Biphasic Functions of Sodium Fluoride (NaF) in Soft and in Hard Periodontal Tissues

Sodium fluoride (NaF) is widely used in clinical dentistry. However, the administration of high or low concentrations of NaF has various functions in different tissues. Understanding the mechanisms of the different effects of NaF will help to optimize its use in clinical applications. Studies of NaF and epithelial cells, osteoblasts, osteoclasts, and periodontal cells have suggested the significant roles of fluoride treatment. In this review, we summarize recent studies on the biphasic functions of NaF that are related to both soft and hard periodontal tissues, multiple diseases, and clinical dentistry.

Peri-implant collagen fibers around human cone Morse connection implants under polarized light: a report of three cases

Most of the histologic studies found in the literature on the peri-implant soft tissues have been done in animals and usually have been confined to mandibular implants fitted with healing or standard abutments. Few studies have investigated human peri-implant soft tissues. Moreover, the structure and dimensions of the peri-implant soft tissues in immediately loaded implants have not been investigated in depth. Human histologic data are valuable to validate animal models. This histologic and histomorphometric study evaluated the peri-implant soft tissues around three immediately loaded implants in humans. The implants were retrieved using a trephine and treated to obtain thin, ground sections. The sulcular epithelium was composed of approximately four to five layers of parakeratinized epithelial cells and had a length of approximately 1.2 to 1.3 mm. The junctional epithelium was composed of approximately three to four layers of epithelial cells and had a length of approximately 1.0 to 1.5 mm. Connective tissue attachment had a width of between 400 and 800 μm. Peri-implant collagen fibers, in the form of bundles (1- to 5-μm thick), began at the crestal bone and were oriented perpendicular to the abutment surface until 200 μm from the surface, where they became parallel running in several directions. Collagen fibers appeared to form a three-dimensional network around the abutment. No acute or chronic inflammatory cell infiltrate was present. Collagen fibers oriented in a perpendicular manner and in direct contact with the abutment surface were not observed in any of the specimens. This differentiated network of fibers may have clinical relevance as a mechanical protection of the underlying bone. These human histologic data are extremely valuable to validate and confirm those obtained from studies performed on animal models. Moreover, immediate loading of the implants did not compromise soft tissue integration.

Expression and function of laminin and integrins on adhesion/migration of primary culture cells derived from rat oral epithelium

BACKGROUND AND OBJECTIVE

It remains controversial whether or not the junctional epithelium cells that are directly attached to teeth migrate on the enamel surface, as those cells are able to adhere firmly to the enamel. The aim of this study was to investigate the expression patterns of laminin gamma(2), integrin beta(4) and integrin alpha(3), and to examine their potential function in cell migration.

MATERIAL AND METHODS

Oral epithelium cells obtained from Sprague-Dawley rats were established in primary culture. We employed a wound-healing assay to characterize the direction of cell extension at the start of cell migration, and observed different localizations of laminin and integrins using immunofluorescence. For functional analyses of integrins, we employed a phosphatidylinositol-3-kinase (PI3K) activator to promote integrin beta(4) function and used P1B5 to inhibit integrin alpha(3) function, and we analyzed the percentage of re-epithelialization as the migration function.

RESULTS

Marked accumulation of laminin gamma(2) was detected in the peripheral cytoplasm of cells adjacent to the wound area, as shown by the results of the migration assay. Integrin beta(4) was detected in the distal cell processes of actively migrating cells, while integrin alpha(3) was found in cell membranes of cells adjacent to the wound area. In the functional analyses, the percentage of re-epithelialization was significantly lower in the PI3K-activator group and in the P1B5-treated group (2.5% and 7.2%, respectively) than in the control group (39.0%) (p < 0.01).

CONCLUSION

The results suggest that laminin gamma(2) is secreted as a foothold for cell migration, that integrin beta(4) participates in cell adhesion and that integrin alpha(3) is involved in cell migration in the primary culture cells.

Involvement of laminin and integrins in adhesion and migration of junctional epithelium cells

BACKGROUND AND OBJECTIVE

The junctional epithelium attaches to the enamel surface with hemidesmosomes (of which laminin-5 and integrin-alpha(6)beta(4) are the main components) in the internal basal lamina. Laminin-5 is also involved in cell motility with integrin-alpha(3)beta(1), although their functions have not yet been clarified.The purpose of this study was to determine the functions of those adhesive components between the tooth and the junctional epithelium during cell migration.Because an idea has been proposed that directly attached to tooth cells (DAT cells) may not contribute to cell migration, 5-bromo-2-deoxyuridine staining was performed to confirm cell migration.

