the rats were killed. Tooth movement was measured cephalometrically in relation to palatal implants. Fractal analysis and visual analog scale assessments were used to evaluate the effect of relaxin on PDL fiber organization at the tension sites in histologic sections. The in-vitro testing for PDL mechanical strength and tooth mobility was performed by using tissue from an additional 20 rats that had previously received the same relaxin or vehicle treatments for 1 or 3 days (n = 5).

RESULTS

Both groups had statistically significant tooth movement as functions of time. However, relaxin did not stimulate significantly greater or more rapid tooth movement. Fractal and visual analog scale analyses implied that relaxin reduced PDL fiber organization. In-vitro mechanical testing and tooth mobility assessments indicated that the PDL of the mandibular incisors in the relaxin-treated rats had reduced yield load, strain, and stiffness. Moreover, the range of tooth mobility of the maxillary first molars increased to 130% to 170%, over vehicle-treated rats at day 1.

CONCLUSIONS

Human relaxin does not accelerate orthodontic tooth movement in rats; it can reduce the level of PDL organization, reduce PDL mechanical strength, and increase tooth mobility at early time points.

The equine periodontium as a continuously remodeling system: morphometrical analysis of cell proliferation

OBJECTIVE

The hypsodont equine cheek tooth erupts continuously throughout life. Tooth eruption is inevitably associated with a remodeling of the periodontium. One major process of remodeling in the PDL is cell proliferation. The aim of this study was to detect cell proliferation at different sites of the equine PDL in order to examine the dynamics of the periodontal cell population.

DESIGN

Specimens from nine warm-blood horses were taken-- containing the PDL interposed between the cementum and the alveolar bone--at three designated levels: subgingival, middle, and apical. Cell proliferation was detected immunohistochemically by use of anti-Ki-67 in combination with an elaborate morphometrical procedure using an image-analysis program. Three zones of the PDL were distinguished in each specimen: a zone next to the dental cementum, a central zone, and a zone next to the alveolar bone. The PDL was divided into three levels and three zones, resulting in nine defined regions of interest.

RESULTS

The proliferation index was high at the apical level and in the zone next to the alveolar bone. The opposite was true of cell density, which was high at the subgingival level and in a zone next to the dental cementum.

CONCLUSIONS

Evaluation and statistical analysis of the parameters proliferation index and cell density in distinct, biologically appropriate sites of the equine PDL suggest the presence of dynamic processes like cell migration by which the cells of the PDL move from an area next to the alveolar bone towards the dental cementum, and in an apico-occlusal direction. Furthermore, our study confirms the close relationship between cell proliferation, cell migration, and eruption.

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.

Tooth eruption: theories and facts

The mechanisms of tooth eruption (i.e., the answer to the question of how and why teeth erupt) has been a matter of long historical debate. This review focuses on human and other mammalian teeth with a time- and spacewise limited period of eruption and analyzes recent observations and experimental data on dogs, rats, primates, and humans in a framework of basic biological parameters to formulate a guiding theory of tooth eruption. Acknowledging basic parameters (i.e., that teeth move in three-dimensional space, erupt with varying speed, and arrive at a functional position that in inheritable) eliminates a number of previously held theories and favors those that accommodate basic parameters, such as alveolar bone remodeling in association with root elongation, with possible correction factors in the form of cementum apposition and periodontal ligament formation. We have critically analyzed, summarized, and integrated recent findings associated with preeruptive movements of developing teeth, the intraosseous stage of premolar eruption in dogs, molar eruption in rodents, and premolar and molar eruption in primates. The variable speeds of eruption are particularly important. We conclude with basic principles of tooth eruption--that is, the type of signals generated by the dental follicle proper, the conditions under which teeth are moved and the clinical understanding to be derived from this knowledge.

