Force-induced rapid changes in cell fate at midpalatal suture cartilage of growing rats

Exploring biological mechanisms in orthodontic tooth movement: Bridging the gap between basic research experiments and clinical applications - A comprehensive review

OBJECTIVES

The molecular mechanisms behind orthodontic tooth movements (OTM) were investigated by clarifying the role of chemical messengers released by cells.

METHODS

Using the Cochrane library, Google scholar, and PubMed databases, a literature search was conducted, and studies published from 1984 to 2024 were considered.

RESULTS

Both bone growth and remodeling may occur when a tooth is subjected to mechanical stress. These chemicals have a significant effect on the stimulation and regulation of osteoblasts, osteoclasts, and osteocytes during alveolar bone remodeling. This regulation can take place in pathological conditions, such as periodontal diseases, or during OTM alone. This comprehensive review outlines key molecular mechanisms underlying OTM and explores various clinical assumptions associated with specific molecules and their functional domains during this process. Furthermore, clinical applications of certain molecules such as relaxin, prostaglandin E (PGE), and interleukin-1β (IL-1β) in accelerating OTM have been reported. Our findings underscore the existing gap between OTM clinical applications and basic research investigations.

CONCLUSION

A comprehensive understanding of orthodontic treatment is enriched by insights into biological systems. We reported the activation of osteoblasts, osteoclast precursor cells, osteoclasts, and osteocytes in response to mechanical stress, leading to targeted cellular and molecular interventions and facilitating rapid and regulated alveolar bone remodeling during tooth movement. Despite the shortcomings of clinical studies in accelerating OTM, this review highlights the crucial role of biological agents in this process and advocates for prioritizing high-quality human studies in future research to gain further insights from clinical trials.

Effect of platelet rich plasma injection on bone formation in the expanded mid-palatal suture in rabbits: a randomized controlled animal study

BACKGROUND

Mid-Palatal suture expansion needs long retention period due to delayed bone formation in the expanded suture. Platelet-rich plasma (PRP) is a concentrated source of growth factors which increase bone formation. The aim of this study was to evaluate the effect of PRP injection on bone formation in expanded mid palatal suture in rabbits.

METHODS

In this prospective randomized controlled animal study, Twenty male rabbits (8-weeks-old) were subjected to mid-palatal expansion for 5 days. Animals were afterwards randomly divided into control group A & study group B. PRP was prepared and injected in the mid-palatal suture in animals belonging to group B only. After 6 weeks of retention, all animals were euthanized, and premaxillae were prepared for histological, histomorphometric and immunohistochemical analysis. Student t-test and paired t-test were used to compare the means of the two groups and within the same group respectively. Significance level set at p ≤ 0.05.

RESULTS

Histomorphometric analysis revealed a significant increase (p < 0.001) in the mean percentage of new bone in the study group (14.4%) compared to the control (1.4%). Suture width in study group was significantly wider than the control group (278.8 ± 9μms and 120.4 ± 3.4μms, p < 0.001). There was a significant increase in vascular density in study group than control group (309 ± 65.34 and 243.86 ± 48.1, p = 0.021). Osteopontin immuno-expression revealed a significant increase in optical density in study group than control group (0.21 ± 0.02 & 0.12 ± 0.01, p < 0.001).

CONCLUSIONS

In rabbit model, PRP injection can accelerate new bone formation in the expanded mid-palatal suture when compared to the control. This could hopefully result in a more stable midpalatal expansion and a reduced retention period.

Extracellular vesicles derived from M1 macrophages enhance rat midpalatal suture expansion by promoting initial bone turnover and inflammation

BACKGROUND

Midpalatal suture (MPS) expansion can be affected by many factors, and researchers have attempted to regulate the initial inflammatory stage of expansion to optimize clinical outcomes and their underlying mechanisms. This study aimed to investigate the potential effects and mechanisms of M1 macrophage small extracellular vesicles during rat MPS expansion.

MATERIALS AND METHODS

RAW264.7 cells were induced to M1 or M2 polarization and, small extracellular vesicles were isolated from the polarized macrophages. Male Sprague-Dawley rats (6-7 weeks) were administered 70 ± 5 g expansion force devices for 7 days. Rats with expanders without force served as controls. M1/M2 small extracellular vesicles were injected into the MPS region (50 µg/day) in the M1 and M2 small extracellular vesicle-assisted groups, while 0.9% saline was injected into the expansion-only group. Suture width, bone mass, and morphological changes in the region of interest (ROI) were examined.

RESULTS

The M1 small extracellular vesicle-assisted group showed a significantly increased MPS suture width in vivo (P < 0.001), and less bone mass was observed in the ROI (P < 0.05). Histological examination showed that the M1 small extracellular vesicle-assisted group exhibited a wider palatal area and obvious fibrous tissue rearrangement. The expression of RANKL and the number of osteoclasts were increased (P < 0.01) in the bony edges, and the p65 protein expression was significantly higher (P < 0.001).

CONCLUSIONS

M1 macrophage-derived small extracellular vesicles have a positive effect in MPS expansion and increase p65 protein content and RANKL expression, thus promoting bone turnover. This study may contribute to the clinical application of small extracellular vesicles in the expansion of the palatal suture.

Suppressing STAT3 activation impairs bone formation during maxillary expansion and relapse

OBJECTIVES

The mid-palatal expansion technique is commonly used to correct maxillary constriction in dental clinics. However, there is a tendency for it to relapse, and the key molecules responsible for modulating bone formation remain elusive. Thus, this study aimed to investigate whether signal transducer and activator of transcription 3 (STAT3) activation contributes to osteoblast-mediated bone formation during palatal expansion and relapse.

METHODOLOGY

In total, 30 male Wistar rats were randomly allocated into Ctrl (control), E (expansion only), and E+Stattic (expansion plus STAT3-inhibitor, Stattic) groups. Micro-computed tomography, micromorphology staining, and immunohistochemistry of the mid-palatal suture were performed on days 7 and 14. In vitro cyclic tensile stress (10% magnitude, 0.5 Hz frequency, and 24 h duration) was applied to rat primary osteoblasts and Stattic was administered for STAT3 inhibition. The role of STAT3 in mechanical loading-induced osteoblasts was confirmed by alkaline phosphatase (ALP), alizarin red staining, and western blots.

RESULTS

The E group showed greater arch width than the E+Stattic group after expansion. The differences between the two groups remained significant after relapse. We found active bone formation in the E group with increased expression of ALP, COL-I, and Runx2, although the expression of osteogenesis-related factors was downregulated in the E+stattic group. After STAT3 inhibition, expansive force-induced bone resorption was attenuated, as TRAP staining demonstrated. Furthermore, the administration of Stattic in vitro partially suppressed tensile stress-enhanced osteogenic markers in osteoblasts.