MATERIAL AND METHODS

We investigated laminin-gamma(2) (contained only in laminin-5), integrin-beta(4) (involved in cell-extracellular matrix contact) and integrin-alpha(3) (inducing cell migration) in the junctional epithelium, oral gingival epithelium and gingival sulcus epithelium of 6-wk-old ICR mice using laser microdissection, quantitative real-time reverse transcription-polymerase chain reaction, immunofluorescence and 5-bromo-2-deoxyuridine staining.

RESULTS

Laminin and integrins were clearly immuno-localized in the basal lamina of all epithelium. Quantitative analysis of laminin and integrin mRNAs by laser microdissection showed that they were more highly expressed in DAT cells than in basal cells in the oral gingival epithelium. In particular, a 12-fold higher expression of laminin-5 was observed in the junctional epithelium compared with the oral gingival epithelium. 5-Bromo-2-deoxyuridine staining showed rapid coronal migration of DAT cells.

CONCLUSION

These results suggest that the abundant expression of laminin-5 and integrin-alpha(6)beta(4) is involved in the attachment of DAT cells to teeth by hemidesmosomes. Abundant expression of laminin-5 and integrin-alpha(3)beta(1) might assist in DAT cell migration, confirmed by 5-bromo-2-deoxyuridine staining during the turnover of junctional epithelium.

Characterization of Apin, a secreted protein highly expressed in tooth-associated epithelia

We previously reported expression of a protein by enamel organ (EO) cells in rat incisors, originally isolated from the amyloid of Pindborg odontogenic tumors called Apin. The aim of the present study was to further characterize the Apin gene and its protein in various species, assess tissue specificity, and clarify its localization within the EO. Northern blotting and RT-PCR revealed that expression of Apin was highest in the EO and gingiva, moderate in nasal and salivary glands, and lowest in the epididymis. The protein sequences deduced from the cloned cDNA for rat, mouse, pig, and human were aligned together with those obtained from four other mammal genomes. Apin is highly conserved in mammals but is absent in fish, birds, and amphibians. Comparative SDS-PAGE analyses of the protein obtained from bacteria, transfected cells, and extracted from EOs all indicated that Apin is post-translationally modified, a finding consistent with the presence of predicted sites for phosphorylation and O-linked glycosylation. In rodent incisors, Apin was detected only in the ameloblast layer of the EO, starting at post-secretory transition and extending throughout the maturation stage. Intense labeling was visible over the Golgi region as well as on the apices of ameloblasts abutting the enamel matrix. Apin was also immunodetected in epithelial cells of the gingiva which bind it to the tooth surface (junctional epithelium). The presence of Apin at cell-tooth interfaces suggests involvement in adhesive mechanisms active at these sites, but its presence among other epithelial tissues indicates Apin likely possesses broader physiological roles.

[Comparison of the attachment and growth characteristics between human junctional epithelium and oral epithelium cells]

OBJECTIVE

To compare the attachment and growth characteristics between human junctional epithelium (JE) and oral epithelium cells.

METHODS

The healthy JE biopsies were derived from the human teeth extracted due to impaction or orthodontic purpose. Enzyme digestion was used to isolate JE cells, which were then cultured in DKGM. The co-culture model of JE cell-tooth slice was built up by adding 3 decalcification cementum slices (5 mm x 3 mm x 1 mm) into sterilized plate containing 1 ml of JE cells (5 x 10(8)/L), 21 slices all together,and incubated in an atmosphere containing 5% CO2 at 37 degrees C for 1-14 days. The attachment structure was observed under transmission electron microscope, and the OE cells was used as control.

RESULTS

The human JE cells were polymorphous in shape and CK19 positive, while OE cells were consisted of equal and closely packed epithelial-like cells in a paving stone arrangement, and CK19 was only strained in a few cells. There were a few cells in JE-slice when co-cultured for 1-3 days, and electron dense plaques on the JE cell surface of the attached slice were observed at 9 days, and 2-3 layer of JE cells and hemidesmosome-like structure formed within 11-14 days. There were more OE cells within 1-3 days, electron dense plaques appeared at 7 days, and stratified epithelium and hemidesmosome-like structure formed in OE-slice at 9 days.

