Alterations of tooth eruption and growth in pups suckling from diabetic dams

An exploratory study of maternal diabetes and offspring use of dental services-Northern Ireland national cohort study

INTRODUCTION

A small number of literature has posited a link between prenatal exposure to gestational diabetes mellitus and an increased risk of developmental defects in the enamel of offspring. However, the evidence remains inconclusive.

AIMS

This study examined the relationship between the diabetes status of mothers and the use of dental services by offspring to that pregnancy.

MATERIAL AND METHODS

Anonymised data from a cohort of mothers who carried a child to term in Northern Ireland between 2012 and 2017 and service use by the child were taken from administrative databases from March 2015 to September 2021. Descriptive statistics, differences in means and regression analyses were used to examine the relationship between service use and maternal diabetes status, controlling for covariates.

RESULTS

In multivariate analyses that controlled inter alia for age and deprivation, diabetes status was negatively related to restoration, extraction, prevention, and total service use. In the analysis of the COVID period, pre-COVID prevention was negatively related to extractions, restorations, prevention and services in general.

CONCLUSION

The relationship between maternal diabetic status and aspects of offspring use of dental services was contrary to that suggested in previous studies and warrants more detailed investigation using this valuable data resource.

Alterations in odontogenesis and tooth eruption resulting from exposure to hexavalent chromium in suckling animals

BACKGROUND

Heavy metals including Cr VI are present in inadequately treated effluents that contaminate drinking water. Hence, Cr VI exposure can affect children through intake of breast milk from an exposed mother or bottle-feeding formula prepared with contaminated water. To date, there are no reports on the effects of Cr VI exposure on tooth formation processes concomitant to tooth eruption.

AIM

To study the effect of Cr VI exposure on tooth tissue formation in suckling Wistar rats by assessing dental tissues at different stages of tooth eruption.

DESIGN

Experimental animals received 12.5 mg/kg body weight/day of a potassium dichromate solution by gavage; control animals were similarly administered an equivalent volume of saline solution. Each group was divided into three subsets according to age at euthanasia: 9, 15, and 23 days. Dental formation was analysed histologically and histomorphometrically.

STATISTICAL ANALYSIS

Student's t test; P < .05.

RESULTS

Cr VI-exposed animals showed a delay in mineralized crown and root tissue formation. These findings are directly associated with the observed delay in tooth eruption.

CONCLUSION

Our findings show the importance of monitoring drinking water levels of toxic substances, since exposure during early childhood can alter tooth formation, growth, and development.

Prenatal exposure to gestational diabetes mellitus increases developmental defects in the enamel of offspring

Background and objective

Gestational diabetes mellitus (GDM) is associated with short- and long-term maternal and perinatal repercussions. Our objective was to evaluate the long-term consequences of intrauterine exposure to hyperglycemia on Developmental Defects of Enamel (DDE) in offspring.

Results

Overall, 50 children of women with GDM and 250 children of normoglycemic women participated, the latter serving as controls. Children were examined at the age between 3 and 12 years. In addition to physical examination, two independent observers examined and rated photographs to identify specific types of DDE in a blinded fashion. Among offspring of mothers with GDM, rates of DDE (all types combined) and hypoplasia (specific type) were significantly higher (p<0.001, p = 0.04), in comparison to offspring of normoglycemic mothers. Considering only the affected teeth (1060 in GDM category; 5499 in controls), rates of DDE (all types combined) were significantly higher for total teeth (p <0.001) and deciduous teeth (p<0.001), but not permanent teeth. In specific types of DDE involving deciduous teeth, rates of demarcate opacity were significantly higher (p<0.001; canine and 2nd mandibular molars) and hypoplasia (p <0.001; 2nd maxillary molars and 2nd mandibular molars). In permanent teeth, the rate of diffuse opacity in association with GDM was significantly higher (p<0.001; maxillary central incisors and 1st maxillary molars).

Conclusion

GDM was associated with the adverse effects of DDE on offspring. This study lays the foundation for future studies to determine the impact of GDM on long-term risk of DDE.

Maternal diabetes modulates dental epithelial stem cells proliferation and self-renewal in offspring through apurinic/apyrimidinicendonuclease 1-mediated DNA methylation

Maternal gestational diabetes mellitus (GDM) has many adverse effects on the development of offspring. Aberrant DNA methylation is a potential mechanism associated with these effects. However, the effects of GDM on tooth development and the underlying mechanisms have not been thoroughly investigated. In the present study, a GDM rat model was established and incisor labial cervical loop tissue and dental epithelial stem cells (DESCs) were harvested from neonates of diabetic and control dams. GDM significantly suppressed incisor enamel formation and DESCs proliferation and self-renewal in offspring. Gene expression profiles showed that Apex1 was significantly downregulated in the offspring of diabetic dams. In vitro, gain and loss of function analyses showed that APEX1 was critical for DESCs proliferation and self-renewal and Oct4 and Nanog regulation via promoter methylation. In vivo, we confirmed that GDM resulted in significant downregulation of Oct4 and Nanog and hypermethylation of their promoters. Moreover, we found that APEX1 modulated DNA methylation by regulating DNMT1 expression through ERK and JNK signalling. In summary, our data suggest that GDM-induced APEX1 downregulation increased DNMT1 expression, thereby inhibiting Oct4 and Nanog expression, through promoter hypermethylation, resulting in suppression of DESCs proliferation and self-renewal, as well as enamel formation.