CONCLUSIONS

STAT3 inactivation reduced osteoblast-mediated bone formation during palatal expansion and post-expansion relapse, thus it may be a potential therapeutic target to treat force-induced bone formation.

Reducing relapse and accelerating osteogenesis in rapid maxillary expansion using an injectable mesoporous bioactive glass/fibrin glue composite hydrogel

Rapid maxillary expansion (RME), as a common treatment for craniomaxillofacial deformity, faces the challenge of high relapse rates and unsatisfactory therapeutic effects. In this study, a standardized Sprague-Dawley (SD) rat RME model was first established with a modified expander as well as retainer design and optimized anterior maxillary expanding force of 100 g which exerted the most synchronized mobility of mid-palatal suture and incisors. Via the standardized model, the high relapse rate was proven to be attributed to insufficient osteogenesis in expanded suture, requiring long-term retainer wearing in clinical situations. To reduce the relapse rate, mesoporous bioactive glass/fibrin glue (MBG/FG) composite hydrogels were developed for an in situ minimal invasive injection that enhance osteogenesis in the expanded palate. The component of 1 wt% MBG was adopted for enhanced mechanical strength, matched degradation rate and ion dissolution, excellent in vitro biocompatibility and osteoinductivity. Effects of 1%MBG/FG composite hydrogel on osteogenesis in expanded mid-palatal sutures with/without retention were evaluated in the standardized model. The results demonstrated that injection of 1%MBG/FG composite hydrogel significantly promoted bone formation within the expanded mid-palatal suture, inhibited osteoclastogenesis and benefited the balance of bone remodeling towards osteogenesis. Combination of retainer and injectable biomaterial was demonstrated as a promising treatment to reduce relapse rate and enhance osteogenesis after RME. The model establishment and the composite hydrogel development in this article might provide new insight to other craniomaxillofacial deformity treatment and design of bone-repairing biomaterials with higher regenerative efficiency.

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A standardized rat RME model was established with optimized parameters.

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Sufficient osteogenesis was the prerequisite of reducing relapse ratio.

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Design of an injectable MBG/FG composite hydrogel for osteogenic enhancement.

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Combinatory treatment of injection and retention was developed for relapse reduction.

Parathyroid hormone promotes maxillary expansion and reduces relapse in the repeated activation maxillary expansion rat model by regulating Wnt/β-catenin pathway

Background

Constricted maxillary bone is a common skeletal deformity, which may lead to crowding and posterior crossbite. Mid-palatal suture expansion is often used to increase the maxillary width, but its skeletal effects are limited and tend to relapse, even with prolonged retention. We hypothesized that parathyroid hormone (PTH) may reduce the relapse of maxillary expansion.

Methods

We established a novel rat maxillary expansion model using palatal tubes with an insertable “W”-shaped spring which can be repeatedly activated. A total of 32 male healthy Wistar rats were randomly divided into six groups: the control group, the PTH group, the expansion group, the expansion + PTH group, the expansion + relapse group and the expansion + PTH + relapse group. All animals in the first 4 groups were killed after 10 days and the 2 relapse groups were killed after 15 days. The maxillary arch widths and histological staining were used to assess the expansion and relapse effects. The immunohistochemical staining, micro-CT, RT-qPCR and Western blot were used to evaluate the bone remodeling during expansion.

Results

The suture width was increased by the expansion device, and the repeated activation maxillary expansion rat model showed better expansion effects than the conventional model. PTH significantly promoted the expansion width and reduced the relapse ratio. Meanwhile, in the expansion + PTH group, histological and immunohistochemical staining showed that osteoblasts, osteoclasts, new cartilage and osteoid were significantly increased, micro-CT showed increased bone mass, and PCR and Western blot results confirmed up-regulation of RANKL, β-catenin, type II collagen and OCN.

Conclusion

The novel repeated activation maxillary expansion rat model has better effects than the conventional model. PTH enhances the maxillary expansion and reduces its relapse by regulating Wnt/β-catenin and RANKL pathways. PTH administration may serve as an adjunctive therapy in addition to mechanical expansion for treatment of maxillary constriction.

Age-related osteogenesis on lateral force application to rat incisor – Part I: Premaxilla suture remodeling

Objectives:

The suture is a fibrous tissue intervening two adjacent bone segments, existing only in the craniofacial region. In spite of wide use of palatal expansion in various ages, the age-dependent cellular mechanism for osteogenesis is largely unknown. The aim of this study was to examine the proliferation and differentiation pattern of the suture cells on lateral expansion in rats depending on the ages.

Materials and Methods:

Calibrated lateral tensile stress of 50 g was given to the male Sprague-Dawley rat incisors using a double helix in 30 young (10 weeks) and another 30 aged (52 weeks) group, respectively. Each group was subdivided into control, 1, 3, 7, 14, and 21 days, with five animals in each group. Premaxilla area was retrieved from each animal for further histologic analyses including H and E, Masson’s trichrome, and immunohistochemical staining using antibodies against phospho-extracellular signal-regulated kinase, proliferating cell nuclear antigen (PCNA), and fibroblast growth factor receptor-2 (FGFR2). Positive cell counts in the region of interest were conducted.

Results:

Gross suture separation and subsequent bone formation on the sutural side bone surface were observed in both groups, characterized as active collagen turnover, remarkable woven bone projection toward the sutural mesenchyme and subsequent maturation in 3 weeks. Increase in PCNA- and FGFR2-postive cell proportions were comparable in both groups, indicating similar time- and area-specific proliferation and osteogenic differentiation patterns in the stretched suture regardless of the age groups.

Conclusion:

According to the results, it can be implicated that the tensile stress applied to the suture in the adult group may induce active bone formation similar to that in young group, in associated with FGFR2 and Erk signaling cascade. Mesenchymal cells in the premaxillary suture appear to retain remarkable potential for further proliferation and differentiation even in aged subjects.

The effect of cetirizine, a histamine 1 receptor antagonist, on bone remodeling after calvarial suture expansion

Objective

The objective of this study was to evaluate the effects of cetirizine, a histamine 1 receptor antagonist, on bone remodeling after calvarial suture expansion.