CONCLUSIONS

The cultured JE cells were immature and lower differentiated epithelial cells which were different from OE cells. Under the same condition the growth and attachment of JE cells on the cementum slice surface were slower than that of OE cells. Their attachment strength needs further study.

Breaking biological barriers with a toothbrush

Toothbrushing exposes epithelia and other tissues of the oral cavity to mechanical stress. Here, we investigated whether brushing induces cell wounding--plasma membrane disruption--in epithelial and other cell types in the oral cavity. Brushing of the gingivae and tongues of rats resulted in a striking increase in the number of cells positive for a marker of disruption injury. These cells included those in all strata of the gingival epithelium, and in the skeletal muscle of the tongue. Additionally, we found that brushing resulted in an increase in c-fos expression by junctional epithelial and skeletal muscle cells. Epithelial barrier function, however, was not overtly affected by brushing, despite the observed individual injuries to cells. We concluded that brushing disrupts cell plasma membrane barriers in the oral cavity and activates gene expression events that may lead to local adaptive changes in tissue architecture beneficial to gingival health.

Location of proliferating gingival cells following toothbrushing stimulation

OBJECTIVES

Mechanical stimulation by toothbrushing promotes healing of gingivitis through accelerating cell proliferation. Junctional epithelium proliferates at periodontal pocket formation. A question is arisen whether toothbrushing contributes to the repair of gingival inflammation or deterioration of pocket formation. The location of proliferating cells in gingiva stimulated mechanically by toothbrushing was investigated.

MATERIALS AND METHODS

A total of 24 teeth of dogs underwent daily plaque removal with a curette (plaque removal) or both plaque removal and toothbrushing (toothbrushing). Proliferative activity of gingival cells in six individual zones was evaluated by assaying expression of proliferating cell nuclear antigen (PCNA).

RESULTS

Toothbrushing increased densities of PCNA-positive basal cells in the junctional epithelium, connective tissues adjacent to the junctional epithelium, the alveolar bone of the oral epithelial side and the oral epithelium. However, the densities of PCNA-positive cells at the apical portion of the junctional epithelium, connective tissues adjacent to the cementum and the alveolar bone of the periodontal ligament side did not increase following toothbrushing.

CONCLUSIONS

Toothbrushing promotes proliferation of gingival cells other than fibroblasts in periodontium and basal cells in the apical portion of the junctional epithelium. The repair of periodontal tissues might be promoted by toothbrushing within the limit of the direct mechanical stimulation.

Effects of a high-cholesterol diet on cell behavior in rat periodontitis

Studies have shown an association between periodontitis and serum cholesterol levels. We hypothesized that high dietary cholesterol could influence periodontitis as a result of proliferation of the junctional epithelium. Rats were divided into 4 groups. Two groups were fed a regular diet, and 2 groups were fed a high-cholesterol diet. One of each dietary group was treated with periodontitis-inducing agents (lipopolysaccharide and proteases), while the other was treated with pyrogen-free water. Feeding rats with a high-cholesterol diet induced an increase in blood total cholesterol and a decrease in high-density lipoprotein cholesterol. Proliferation of the junctional epithelium with increasing bone resorption was promoted by the consumption of a high-cholesterol diet. High dietary cholesterol further increased the cell-proliferative activity of the junctional epithelium induced by lipopolysaccharide and proteases. These results suggest that high dietary cholesterol can initiate and augment periodontitis in the rat periodontitis model.

Cloning of rat amelotin and localization of the protein to the basal lamina of maturation stage ameloblasts and junctional epithelium