The basic and applied biology of tooth eruption

The dentition and the alveolar process of each jaw develop simultaneously so that, by the time the crown is completed and eruption begins, the crown is enclosed in a crypt within alveolar bone. Thus, the eruption of a tooth to its functional position involves discretely localized, bilaterally symmetrical bone resorption to produce an eruption pathway and bone formation to fill in the space previously occupied by the crown and growing roots. Studies of crypt surfaces during eruption confirm this polarization of alveolar bone metabolism around a tooth with respect to both bone cells and mineralized surface topography. Experimental studies of tooth eruption have shown that the dental follicle, the dense connective tissue investment of the tooth, is necessary for eruption and that neither bone resorption nor bone formation occur without the adjacent part of the dental follicle. Early in eruption the coronal part of the follicle accumulates mononuclear cells which have cytochemical and ultrastructural features of osteoclasts and the apical part of the follicle, a site of intense cell proliferation, binds epidermal growth factor (EGF). The dental follicle contains a variety of proteins and the concentration of several change during eruption. Prominent among them are a reduction in matrix metalloproteinases and an increase in protoglycans as eruption proceeds. The contribution of these changes to those in cell proliferation, migration and differentiation during tooth eruption present experimental opportunities for developmental biologists. The rate-limiting factor of the earliest (intraosseous) stage of tooth eruption is bone resorption and eruption can be accelerated or retarded by the local delivery of factors which increase or decrease the activity of osteoclasts.(ABSTRACT TRUNCATED AT 250 WORDS)

Effect of loading on the migration of periodontal fibroblasts in the rat incisor

The influence of occlusal loading on periodontal fibroblasts was investigated in hypoloaded (shortened out of occlusion), functionally loaded and hyperloaded (constant linguointrusive mechanical loads of 9.4 +/- 0.06 g) lower left rat incisors. One hour following injection of 3H-thymidine, half of the animals in each group were killed, while the remaining rats were killed 2 weeks later. The decalcified incisors were embedded in glycolmethacrylate and sectioned (2 microns) serially, perpendicularly to the long tooth axis. Labeled and unlabeled fibroblasts in the tooth-related periodontal ligament were counted in 8 x 80 microns consecutive layers. Cell density (CD) and labeling index (LI) were plotted according to their location on the apico-incisal and cementum-bone axes. Loading caused a decrease in CD and a shift of cells from the cementum towards the middle of the ligament, proportionally to load intensity and duration. The average tooth-to-bone movement of the cells was 2 microns/day in the hypoloaded and 4 microns/day in the two loaded groups. The mean daily tooth eruption rate was 975 +/- 60 microns, 499 +/- 18 microns and 103 +/- 27 microns in the hypo-, functionally- and hyperloaded teeth, respectively. The respective concomitant average daily cell migration rates in the incisal direction were 786 microns, 500 microns, and 500 microns, i.e. 80%, 100% and 485% of the tooth eruption rates. The gross disparity between cell velocity and tooth movement under conditions of restrained eruption indicates active motility of the fibroblasts, rather than their passive tooth-eruption dependent translation.

Current concepts of the biology of tooth eruption

Tooth eruption is defined as the movement of a tooth from its site of development within the jaws to its position of function within the oral cavity. We present a critical review of evidence for the mechanisms and regulation of the intraosseous and supraosseous phases of eruption, with an emphasis upon the canine premolar model studied by the authors. Analyses at different stages of premolar eruption indicate that selective fragmentation of dental follicle protein DF-95 correlates with the presence of elevated levels of follicular collagenase and stromelysin, and with the onset of premolar movement. A dramatic decrease in these metalloproteinases followed initiation of movement. A biochemical and cell biological model for regulation of tooth eruption is proposed based upon these new and existing data.

Dynamics of tissue changes found after mechanical loading of the rat incisor. I. A three-dimensional longitudinal study of the morphologic aspects