Methods

Sixty male Sprague–Dawley rats were divided into 4 groups; the phosphate-buffered saline (PBS)-injected no expansion group, cetirizine-injected no expansion group, PBS-injected expansion group, and cetirizine-injected expansion group, and were observed at 7, 14, and 28 days. Five rats per group were examined at each observation day. Daily injections of cetirizine or PBS were administered to the relevant groups starting 2 weeks prior to expander insertion. A rapid expander was inserted in the calvarial bone to deliver 100 cN of force to the parietal suture. The specimens were prepared for hematoxylin and eosin and tartrate-resistant acid phosphatase (TRAP) staining. Suture opening and bone regeneration were evaluated using microcomputed tomography and bone histomorphometric analysis. Serum blood levels of osteocalcin and carboxy-terminal collagen crosslinks (CTX) were also evaluated.

Results

TRAP-positive cell counts and CTX levels decreased while osteocalcin levels increased in the cetirizine-injected expansion group at observation day 28. In the expansion groups, the mineralized area gradually increased throughout the observation period. At day 28, the cetirizine-injected expansion group showed greater bone volume density, greater mineralized area, and narrower average suture width than did the PBS-injected expansion group.

Conclusions

Cetirizine injection facilitated bone formation after suture expansion, mostly by suppressing osteoclastic activity. Histamine 1 receptor antagonists may aid in bone formation after calvarial suture expansion in the rat model.

Effects of continuous and intermittent parathyroid hormone administration on midpalatal suture expansion in rats

OBJECTIVES

The aim of this study was to investigate the effects of continuous parathyroid hormone (cPTH) and intermittent parathyroid hormone (iPTH) on bone formation and bone resorption in midpalatal suture during maxillary expansion.

METHODS

Forty-eight male SD rats were randomly divided into four groups (n = 12 each), including the control, the expansion (E), the E + cPTH, and the E + iPTH. A thermosensitive controlled-release hydrogel was synthesized for cPTH administration. All animals were sacrificed after seven days. Microcomputed tomography, histochemical staining and real-time PCR were used to investigate the bone remodeling of midpalatal suture. Serum chemistry was adopted to evaluate the systemic condition of experimental animals.

RESULTS

The suture width was increased by the expansion, and further elevated by cPTH and iPTH administration. Both regimes improved bone volume fraction and trabecular thickness of suture bone region. Moreover, both cPTH and iPTH decreased SOST expression and enhanced the expression of β-catenin and Col-I. cPTH increased RANKL expression, inhibited OPG expression, and resulted in an increment of osteoclasts, while iPTH had no influence on osteoclastogenesis. The serum calcium concentration was enhanced by PTH administration.

CONCLUSION

Both cPTH and iPTH promote midpalatal suture expansion by enhancing bone formation, probably via SOST downregulation and the resulting β-catenin activation. Our results demonstrated that PTH administration may have potential to be an adjunctive approach for maxillary expansion treatment.

Micro-osteoperforations accelerate orthodontic tooth movement by stimulating periodontal ligament cell cycles

INTRODUCTION

The aim of this study was to investigate the mechanism of how micro-osteoperforations (MOPs) accelerate tooth movement. We focused on inflammation, cell proliferation, and apoptosis of periodontal ligament cells and performed immunostaining of MOPs exposed to tumor necrosis factor-alpha (TNF-α), proliferating cell nuclear antigen (PCNA), and terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) during experimental tooth movement.

METHODS

Eleven-week-old male Wistar rats were divided into 2 groups: (1) 10 g of orthodontic force applied to the maxillary first molar (TM) and (2) force application plus 3 small perforations of the cortical plate (TM + MOPs). On days 1, 4, 7, 10, and 14 after force application, we investigated tooth movement and alveolar bone microstructure using microcomputed tomography (n = 5). We also determined the expression of TNF-α and PCNA in the pressure sides of periodontal ligaments via an immunohistochemical analysis. The expression of apoptotic cells was also determined by the TUNEL method.

RESULTS

The tooth movement in the TM + MOPs group was significantly greater on days 4 to 14 than in the TM group. The TM + MOPs group showed statistically significant decreases in bone volume/tissue volume ratio and bone mineral density compared with the TM group. The ratios of TNF-α positive cells in the TM + MOPs group were increased on days 1, 4. 7, and 10 compared with the TM group. The ratios of PCNA positive cells in the TM + MOPs group were increased on days 1, 4, and 7 compared with the TM group, and the ratios of TUNEL positive cells in the TM + MOPs group were increased on days 1 and 7 compared with the TM group.

CONCLUSIONS

These results suggest that MOPs may accelerate tooth movement through activation of cell proliferation and apoptosis of periodontal ligament cells.

Effects of lactoferrin on bone resorption of midpalatal suture during rapid expansion in rats

INTRODUCTION

The aim of this study was to investigate the effect of lactoferrin (LF) on bone resorption of rats' midpalatal sutures during rapid palatal expansion.

METHODS

Sixty male 5-week-old Wistar rats were randomly divided into 3 groups: expansion only (EO), expansion plus LF (E + LF), and sham device (control).

RESULTS

Microcomputed tomography showed that the bone volume/tissue volume ratio and the relative bone mineral density of the suture bone were significantly increased in the E + LF group compared with the EO group. Histochemical staining suggested that the activity of osteoblast-like cells and the amount of new bone formation were stimulated in the E + LF group whereas the activity of osteoclasts showed no obvious difference between groups. On the other hand, the immunohistochemical and the real-time polymerase chain reaction results showed that the expressions of receptor activator of nuclear factor kappa B ligand and osteoprotegerin had no significant difference between the EO and E + LF groups.

CONCLUSIONS

These findings demonstrated that LF could stimulate bone volume and bone density in midpalatal sutures during the suture remodeling process under tensile force. However, this enhancement effect was not caused by the reduction of bone resorption.

Inhibition of bone resorption by bisphosphonates interferes with orthodontically induced midpalatal suture expansion in mice

OBJECTIVES

Craniofacial sutures are important growth sites for skull development and are sensitive to mechanical stress. In order to determine the role of bone resorption in stress-mediated sutural bone growth, midpalatal suture expansion was performed in mice receiving alendronate, an anti-resorptive bisphosphonate.

MATERIALS AND METHODS

The midpalatal sutures of 8-week-old C57BL/6 mice were expanded by orthodontic wires over the period of 2 weeks. Mice with maxillary expansion without drug treatment as well as untreated animals served as controls. Skulls were analyzed with micro-computed tomography (micro-CT), immunohistochemistry and histology.

RESULTS

Maxillary expansion in mice without drug treatment resulted in an increase of TRAP-positive osteoclasts. In contrast, no increase in osteoclasts was observed in expanded sutures of mice with bisphosphonate treatment. Double calcein labeling demonstrated rapid bone formation on the oral edges of the expanded sutures in mice without bisphosphonate treatment. Less bone formation was observed in bisphosphonate-treated mice after expansion. Histology revealed that the sutural architecture was reestablished in expanded sutures of mice without bisphosphonate treatment. In contrast, the sutural architecture was disorganized and the cartilage had an irregular form, following expansion in bisphosphonate-treated mice. Finally, micro-CT imaging demonstrated that the total amount of maxillary expansion was significantly lower in mice with bisphosphonate treatment as compared to those of mice without drug treatment.