Formation of tooth enamel is a very complex process in which a specific set of proteins secreted by ameloblasts play a primordial role. As part of a screening procedure to identify novel proteins secreted by EO (enamel organ) cells of rat incisors, we isolated a partial cDNA fragment (EO-017) that is the homologue of the recently described mouse Amtn (amelotin) gene [Iwasaki, Bajenova, Somogyi-Ganss, Miller, Nguyen, Nourkeyhani, Gao, Wendel and Ganss (2005) J. Dent. Res. 84, 1127-1132]. Presented herein is the cloning of rat and pig full-length cDNAs with their deduced protein sequences. Detailed expression profiling by Northern-blot analysis and RT (reverse transcriptase)-PCR on rat and mouse tissues revealed highest expression in the mandible, more specifically in the maturation stage of the EO. Among all tissues tested, low expression was detected only in periodontal ligament, lung, thymus and gingiva. In silico analyses revealed that the Amtn gene is highly conserved in seven other mammals, but is absent from fish, birds and amphibians. The Amtn protein is enriched in proline, leucine, glutamine and threonine (52% of total) and contains a perfectly conserved protein kinase CK2 phosphorylation site. Transient transfection experiments in HEK-293 cells (human embryonic kidney cells) showed that secreted Amtn is post-translationally modified possibly through O-linked oligosaccharides on threonine residues. In concordance with its predominant expression site, immunofluorescence localization within the rat and mouse mandibles revealed Amtn localized to the basal lamina of maturation stage ameloblasts of incisors and unerupted molars. Intense Amtn protein expression was also detected in the internal basal lamina of junctional epithelium in molars. The peculiar and unique cellular localization of Amtn suggests a role in cell adhesion.

Regulation of epithelial cell growth factor receptor protein and gene expression using a rat periodontitis model

BACKGROUND AND OBJECTIVE

Regulation of epithelial cell behavior associated with periodontitis is not well elucidated but many responses will ultimately be regulated by growth factor receptors. Using a rat experimental periodontitis model, protein and gene expression of select growth factor receptors in junctional and pocket epithelium were examined.

MATERIAL AND METHODS

Periodontal disease was induced by daily topical application of lipopolysaccharide using an established protocol. Animals were killed at time 0 (control), and at 2 and 8 wk. Frozen tissue samples were collected from the right palatal gingival soft tissue, and the left periodontal tissues were decalcified and embedded in paraffin. Laser microdissection and quantitative reverse transcription-polymerase chain reaction (qRT-PCR) was used to quantify keratinocyte growth factor receptor (KGFR), hepatocyte growth factor receptor (HGFR), epidermal growth factor receptor (EGFR) and fibroblast growth factor receptor 1 (FGFR1) gene expression, and in situ RT-PCR localized these increases to specific epithelial cells. Receptor protein expression was examined immunohistochemically. In cell culture, induction of HGFR and KGFR protein expression by serum, lipopolysaccharide and pro-inflammatory cytokines were examined using flow cytometry.

RESULTS

Eight-week tissue samples exhibited histological changes consistent with periodontitis. KGFR and HGFR gene and protein expression were significantly induced at the 8 wk time point. KGFR expression was significantly up-regulated in basal and parabasal pocket epithelial cells, but HGFR was up-regulated throughout the pocket epithelium. In cell culture serum, lipopolysaccharide and pro-inflammatory cytokines, interleukin-1beta and tumour necrosis factor-alpha significantly induced KGFR protein receptor expression, but HGFR expression was only induced by serum.

CONCLUSION

KGFR and HGFR are highly up-regulated in this model of periodontal disease and may play a significant role in regulating the proliferation and migration of pocket epithelium.

Expression pattern of adhesion molecules in junctional epithelium differs from that in other gingival epithelia

BACKGROUND AND OBJECTIVE

The gingival epithelium is the physiologically important interface between the bacterially colonized gingival sulcus and periodontal soft and mineralized connective tissues, requiring protection from exposure to bacteria and their products. However, of the three epithelia comprising the gingival epithelium, the junctional epithelium has much wider intercellular spaces than the sulcular epithelium and oral gingival epithelium. Hence, the aim of the present study was to characterize the cell adhesion structure in the junctional epithelium compared with the other two epithelia.

MATERIAL AND METHODS

Gingival epithelia excised at therapeutic flap surgery from patients with periodontitis were examined for expression of adhesion molecules by immunofluorescence.

RESULTS

In the oral gingival epithelium and sulcular epithelium, but not in the junctional epithelium, desmoglein 1 and 2 in cell-cell contact sites were more abundant in the upper than the suprabasal layers. E-cadherin, the main transmembranous molecule of adherens junctions, was present in spinous layers of the oral gingival epithelium and sulcular epithelium, but was scarce in the junctional epithelium. In contrast, desmoglein 3 and P-cadherin were present in all layers of the junctional epithelium as well as the oral gingival epithelium and sulcular epithelium. Connexin 43 was clearly localized to spinous layers of the oral gingival epithelium, sulcular epithelium and parts of the junctional epithelium. Claudin-1 and occludin were expressed in the cell membranes of a few superficial layers of the oral gingival epithelium.