Maternal diabetes modulates offspring cell proliferation and apoptosis during odontogenesis via the TLR4/NF-κB signalling pathway

OBJECTIVES

Maternal gestational diabetes leads to an adverse in utero environment and increases the risk of malformations during embryo organogenesis. In the present study, we analysed the effects of maternal diabetes on tooth germ cell proliferation and apoptosis in offspring, and investigated their underlying mechanisms.

MATERIALS AND METHODS

A rat model of maternal diabetes was induced by intraperitoneal injection of streptozotocin and the pregnant rats were divided into three groups: controls, the diabetic group and diabetic group with insulin treatment. Offspring of the three groups were collected and cell proliferation and apoptosis in tooth germs were analysed. Primary dental papilla cells and dental epithelial stem cells were isolated and treated with high glucose in vitro, in an attempt to simulate maternal diabetes-induced hyperglycaemia in vivo.

RESULTS

Maternal diabetes significantly affected cell proliferation and apoptosis in offspring tooth germs. The TLR4/NF-ĸB signalling pathway was activated in the tooth germs of offspring of diabetic dams. High glucose treatment activated the TLR4/NF-ĸB signalling pathway in primary dental papilla cells and dental epithelial stem cells in vitro, resulting in suppression of cell proliferation and enhancement of apoptosis. TLR4 knockdown significantly reduced adverse effects induced by high glucose treatment.

CONCLUSIONS

Maternal gestational diabetes significantly impaired dental epithelial and mesenchymal cell proliferation and apoptosis in offspring, possibly by activation of the TLR4/NF-ĸB signalling pathway.

Fluoride alters connexin expression in rat incisor pulp

OBJECTIVE

Connexins (Cxs) are important to control growth and cell differentiation of dental tissues. The aim of the present study was to assess the impact of chronic exposure to sodium fluoride (NaF) on Cxs expression and alkaline phosphatase (ALP) activity in dental pulp, and on morphometric parameters of adult rat mandible and incisors.

DESIGN

Three groups of male Wistar rats (22 days-old) were given water containing: (a) 0.3 mg/L (Control), (b) 10 mg/L and (c) 50 mg/L of NaF for eight weeks. Incisor pulp homogenates were prepared for determination of Cx32, Cx43 and Cx45 gene expression, using semi-quantitative RT-PCR, and of ALP activity. Morphometric parameters of mandible and incisors were determined on radiographs.

RESULTS

Cx43 gene expression increased with exposure to NaF in a dose-dependent manner. Cx32 mRNA levels were higher than controls in the 10mg/L NaF group only; Cx45 mRNA levels were lower in groups given 10 and 50mg/L of NaF than in controls. ALP activity was higher in both high-NaF dose groups compared to the control group (p<0.05). Lower incisor diameter was lower in the 50 mg/L NaF than in the control group (p<0.01). None of the mandibular growth parameters were affected by NaF treatment.

CONCLUSION

Our results showed that fluorotic alterations in rat incisor were associated with increased Cx43 expression and ALP activity, as well as with changes in the expression pattern of different Cxs in pulp tissue. The observed changes may have a stimulating effect on dentin mineralization.

Impairment of rat tooth eruption in pups born to mothers exposed to chronic stress during pregnancy

OBJECTIVE

Tooth eruption is a multifactorial process in which bone tissue plays a prevailing role. In this study we evaluated the bone overlying the developing tooth germ and the degree of tooth eruption of the first mandibular molar in pups born to mothers subjected to constant light during pregnancy.

DESIGN

Pregnant rats were divided into two groups: mothers chronically exposed to a 12:12 light/light cycle (LL) from day 10 to 20 of pregnancy and controls (C) maintained on a 12:12 h light/dark cycle. Pups from each group were euthanized at the age 3 or 15 days. Buccolingually oriented sections of mandibles were stained with haematoxylin-eosin or for histochemical detection of tartrate resistant acid phosphatase (TRAP). The histomorphometric parameters evaluated were bone volume, number of osteoclasts, TRAP+ bone surface, number of TRAP+ and TRAP- osteoclasts per mm(2) and degree of tooth eruption (mm).

RESULTS

It was found an increase in bone volume (LL: 58.14±4.24 vs. C: 32.31±2.16; p<0.01) and a decrease in the number of osteoclasts (LL: 3.5±0.65 vs. C: 8.03±1.31; p<0.01) and TRAP+ cells (LL: 0.84±0.53 vs. C: 8.59±1.26; p<0.01) in 3-day-old pups born to LL-exposed mothers. These observations are consistent with the decrease in the degree of tooth eruption observed in 15-day-old experimental pups (LL: -0.605±0.05 vs. C: -0.342±0.02; p<0.0001).

CONCLUSION

Our results suggest that chronic constant light applied as a pre-natal stressor impairs the resorptive capacity of osteoclasts involved in the formation of the eruption pathway and consequently the degree of tooth eruption.