CONCLUSIONS

In conclusion, our results indicate that osteoclast-mediated bone resorption is needed for maxillary suture expansion and reorganization of sutural architecture.

CLINICAL SIGNIFICANCE

Orthodontic palatal expansion can be complicated in patients with inherited or drug-induced diseases of osteoclast dysfunction.

Stretch force guides finger-like pattern of bone formation in suture

Mechanical tension is widely applied on the suture to modulate the growth of craniofacial bones. Deeply understanding the features of bone formation in expanding sutures could help us to improve the outcomes of clinical treatment and avoid some side effects. Although there are reports that have uncovered some biological characteristics, the regular pattern of sutural bone formation in response to expansion forces is still unknown. Our study was to investigate the shape, arrangement and orientation of new bone formation in expanding sutures and explore related clinical implications. The premaxillary sutures of rat, which histologically resembles the sutures of human beings, became wider progressively under stretch force. Micro-CT detected new bones at day 3. Morphologically, these bones were forming in a finger-like pattern, projecting from the maxillae into the expanded sutures. There were about 4 finger-like bones appearing on the selected micro-CT sections at day 3 and this number increased to about 18 at day 7. The average length of these projections increased from 0.14 mm at day 3 to 0.81 mm at day 7. The volume of these bony protuberances increased to the highest level of 0.12 mm³ at day 7. HE staining demonstrated that these finger-like bones had thick bases connecting with the maxillae and thin fronts stretching into the expanded suture. Nasal sections had a higher frequency of finger-like bones occuring than the oral sections at day 3 and day 5. Masson-stained sections showed stretched fibers embedding into maxillary margins. Osteocalcin-positive osteoblasts changed their shapes from cuboidal to spindle and covered the surfaces of finger-like bones continuously. Alizarin red S and calcein deposited in the inner and outer layers of finger-like bones respectively, which showed that longer and larger bones formed on the nasal side of expanded sutures compared with the oral side. Interestingly, these finger-like bones were almost paralleling with the direction of stretch force. Inclined force led to inclined finger-like bones formation and deflection of bilateral maxillae. Additionally, heavily compressive force caused fracture of finger-like bones in the sutures. These data together proposed the special finger-like pattern of bone formation in sutures guided by stretch force, providing important implications for maxillary expansion.

Expression of MMP-2 and TIMP-1 during rapid maxillary expansion in rats

OBJECTIVE

The aim of this study was to investigate the expression of MMP-2 and TIMP-1 during midpalatal suture expansion in rats.

DESIGN

72 male Wistar rats were randomly divided into 2 groups: the experimental group and the control group. In the experimental group, opening loops were applied across the midpalatal suture with an initial force of 50g, whereas in the control group, rats were subjected to sham installation of opening loops without activation. On day 1, 4, 7 and 14, nine rats from each group were sacrificed, and the maxillae were dissected and prepared for Immunohistochemistry (IHC) and RT- PCR examination of MMP-2 and TIMP-1 expression.

RESULTS

The results of IHC and Real Time PCR revealed that both protein and mRNA expression of MMP-2 and TIMP-1 were significantly increased after midpalatal expansion, and the ratio of MMP-2/TIMP-1 was also significantly enhanced.

CONCLUSIONS

The data suggested that MMP-2 and TIMP-1 might play an important role during the mid-palatal suture remodeling process of maxillary expansion.

Intramuscular injection of bone marrow mononuclear cells contributes to bone repair following midpalatal expansion in rats

Healing from injury requires the activation and proliferation of stem cells for tissue repair. Previous studies have demonstrated that bone marrow is a central pool of stem cells. The present study aimed to investigate the route undertaken by bone marrow mononuclear cells (BMMCs) following BMMC transplantation by masseter injection in a rat model of midpalatal expansion. The rats were divided into five groups according to the types of midpalatal expansion, incision and BMMC transplantation. Samples of midpalatal bone from the rats in each group were used for histological and immunohistochemical assessments to track and evaluate the differential potentials of the transplanted BMMCs in the masseter muscle and midpalatal bone. Bromodeoxyuridine was used as a BMMC tracing label, and M-cadherin was used to detect muscle satellite cells. The BMMCs injected into the masseter were observed, not only in the masseter, but also in the blood vessels and oral mucosa, and enveloped the midpalatal bone. A number of the BMMCs transformed into osteoblasts at the boundary of the neuromuscular bundle, and were embedded in the newly formed bone during midpalatal bone regeneration. The results of the present study suggested that BMMCs entered the circulation and migrated from muscle to the bone tissue, where they were involved in bone repair. Therefore, BMMCs may prove useful in the treatment of various types of cancer.

Effect of Royal Jelly on new bone formation in rapid maxillary expansion in rats

Background

The aim of this study was to evaluate the effects of long and short term systemic usage of royal jelly on bone formation in the expanded maxillary suture in a rat model.

Material and Methods

Twenty eight Wistar albino rats were randomly divided into 4 equal groups: Control (C); Only Expansion (OE), Royal Jelly (RJ) group, Royal Jelly was given to rats by oral gavage only during the expansion and retention period; Royal Jelly plus Nursery (RJN) group, Royal Jelly was given to rats by oral gavage during their nursery phase of 40 days and during the retention period. After the 5 day expansion period was completed, the rats underwent 12 days of mechanical retention. All rats were sacrificed in same time. Histological examination was performed to determine the number of osteoclasts, number of osteoblasts, number of capillaries, inflammatory cell infiltration, and new bone formation.

Results

New bone formation, number of osteoclasts, number of osteoblasts, and the number of capillaries in the expanded maxillary sutures were higher in the RJ and RJN groups than in the other groups. Statistical analysis also demonstrated that new bone formation and the number of osteoblasts was also highest in the RJN group.

Conclusions

The systemic administration of Royal Jelly in conjunction with rapid maxillary expansion may increase the quality of regenerated bone.

Key words:Bone formation, rapid maxillary expansion, Royal jelly.