CONCLUSION

These findings indicated that the junctional epithelium contains only a few desmosomes, composed of only desmoglein 3; adherens junctions are probably absent because of defective E-cadherin. Thus, the anchoring junctions connecting junctional epithelium cells are lax, causing widened intercellular spaces. In contrast, the oral gingival epithelium, which has a few tight junctions, functions as a barrier.

Junctional epithelium in rats is characterized by slow cell proliferation

BACKGROUND

The integrity of junctional epithelium (JE) and a firm epithelial adhesion to the tooth surface are maintained by the balance between cell proliferation and cell death. Maintaining the JE structure is essential for the protection of periodontal connective tissues against oral microbes. In this study, the proliferative activity and the expression of caspase 3, a cysteine protease associated with cell death, were studied in rat JE and other epithelial structures during molar tooth development.

METHODS

Fourteen rats aged 10 to 70 days were injected with bromodeoxyuridine (BrdU). Samples of first and second molars were selected for immunohistochemical staining. BrdU incorporation was studied in oral epithelium (OE) covering the erupting tooth, reduced enamel epithelium (REE), and gingival epithelium (GE), sulcular epithelium (SE), and JE. Samples were also subjected to immunohistochemical analysis for proliferating cell nuclear antigen (PCNA) and caspase 3.

RESULTS

The basal cells of the GE were actively proliferating, but in the JE, only a few cells were positive for BrdU or PCNA immunostaining. Some outer REE cells were proliferating during tooth eruption. Caspase 3 expression was in specific areas of REE after completion of amelogenesis.

CONCLUSIONS

Results showed slow proliferative activity in the rat JE. However, specific studies on cellular turnover and cell migration are needed to understand tissue homeostasis in this area.

[Culture and comparison of the biological characteristics of human junctional epithelium and gingival epithelium]

PURPOSE

To study the different biological characteristics of human junctional epithelium (JE) and gingival epithelium (GE).

METHODS

Human JE cells were cultured and identified by the cell culture and immunohistochemistry, and the biological characteristics of JE cells and GE cells were compared.

RESULTS

The morphology of cultured JE cells was various and unequal, the arrangement of the cells was loose and mitosis was common, while GE colony was consisted of equal and closely packed epithelial-like cells in a paving stone arrangement. CK-Pan staining was positive in all JE and GE cells. CK19 was strongly stained in all JE cells but only moderately stained in some GE cells, and most GE cells were negative which was obviously different from JE cells. JE cells had longer latent period (7 days) than GE cells (4 days) during the cell growth period, and then the cells proliferated rapidly (4 days) to attain the maximum and descended rapidly in the declining period. While GE cells ascended evenly (7 days) to attain the maximum and descended slowly in the declining period. Proliferation study demonstrated the doubling time of JE cells was 48 to 60 hours and that of GE cells was 72 to 96 hours. It was possible to subculture JE cells up to 5 times serially, and that of GE cells was up to 7 times.

CONCLUSIONS

The human JE cells are a kind of unique non-differentiated epithelial cells different from GE cells. In this experimental culture condition the subculture times of JE cells were less than GE cells, which affects JE cells, so the culture methods and conditions should be improved.

Cytoskeleton and surface structures of cells directly attached to the tooth in the rat junctional epithelium

OBJECTIVE

It is still an open question whether cells directly attached to the tooth (DAT) cells are migratory or non-migratory cells. The purpose of this study was to examine cytoskeletal and surface structures of DAT cells that might be involved in migration.

METHODS

We investigated the distribution of stress fibers composed of actin filaments in DAT cells using phallacidin fluorescent dye methods in a confocal laser scanning microscope. To observe the three-dimensional structure of the DAT cell surface, the osmium maceration scanning electron microscope (SEM) method, which removes various soluble materials between DAT cells and the enamel, was employed.

RESULTS

Stress fibers were found in the most apically located DAT cells, and were arranged in parallel to the presumable cervical-line, whereas some of the fibers ran parallel to the tooth axis in the more coronally located DAT cells. The parallel arrangement to the tooth axis of the fibers may be involved with migration for turnover, and the parallel accumulation to the presumable cervical-line may be concerned with the cervical contraction of DAT cells. Osmium maceration SEM images at high magnification revealed the existence of microvilli-like structures on the enamel surfaces (facing to the tooth surface) of DAT cells after removal of the soluble matrices. The thicknesses of the microvilli-like structures on the enamel surfaces and cell processes of intercellular bridges were significantly different.