A three-dimensional morphometric method was used to evaluate progressive changes in shape and size of recovering dental and periodontal tissues after orthodontic loading. In 35 female rats weighing 212 +/- 4 gm, loads of 19.7 +/- 1.6 gm generated by closed-coil springs were applied for 2 weeks to the shortened lower left incisor. The rats were killed in groups of five at 0, 1, 3, 5, 7, 9, and 10 weeks (groups 0-w to 10-w) after the springs were removed. A group of rats with normal incisors (group C-1) and one with five incisors that had been continually shortened for 10 weeks (group C-2) served as controls for groups 0-w and 10-w, respectively. Width, area, and volume of the tooth and enamel-bordering periodontal ligament (e-PDL) and cementum-bordering PDL (c-PDL) were measured. After 2 weeks of loading (group 0-w), the volume of the compressed e-PDL had decreased by 22%, and the volume of the stretched c-PDL had increased by 72%, suggesting that bone apposition lags behind the rate of tooth movement. During the recovery period, the dental and periodontal parameters tended toward a gradual return to control (C-2) values, although at the end of 10 weeks many still lagged significantly behind the controls. Recovery was slowed by repeated reversals at different sites in the various groups. The ability of the preloaded incisor to adjust to changes in occlusal function was lastingly impaired.

The effect of cyclophosphamide on the eruption of impeded and resected incisors in rats

It is known that a single dose of cyclophosphamide (40 mg.kg-1 intraperitoneal) slows the eruption of unimpeded incisors but has no effect on impeded incisors. In this study incisors that were impeded when cyclophosphamide was given were subsequently made unimpeded. When they were unimpeded they erupted more slowly than the controls. Therefore the changes cyclophosphamide produces which slow eruption are formed in impeded incisors but have an effect only in unimpeded incisors. It has been reported that cyclophosphamide slows the eruption of resected incisors when it is given before the resection. In a second experiment cyclophosphamide was given after the resection and had no effect on eruption rates. It is suggested from these and earlier findings that cyclophosphamide slows eruption by imposing a maximum on the rate at which it can occur and that it does so through the changes it produces in the periodontal ligament. The periodontal changes make it harder for the tooth to move rather than altering the forces moving the tooth. This explanation of how cyclophosphamide slow eruption produces an alternative interpretation of some, but not all, of the findings that have been cited as evidence that there are two mechanisms of tooth eruption.

A method for sampling the stages of amelogenesis on mandibular rat incisors using the molars as a reference for dissection

A method for locating specific stages of amelogenesis on continuously erupting incisors was devised for rats weighing 101 +/- 5 g (n = 32). The technique is based on reflecting reference lines from the mandibular molars as perpendiculars to the labial surface of mandibular incisors. From these reference lines additional measurements are then made along the midline of the labial surface of the incisor in an apical or incisal direction to find the site desired for sampling. Histological studies on 24 decalcified incisors split into segments by using such reference lines and reconstructed by morphometry indicated that a reference line reflected from the contact point between the 2nd and 3rd molars crossed the enamel organ and adjacent enamel at 3,181 +/- 329 microns incisal to the start of the secretory zone of amelogenesis. A reference line from the 2nd and 1st molars crossed the enamel organ and enamel at 1,238 +/- 424 microns incisal to the start of the maturation zone of amelogenesis, while a reference line from the mesial side of the 1st molar crossed the enamel organ and enamel almost exactly where the enamel becomes completely soluble following prolonged decalcification in EDTA. Although reference lines were reproducible within a group of male rats having similar body weights, the linear distance between the apical end of the incisor and the point at which they crossed the tooth increased at a rate of 1 mm per 159 g for rats between 50 and 300 g body weight. This suggests that molars do not maintain a fixed relationship to incisors over time, and extreme care must be taken to standardize an experiment to a specific body weight when using this method.

Three-dimensional presentation of cell migration in the periodontal ligament of the rat incisor

The progenitor compartments and cell migration were examined in the tooth-related periodontal ligament (t-PDL) of rat incisors. A pulse injection of 3H-Tdr was administered to 15 rats (200 gm each) and the animals were killed in groups of five, at 1 hr and at 1 and 2 weeks after injection. Three-dimensional analysis of cell counts and labeling index demonstrated the existence of two progenitor compartments (PC). The apical PC (responsible for 70% of synthesizing cells) was concentrated in the apical 5 mm of the t-PDL. The paracemental PC (30% of synthesizing cells) was located along and around the cementum, occupying 24 micron of the t-PDL. The cells from the apical PC migrated incisally at a rate of 6 mm/week, which is a rate similar to that of tooth eruption. The cells from the paracemental PC moved in a transverse direction toward either bone or cementum at the much slower rate of 16 micron/week.