Effect of heterologous bone marrow mononuclear cell transplantation on midpalatal expansion in rats

The aim of this study was to explore whether bone marrow mononuclear cell (BMMC) transplantation is able to accelerate the bone remodeling induced by midpalatal expansion in rats. A total of 48 male Sprague-Dawley rats (mean weight, 208.36±7.32 g) were divided into control and midpalatal expansion with or without BMMC transplantation groups. Histological and morphological changes were observed in each group. The osteogenic activities and differential potentials of the transplanted BMMCs labeled with bromodeoxyuridine in the midpalatal bone tissue were assessed by osteocalcin expression. The receptor activator of nuclear factor κB ligand (RANKL)/osteoprotegerin (OPG) ratio was determined by reverse transcription-quantitative polymerase chain reaction (RT-qPCR) to reflect the equilibrium between bone resorption and formation. The results demonstrated that the width of the maxillary dental arch increased distinctly within 2 weeks of midpalatal expansion with BMMC transplantation. The morphology of the midpalatal suture in this group changed significantly; the cartilage was completely replaced by fibrous-like tissue expressing osteocalcin. The palatal bone was reorganized from a cancellous form into a mature compact structure after an additional 2-week relapse period. Immunostaining results indicated that the heterologous transplanted BMMCs survived and differentiated into osteoblasts during the remodeling induced by midpalatal expansion. The RANKL/OPG expression ratio significantly decreased after 2 weeks of midpalatal expansion with BMMC transplantation due to the inhibition of RANKL expression. Heterologous BMMC transplantation appears to accelerate the midpalatal bone remodeling induced by expansion of the rats through increasing the number of osteoprogenitor cells and regulating the RANKL-OPG signaling pathway.

Expressão de TGFβ1 mRNA nas fases iniciais de expansão da sutura palatina mediana

INTRODUÇÃO: a expansão da maxila induz a formação de novo osso na sutura palatina mediana por um processo de proliferação e diferenciação celular. A força de expansão pode estimular, nas células progenitoras, a produção de citocinas com atividade osteoindutiva, tais como o transforming growth factor β1(TGFβ1). OBJETIVOS: o principal objetivo deste estudo foi determinar a função dessa citocina nos estágios iniciais de expansão da sutura palatina mediana. MÉTODOS: um aparelho ortodôntico foi instalado entre os molares superiores direito e esquerdo de ratos com 4 semanas de idade. A força de expansão inicial foi de 50g. Os grupos controle e experimental foram sacrificados nos dias 0, 2 e 5. Cortes bucais de 6µm foram obtidos e sujeitos à técnica de hibridização in-situ. RESULTADOS: dois dias após a aplicação de força, as células osteocondroprogenitoras, distribuídas no lado interno do tecido cartilaginoso, exibiram altos níveis de transcrição de transforming growth factor β1. No dia 5, o nível de transcrição de TGFβ1 foi observado nos osteócitos e nas células osteoblásticas, na superfície do novo osso. A atividade osteoblástica foi confirmada por meio de um estudo imunohistoquímico utilizando-se Osteocalcina-Pro (OC-Pro). CONCLUSÕES: os dados sugerem que a expansão da sutura palatina induz a diferenciação de células osteocondroprogenitoras em osteoblastos, estimuladas pela produção de citocinas

Lithium delivery enhances bone growth during midpalatal expansion

Lithium is an activator of β-catenin signaling, and β-catenin mediates bone acquisition in response to mechanical loading in the bone. We tested the hypothesis that lithium enhances new bone formation during midpalatal suture expansion. Forty-eight Wistar rats with or without suture expansion were gavage-fed daily with lithium chloride or sodium chloride. We labeled the rats with bromodeoxyuridine to evaluate the proliferation and differentiation of the osteoprogenitors. Lithium increased β-catenin expression and cell proliferation in expanding sutures. Initial delay in the differentiation of osteoprogenitors into mature osteoblasts by lithium treatment corresponded with expansion of pre-osteoblasts, which preceded the increase of new bone formation in the suture. These results suggested that β-catenin regulates proliferation of osteoprogenitors and maturation of osteoblasts during midpalatal suture expansion osteogenesis, and that lithium enhances bone regeneration by elevating β-catenin expression. Lithium treatment could be a pharmaceutical aid to improve the stability of orthodontic treatment like rapid palatal expansion.

Cleft lip and palate genetics and application in early embryological development

The development of the head involves the interaction of several cell populations and coordination of cell signalling pathways, which when disrupted can cause defects such as facial clefts. This review concentrates on genetic contributions to facial clefts with and without cleft palate (CP). An overview of early palatal development with emphasis on muscle and bone development is blended with the effects of environmental insults and known genetic mutations that impact human palatal development. An extensive table of known genes in syndromic and non-syndromic CP, with or without cleft lip (CL), is provided. We have also included some genes that have been identified in environmental risk factors for CP/L. We include primary and review references on this topic.

Up-regulation of multiple proteins and biological processes during maxillary expansion in rats

Background

Maxillary expansion (ME) is a common practice in orthodontics that aims to increase the constricted maxillary arch width. Relapse often occurs, however, and better treatment strategies are needed. In order to develop a more effective method, this study was designed to further examine the process of tissue remodeling during ME, to identify the changes in expression of several proteins of interest, and to clarify the molecular mechanism responsible for tissue remodeling.

Methods

Male Wistar rats were randomly divided into control and ME groups. The rats were euthanized at various intervals over 11 days, and the dissected palates were prepared for histological examination. The structure of the midpalatal sutures changed little during the first three days. Proteins from samples in the ground midpalatal tissues obtained on the third day were subjected to two-dimensional polyacrylamide gel electrophoresis (2-DE) and matrix assisted laser desorption/ionization-time of flight mass spectrometry (MALDI-TOF MS) analysis. Validation of protein expression was performed by Western blot analyses.

Results

From day 5, chondrocytes in the inner layer of suture cartilage and osteoblasts at the end of the suture cartilage began to proliferate, and the skeletal matrix increased later adjacent to the cartilage in the ME group. Comparative proteomic analysis showed increases in 22 protein spots present in the ME group. The changes in three proteins closely related to osteogenesis (parathyroid hormone, osteoprotegerin and vimentin) were confirmed by Western blotting.

Conclusion

Many proteins are over-expressed during ME, and they may play an important role in the remodeling process.

Immunohistochemical identification of TGF-beta1 at the maxillaries in growing Sprague-Dawley rats and after muscle section

Growth factors are currently being extensively studied in the literature to ascertain their role during maxillofacial development. Taking into account that few investigations refer to the functions of growth in the maxillaries, our aim was to identify the TGF-beta1 immunohistochemical expression pattern in the maxillaries of growing rats. A secondary aim was to identify this pattern after orofacial function inhibition by muscle section. In the palate and the mandibular symphysis and body, we found that bone was formed through an endomembranous pathway with intense TGF-beta1 staining inside chondroid cells during the maximum development stages. At the midpalatal suture and the mandibular symphysis and condyle, endochondral ossification was detected with an intense expression of TGF-beta1 inside the chondrocytes when major growth occurred. After the muscle had been sectioned, at the mandible the maturation process was accelerated, this change being transitory until muscular function was recovered. However, at the palate, the intervention caused a greater disturbance of the growing pattern, which did not recover normality.