CONCLUSION

DAT cells possess stress fibers arranged in parallel to the tooth axis and to the presumable cervical-line in the cytoplasm, and microvilli-like structures on their enamel surfaces. These results suggest that these structures contribute to DAT cell migration.

[Cytokeratin expression in human junctional epithelium, oral epithelium and sulcular epithelium]

OBJECTIVE

To investigate the expression of cytokeratins (CK) in the normal human gingival epithelium and to explore the difference between junctional epithelium (JE), oral epithelium (OE) and sulcular epithelium (SE).

METHODS

Teeth specimens with gingival tissue were collected from 5 people. Paraffin-embedded sections were stained with monoclonal antibodies responded respectively to human CK5/6, 7, 8/18, 10/13, 16, 17, 19, 20.

RESULTS

CK7 and 17 was not expressed in all strata of JE, OE and SE. CK5/6 and 20 were weekly or moderately expressed in the suprabasal, and not expressed in the basal layer of all three epithelia. CK10/13 and 16 were positive in all strata of JE and in the suprabasal layers of OE and SE. CK10/13 was moderately to strongly expressed and CK16 was weekly to moderately expressed. The staining for CK19 was intense in all strata of JE and the basal layer of OE and SE. There was a remarkable demarcation between JE and SE. The pattern of CK8/18 expression was similar to that of CK19, but was weaker. Besides the basal layer, some suprabasal layers close to the basal layer were stained.

CONCLUSIONS

JE is an unique non-differentiated stratified epithelium different from OE and SE. CK19 would be a histological marker and CK10/13, 16 would be the cellular markers to differentiate JE from OE and SE.

Syndecan-1 Expression During the Formation of Junctional Epithelium

BACKGROUND

Syndecans are cell surface heparan sulfate proteoglycans (PG) which can bind to and modulate the action of growth factors and extracellular matrix components (ECM). Syndecan- 1 has been shown to play important roles during early tooth development and wound healing and repair. Among diverse cells and tissues that comprise the periodontium, the junctional epithelium (JE) constitutes a region of significant anatomic and clinical importance, but the nature of inductive signals and molecules involved in its formation is still unclear. Therefore, this work examines if syndecan-1 is associated with formation of JE, and the distribution of other syndecan family members in the epithelium.

METHODS

In situ hybridization and immunohistochemical techniques were performed using oral tissues from 4-day-old to 10-week-old mice to investigate the expression of syndecan- 1, -2, -3 and -4 mRNAs and their corresponding proteins.

RESULTS

Based on in situ hybridization experiments, all syndecan mRNAs were detected in sulcular epithelium (SE), gingival epithelium (GE), and JE with varying intensity and distribution. Syndecan-1 immunostaining was localized on the cell surface while that of syndecan-2 did not show clear membrane localization. Our experiments in the developing tooth demonstrated that syndecan-1 protein followed characteristic patterns of expression during JE formation and that immunoreactivity for syndecan-1 protein decreased with age when JE cells underwent terminal differentiation.

CONCLUSION

Results of syndecan-1 mRNA and protein expression patterns suggested that this proteoglycan might be an important molecule during the formation of JE.

Histochemical examination of periodontal junctional epithelium in p21/p27 double knockout mice

The periodontal junctional epithelium (JE) is maintained in a steady state through a dynamic process that balances proliferation and exfoliation of epithelial cells. However, mechanisms that regulate JE are not well understood. To better understand how proliferation of the JE is controlled in healthy gingiva, we have studied functional roles of the CDK (cyclin dependent kinase) inhibitors p21 and p27 in JE using knockout mouse model systems. Image analysis of the dentogingival junction in p21 or p27 single knockout mice as well as p21/p27 double knockout mice (dKO) was performed. The analysis revealed enlarged JE in p21/p27 dKO mice due to an increase in the area of the epithelium and associated connective tissue 'islands'. Immunohistochemistry was performed for p21, p27, cyclin D1, and proliferating cell nuclear antigen (PCNA). The highest levels of PCNA-positive cells were detected in the p21/p27 dKO mice, reflecting increased cell turnover. Lower levels of cyclin D1 were detected in the JE of p21/p27 knockout mice, suggesting that p21 and p27 regulate stability of cyclin D1 in oral epithelium. These data suggest that p21 and p27 have a critical role in controlling epithelial cell proliferation in the JE and thus function to maintain the JE at a normal size.