Mechanical force-induced midpalatal suture remodeling in mice

Mechanical stress is an important epigenetic factor for regulating skeletal remodeling, and application of force can lead to remodeling of both bone and cartilage. Chondrocytes, osteoblasts and osteoclasts all participate and interact with each other in this remodeling process. To study cellular responses to mechanical stimuli in a system that can be genetically manipulated, we used mouse midpalatal suture expansion in vivo. Six-week-old male C57BL/6 mice were subjected to palatal suture expansion by opening loops with an initial force of 0.56 N for the periods of 1, 3, 5, 7, 14 or 28 days. Periosteal cells in expanding sutures showed increased proliferation, with Ki67-positive cells representing 1.8+/-0.1% to 4.5+/-0.4% of total suture cells in control groups and 12.0+/-2.6% to 19.9+/-1.2% in experimental/expansion groups (p<0.05). Starting at day 1, cells expressing alkaline phosphatase and type I collagen were seen. New cartilage and bone formation was observed at the oral edges of the palatal bones at day 7; at the nasal edges only bone formation without cartilage appeared to occur. An increase in osteoclast numbers suggested increased bone remodeling, ranging from 60 to 160% throughout the experimental period. Decreased Saffranin O staining after day 3 suggested decreased proteoglycan content in the secondary cartilage. Micro-CT showed a significant increase in maxillary width at days 14 and 28 (from 2334+/-4 microm to 2485+/-3 microm at day 14 and from 2383+/-5 microm to 2574+/-7 microm at day 28, p<0.001). The suture width was increased at days 14 and 28, except in the oral third region at day 28 (from 48+/-5 microm to 36+/-4 microm, p<0.05). Bone volume/total volume was significantly reduced at days 14 and 28 (50.2+/-0.7% vs. 68.0+/-3.7% and 56.5+/-1.0% vs. 60.9+/-1.3%, respectively, p<0.05), indicative of increased bone marrow space. These findings demonstrate that expansion forces across the midpalatal suture promote bone resorption through activation of osteoclasts and bone and cartilage formation via increased proliferation and differentiation of periosteal cells. Mouse midpalatal suture expansion would be useful in further studies of the ability of mineralized tissues to respond to mechanical stimulation.

Role of the osteoclast in cranial suture waveform patterning

This study investigates the role of bone resorption in defining interdigitations characteristic of cranial suture waveform. Male mice from the CD-1 (ICR) background were analyzed at six age groups (n = 5 mice per group) in order to study the ontogenetic changes of osteoclast counts using tartrate-resistant acid phosphatase-stained histological sections of sagittal sutures. Additionally, the complexity of suture lines were measured ectocranially from the same age groups (n = 5 per group) using image capture and fractal geometry (ruler dimension method). The results suggest that osteoclast resorption is a contributor to suture patterning. Specifically, osteoclasts show the greatest activity along concave suture regions at 42 and 84 days (Kruskal-Wallis test statistic = 14.9; P < or = 0.01). This coincides with significant increases incrementally in suture complexity as measured with fractal dimension at 42 and 84 days of age (ANOVA F-statistic = 19.84; P < or = 0.001). In congruence with these data, mice given osteoclast-depleting injections of alendronate show a decrease in sagittal suture complexity. Data from this experiment indicate a positive relationship between suture complexity and osteoclast count (P < 0.01; r = 76%). Increases in suture complexity and osteoclast activity occur after peak rates of cranial width growth and coincide with weaning and the transition to a hard chow diet. These data demonstrate osteoclasts along the bone margin of the cranial suture and also indicate that sutures attain their complex shape at the same age when osteoclast number is highest along concave suture margins, underscoring the role of osteoclasts in generating the suture waveform pattern.

Cellular response to force application at craniofacial sutures

OBJECTIVES

To provide a comprehensive review of the literature describing research done on the responses of suture cells to force application in vitro and in vivo.

DESIGN AND RESULTS

This review outlines the types of forces that can be applied, methods of applying the forces, the sutures used in experiments, and the changes in morphology, molecular biology (gene and protein expression), and cell biology (proliferation, differentiation, apoptosis) in response to these forces.

CONCLUSION

The molecular response of sutures to force needs to be further investigated as these molecules can be used to enhance the way in which craniofacial sutures respond to mechanical force during orthopedic-orthodontic treatment.

A new approach to repairing cleft palate and acquired palatal defects with distraction osteogenesis

Cleft palate (CP) is one of the most common human congenital deformities, and acquired palate defects after trauma or tumour resection are also common. In this study, distraction osteogenesis (DO) for CP and other palatal bone defects was evaluated. Twenty cats were assigned randomly to 3 groups of (1) 15, (2) 3 and (3) 2 cats. In groups 1 and 2, a rectangular ostectomy, in the posterior of the palatal bone shelf, was performed in the sagittal axis to establish the CP defect model. At the same time, a pure titanium intraoral distractor was fixed to molar teeth with brackets and to the palatal bone shelf across the defect with titanium miniscrews bilaterally. Four weeks later, a secondary transport disc (TD) osteotomy was performed, and gradual DO treatment started at 0.4mm twice a day, after 6 days of latency. DO was performed until the TD reached the opposite margin over the gap in 5-6 days. Three cats each of group 1 were killed at 2, 4, 6, 8 and 12 weeks after completion of DO. In group 2, the bone and soft-tissue defects were untreated until death 6 weeks later. Group 3 cats (control) were killed after 6 weeks. The TD successfully recombined with the opposite palatal bone stump, and proportional expansion of the overlay mucoperiosteal flap was achieved. Intramembranous bone formation was revealed: parallel collagen bundles gradually deposited on new bone trabeculae while the proliferative osteoblasts produced bone matrix. The bone defect was finally reconstructed by de novo osteogenesis. The control group was observed to have no spontaneous repairing. These results suggest that the CP defect was reconstructed by osteogenesis in situ, and the soft tissues expanded simultaneously to achieve functional correction. The intraoral distractor provided both effective distraction and stability.

Matrix and gene expression in the rat cranial base growth plate

Recent data have shown that the proliferation and differentiation of the cranial base growth plate (CBGP) chondrocytes are modulated by mechanical stresses. However, little is known about the expression of genes and matrix molecules in the CBGP during development or under mechanical stresses. The objective of the present study was to determine whether several cartilage- and bone-related molecules are expressed in the CBGP and whether their expression is modulated by cyclic loading. The CBGP of normal 8-day-old rats (n=8) were isolated immediately after death, followed by extraction of total RNA and reverse transcription/polymerase chain reaction (RT-PCR) analysis. All studied genes, including type II and X collagens, biglycan, versican, osteocalcin, osteopontin, and fetal liver kinase 1, were expressed in the CBGP with a reproducible absence of decorin mRNA. In age- and sex-matched rats (n=10), exogenous cyclic forces were applied to the maxilla at 500 mN and 4 Hz for 20 min/day over 2 days, followed by RNA isolation and RT-PCR analysis. This exogenous cyclic loading consistently induced the expression of the decorin gene, which was non-detectable, by the current RT-PCR approach, in control neonatal CBGPs without loading. Immunolocalization of several of the above-studied gene products demonstrated their remarkable site-specific expression. Decorin proteoglycan was primarily expressed in the perichondrium instead of various cartilage growth zones, especially upon mechanical loading. These findings serve as baseline data for the expression of several genes and gene products in the neonatal CBGP. Mechanical modulation of decorin expression is consistent with recent reports of its susceptibility to mechanical loading in several connective tissues.

Lifetime high calcium intake increases osteoporotic fracture risk in old age

Caloric restriction prolongs life span. Calcium restriction may preserve bone health. In osteoporosis, bone mineral density (BMD) has significantly decreased, due to a lack of osteoblast bone formation. Traditional osteoporosis prevention is aimed at maximizing BMD, but the lifetime effects of continuously maintaining a high BMD on eventual bone health in old age, have not been studied. Strikingly, in countries with a high mean BMD, fracture rates in the elderly are significantly higher than in countries with a low mean BMD. Studies show that this is not based on genetic differences. Also, in primary hyperparathyroidism, on the brink of osteoporosis, BMD levels may be significantly higher than normal. Maybe, BMD does not represent long term bone health, but merely momentary bone strength. And maybe, maintaining a high BMD might actually wear out bone health. Since osteoporosis particularly occurs in the elderly, and because in osteoporotic bone less osteoblasts are available, the underlying process may have to do with ageing of osteoblastic cells. In healthy subjects, osteoblastic bone cells respond to the influx of calcium by composing a matrix upon which calcium precipitates. In the process of creating this matrix, 50-70% of the involved osteoblasts die. The greater the influx of calcium, the greater osteoblast activity, and the greater osteoblast apoptosis rate. An increased osteoblast apoptosis rate leads to a decrease in the age-related osteoblast replicative capacity (ARORC). In comparison to healthy bone, in osteoporotic bone the decrease in the replicative capacity of osteoblastic cells is greater. Due to the eventual resulting lack of osteoblast activity, micro-fractures cannot be repaired. Continuously maintaining a high BMD comes with continuously high bone remodeling rates, which regionally exhaust the ARORC, eventually leading to irreparable microfractures. Regarding long time influences on bone health, adequate estrogen levels are known to be protective against osteoporosis. This is generally attributed to its inhibiting influence on osteoclast activity. Instead, its net effects on osteoblast metabolism may be the key to osteoporosis prevention. Adequate estrogen levels inhibit osteoblast activity, calcium apposition and osteoblast apoptosis rate, preserving the ARORC.

CONCLUSION

Regarding osteoporosis prevention, ARORC better than BMD represents bone health. Regarding ARORC, adequate estrogen levels are protective, opposing the similar effects of hyperparathyroidism and a high calcium diet. Tests need to be performed in mice to assess the lifetime effects of a high versus a low calcium diet, on eventual bone fracture toughness.

Influence of growth hormone on the mandibular condylar cartilage of rats

Growth hormone (GH) stimulates mandibular growth but its effect on the mandibular condylar cartilage is not well understood.

OBJECTIVE

This study was designed to understand the influence of GH on mitotic activity and on chondrocytes maturation. The effect of GH on cartilage thickness was also determined.

DESIGN

An animal model witt differences in GH status was determined by comparing mutant Lewis dwarf rats with reduced pituitary GH synthesis (dwarf), with normal rats and dwarf animals treated with GH. Six dwarf rats were injected with GH for 6 days, while other six normal rats and six dwarf rats composed other two groups. Mandibular condylar tissues were processed and stained for Herovici's stain and immunohistochemistry for proliferating cell nuclear antigen (PCNA) and alkaline phosphatase (ALP). Measurements of cartilage thickness as well as the numbers of immunopositive cells for each antibody were analysed by one-way analysis of variance.

RESULTS

Cartilage thickness was significantly reduced in the dwarf animals treated with GH. PCNA expression was significant lower in the dwarf rats, but significantly increased when these animals were treated with GH. ALP expression was significant higher in the dwarf animals, while it was significantly reduced in the dwarf animals treated with GH.

CONCLUSIONS

The results from this study showed that GH stimulates mitotic activity and delays cartilage cells maturation in the mandibular condyle. This effect at the cellular level may produce changes in the cartilage thickness.

Propulsive appliance stimulates the synthesis of insulin-like growth factors I and II in the mandibular condylar cartilage of young rats

Functional orthopedic appliances correct dental malocclusion partially by exerting indirect mechanical stimulus on the condylar cartilage, modulating growth and the adaptation of orofacial structures. However, the exact nature of the biological responses to this therapy is not well understood. Insulin-like growth factors I and II (IGF-I and IGF-II) are important local factors during growth and differentiation of several tissues, including cartilage. The aim of this study was to verify the mRNA and protein expression of IGF-I and IGF-II in the condylar cartilage of young male Wistar rats that used a mandibular propulsive appliance for 3, 5, 7, 9, 11, 13 or 15 days. For this purpose, sagittal sections of decalcified and paraffin-embedded condyles were submitted to immunohistochemistry and in situ hybridization. IGF-I and IGF-II expression increased with developmental age in the control and treated rats. After 9 days of treatment the positivity for both peptides in the animals that wore the propulsive appliance increased even more, expressively different from the age-matched controls. The expression patterns of both IGFs were similar, although IGF-I labelling was stronger. Furthermore, the enhanced expression of both peptides was in parallel with the proliferating cell nuclear antigen (PCNA) positivity, a proliferation cell marker. The modulation of IGF-I and IGF-II expression in the condylar cartilage in response to the propulsive appliance suggests that both peptides are involved in the mandibular adaptation during this therapy.