Proliferative activities of epithelial and connective tissue cells in the rat periodontal regeneration using argyrophilic nucleolar organizer regions staining

BACKGROUND AND OBJECTIVE

It is still an open question why long junctional epithelium can proliferate and occupies the root surface following periodontal surgery or experimentally produced periodontitis, and why the epithelium repopulated once on the root surface is replaced by the connective tissue. The aim of this study is to investigate the proliferative activity of the newly formed regenerative connective tissue and long junctional epithelium during wound healing by staining argyrophilic proteins of the nucleolar organizer regions (AgNORs).

METHODS

Regenerative connective tissue and long junctional epithelium were experimentally created by insertion of a rubber piece between maxillary molars of rats for 1 week. After removal of the rubber, AgNORs parameters including nuclear area (NA), AgNORs area (AA), AgNORs percentage nuclear area (APNA), AgNORs number (AN) and nuclear number (NN) in regenerative connective tissue and long junctional epithelium were measured and analyzed statistically.

RESULTS

APNA in long junctional epithelium after 1 and 4 weeks was over two times greater than that in the regenerative connective tissue. AA in long junctional epithelium was significantly higher than in regenerative connective tissue at 1 and at 4 weeks post-treatment. AN was higher in the central portion than at the root surface except at 20 weeks. APNA and AA decreased remarkably in long junctional epithelium at 12 weeks post-treatment (approximately half at 4 weeks), whereas in regenerative connective tissue, they did not change distinctly.

CONCLUSIONS

These results imply that long junctional epithelium cannot supply sufficient epithelial cells because of their significantly low rates of proliferation, consequently long junctional epithelium becomes shorter after 12 weeks, whereas the proliferative activity of regenerative connective tissue maintains the same level of proliferation, and ultimately long junctional epithelium is replaced by regenerative connective tissue.

Effects of toothbrushing frequency on proliferation of gingival cells and collagen synthesis

BACKGROUND

Mechanical stimulation by toothbrushing enhances proliferation of fibroblasts and junctional epithelium (JE). These changes in gingiva may depend on the interval between toothbrushing. The effects of toothbrushing frequency on proliferation of gingival fibroblasts and basal cells of JE were evaluated.

METHODS

Twelve mongrel dogs were used. Each tooth was brushed for 20 s at 1.96 N. The subepithelial connective tissue of JE was examined for proliferating cell nuclear antigen (PCNA)-positive fibroblasts and procollagen type-I C-peptide (PIP)-positive fibroblasts. JE was examined for PCNA-positive basal cells.

RESULTS

Gingiva that received brushing twice a day showed increases in the density of fibroblasts and ratio of PCNA-positive fibroblasts to total fibroblasts at 4 weeks. The ratio of PIP-positive fibroblasts increased at 8 weeks in gingiva brushed twice a day and once a day. PCNA-positive basal cell ratio increased at 4 weeks in gingiva brushed twice a day and once a day.

CONCLUSIONS

A high frequency of brushing was associated with increased numbers of PCNA-positive fibroblasts, PIP-positive fibroblasts and PCNA-positive basal cells. Gingival cell proliferation increased and reached a plateau earlier in gingiva brushed twice a day than in gingiva brushed once a day.

Keratinocyte growth factor and scatter factor expression by regionally defined oral fibroblasts