The regulation of bone resorption in tooth formation and eruption processes in mouse alveolar crest devoid of cathepsin k

Osteoclastic bone resorption has recently been implicated in the tooth formation and eruption in alveolar bone. Cathepsin K (CK) is a cysteine proteinase expressed predominantly in osteoclasts and is believed to play a critical role in degradation of bone matrix proteins. Here we present evidence that the alveolar bone resorption is essential for the tooth formation and that eruption proceeds normally in CK-deficient (CK-/-) mice. Radiographic and histological analyses revealed that the alveolar bone from these animals had no significant abnormalities during the tooth development between 5 and 28 days after birth. The tooth crown was normally erupted through the alveolar bone layer at 28 days after birth. The number of tartrate-resistant acid phosphatase-positive multinuclear cells in the alveolar bone around the tooth germ was apparently increased in 5-day-old CK-/- mice compared with age-matched littermates. More important, however, the immunohistochemical localization of matrix metalloproteinase-9 (MMP-9) was clearly increased in the CK-/- osteoclasts. In contrast, no significant difference in the immunoreactivity for cathepsin D was observed between the CK-/- osteoclasts and the wild-type ones. These results indicate that CK-/- osteoclasts are fully differentiated and are capable of degrading the organic phase of alveolar bone during the tooth formation and eruption, which may result from the compensatory action by MMP-9 increasingly expressed in the osteoclasts.

Cell death and mechanoprotection by filamin a in connective tissues after challenge by applied tensile forces

Cells in mechanically challenged environments must cope with high amplitude forces to maintain cell viability and tissue homeostasis. Currently, force-induced cell death and the identity of mechanoprotective factors are not defined. We examined death in cultured periodontal fibroblasts, connective tissue cells that are exposed to heavy applied forces in vivo. Static tensile forces (0.48 piconewtons/microm2 cell area) were applied through magnetite beads coated with collagen or bovine serum albumin. There was a time-dependent increase of the percentage of propidium iodide-permeable cells in force-loaded cultures incubated with collagen but not bovine serum albumin beads, indicating a role for integrins. Cells exhibited reduced mitochondrial membrane potential, increased caspase-3 activation, nuclear condensation, terminal deoxynucleotidyl transferase nick end labeling staining, and detachment from the culture dish. The caspase-3 inhibitor acetyl-Asp-Glu-Val-Asp-aldehyde reduced detachment 3-fold. There was a rapid (<10-s) decrease in plasma membrane potential after force application, which, in filamin A-deficient melanoma cells, contributed to irreversible cell depolarization. In fibroblast cultures, cells with increased permeability to propidium iodide exhibited approximately 2-fold less filamin A content than impermeable cells. Fibroblasts transfected with antisense filamin A constructs or with filamin A constructs without an actin-binding domain exhibited 2-3-fold increased proportions of dead cells relative to controls. We conclude that high amplitude forces delivered through integrins can promote apoptosis in a proportion of cells and that filamin A confers mechanoprotection by preventing membrane depolarization.

Cell proliferation and cell death in periodontal ligaments during orthodontic tooth movement

The purpose of this study was to investigate cellular responses of periodontal ligaments during tooth movement. Twenty-eight male Sprague-Dawley rats, weighing 200-250 g each, were used. To create the orthodontic force, elastic rubber blocks (0.65 mm thick) were inserted between the maxillary first and second molars on both sides. On days 3, 7, 10, 14, 21 and 28 after rubber block insertion, histopathological changes in both the tension and the pressure sides were examined by immunohistochemistry using proliferating cell nuclear antigen (PCNA) and by the TUNEL method. The ratios of PCNA-positive cells on the tension side 3 and 7 days after rubber block insertion were higher than those on the pressure side. The ratios of PCNA-positive cells on the tension side were highest at day 3 after insertion and then decreased during the remainder of the experimental period. On the pressure side, the ratios of PCNA-positive cells increased up to day 10 post insertion, then decreased from 14 to 28 days. The ratios of TUNEL-positive cells on both the tension and the pressure sides increased throughout the entire experimental period. These results indicate that the periodontal ligaments on the tension side are able to respond more promptly to orthodontic forces than those on the pressure side. The data also suggest that the ratios of cell proliferation and of cell death are closely related to the regeneration and reconstruction of periodontal ligaments which reflect the orthodontic force.

Osteoclast clearance from periodontal tissues during orthodontic tooth movement

The presence of osteoclasts at locations of alveolar bone remodeling is antecedent to orthodontic tooth movement. Cell recruitment and clearance are the mechanisms by which osteoclast populations are regulated. Research in other tissues has revealed that many cells die after their functional lives are past by a process called apoptosis, or programmed cell death. The purpose of this study was to examine the role of apoptosis in osteoclast clearance at orthodontically treated sites as a function of time and location. Orthodontic appliances were placed on 96 rats of the Sprague-Dawley strain. The rats were assigned to either treatment or sham (control) groups and killed 1, 3, 5, and 7 days after appliance placement. Tissue samples were prepared for histochemical evaluation and quantification of morphologic features. Tartrate-resistant acid phosphatase (TRAP) and ApopTag (TdT-mediated dUTP-biotin nick 3' end labeling) stains were used to identify osteoclasts and committed preosteoclasts and to discriminate between apoptotic and nonapoptotic nuclei. Pyknotic nuclei and apoptotic bodies were also counted as a morphologic assessment of apoptosis. The percentages of TRAP/ApopTag-positive nuclei were measured in 4 different periodontal regions. There was a highly significant difference in the overall percentage of TRAP/ApopTag-positive nuclei between the control and the treatment groups at 3, 5, and 7 days (P <.001). Morphologic criteria were also statistically different at days 5 and 7 (P <.05). These data strongly suggested that osteoclasts recruited for orthodontic tooth movement are, at least in part, cleared by apoptosis.

Expression and localization of MGP in rat tooth cementum

Tooth cementum, a calcified hard tissue covering the root surfaces, is an important component connecting the teeth to the collagenous fibres of the periodontal ligament. Although the overall composition of cementum may closely resemble that of bone, each part has not been fully characterized. Here, the localization of the matrix gamma-carboxyglutamic acid (Gla) protein (MGP), one of the major Gla-containing proteins in the body, in cementum was investigated using immunohistochemistry and in situ hybridization. (1) Strong MGP antigenicity was observed in the acellular cementum, but was only moderate in the cellular cementum; (2) polygonal periodontal ligament cells facing the acellular cementum and the uncalcified cellular cementum expressed MGP mRNA, indicating that these cells produced MGP and deposited it on the cementum; (3) MGP accumulated at the junction between the uncalcified and calcified cellular cementum; and (4) the distribution pattern of MGP antigenicity resembled that of osteopontin. As one function of MGP could be as a negative regulator for mineral apposition, the expression of MGP in the cells adjacent to the cementum may be important to prevent hyperapposition of minerals.