Keratinocyte growth factor (KGF) and hepatocyte growth factor/scatter factor (SF) are two signalling molecules thought to play important roles in regulating epithelial-mesenchymal interactions. Expression of both factors by fibroblasts in subepithelial connective tissue may play a role in maintaining epithelial integrity in health and in the apical migration of junctional epithelium in periodontitis. The aims of this study were (a) to compare expression levels of KGF and SF by periodontal ligament (PDL) and gingival fibroblasts; and (ii) to determine the effects of interleukin (IL)-1 beta, transforming growth factor (TGF)-beta 1, platelet-derived growth factor (PDGF)-BB and epidermal growth factor (EGF) on KGF/SF expression by these cell populations. Three paired PDL and gingival fibroblast strains were developed. The KGF and SF protein levels were analysed by enzyme-linked immunosorbent assay. Relative levels of KGF and SF mRNA in cytokine-treated cultures were determined using semiquantitative reverse transcriptase polymerase chain reaction. No differences in the levels of KGF and SF produced by PDL and gingival (SOG) populations were found. In both cell types IL-1 beta stimulated KGF and SF expression, while TGF-beta 1 significantly inhibited expression at both the mRNA and protein levels. Epidermal growth factor and PDGF-BB induced differing effects on expression, stimulating SF protein production but inhibiting KGF output in both fibroblast populations. Differences in response to EGF and PDGF were also seen between paired PDL and gingival fibroblasts.

AN EXPERIMENTAL STUDY ON THE FEATURES OF PERI-IMPLANT EPITHELIUM: IMMUNOHISTOCHEMICAL AND ELECTRON-MICROSCOPIC OBSERVATIONS

The purpose of this study was to investigate the immunohistochemical and the ultrastructural features of the implant circumference epithelium of the beagle dog using various types of antibodies. The peri-implant epithelium was at an acute-angle from the gingival epithelium and was arranged in parallel to the implant surface. With immunohistochemical staining, the peri-implant epithelium was strongly positive for KL-1, and weakly positive for CK4, CK8 and CK19. These positive reactions for keratins and also for PCNA and BM-1 were similar to those seen in the oral mucosa. In the peri-implant epithelium, a plentitude of microvilli were observed at the periphery of cells at the implant sites, and bacteria were observed between the implant and the peri-implant epithelium without the formation of half desmosomes. There were many lipid-like vacuoles or lysosome-like granules. The intercellular space was wider than the junctional epithelium, and random migrations of large numbers of neutrophils could be seen. Taken together, the peri-implant epithelium is similar to that seen in the oral mucosa, and it is structurally different from the junctional epithelium.

Influence of anti-CD49f and anti-CD29 monoclonal antibodies on mitotic activity of epithelial cells (HaCaT) and gingival fibroblasts in vitro

A major complication in the treatment of periodontitis marginalis is the reepithelization of periodontal defects inhibiting collagen fiber attachment and periodontal regeneration. In this study we investigated the possibility of a molecular blockade of epithelial mitosis in vitro. Monoclonal antibodies against the VLA-6 laminin receptor subunit alpha 6 interrupted interactions between epithelial cells (HaCaT cells) and their extracellular matrix and thus resulted in reduction of proliferation rates by more than 50%. The same effect was observed with anti beta 1-antibodies. In contrast, collagen-producing and -secreting gingival fibroblasts, which play an important role in periodontal regeneration, remained unaffected by the applied anti alpha 6 antibodies. Correspondingly, these cells were found to lack VLA-6 laminin receptors. Selective molecular inhibition of epithelial proliferation and apical migration by monoclonal anti alpha 6 antibody application may provide an adjuvant periodontitis therapy resulting in an enhanced periodontal regeneration.

The effect of duration and force of mechanical toothbrushing stimulation on proliferative activity of the junctional epithelium

BACKGROUND

Gingival bleeding is frequently accompanied by an ulcerated epithelium, with repair depending on the proliferative activity of the epithelial cells. The present study examined the proliferative activity of the junctional epithelium (JE) under several different methods of toothbrushing stimulation.

METHODS

Twelve dogs were used in this 3-week experiment. Prior to the experiment, all teeth underwent daily removal of plaque and calculus using a scaler. Teeth were then divided into quadrants: 9 teeth in 3 quadrants (test, 3 per quadrant) were mechanically stimulated by toothbrushing for various time intervals (10, 20, or 40 seconds) and at various forces (100, 200, or 250 gf). The 3 teeth in the fourth quadrant served as controls. The proliferative activity of the basal cells of the junctional epithelium was evaluated for expression of proliferating cell nuclear antigen (PCNA). The numbers of PCNA-positive basal cells and total basal cells were counted, and the width of the junctional epithelium was measured.

RESULTS

Toothbrushing force significantly affected the PCNA-positive basal cell ratio (P < 0.05). The 200 g toothbrushing force produced the highest PCNA-positive basal cell ratio, which was significantly higher than that using the 100 g force (P < 0.05).

CONCLUSION

In junctional epithelium stimulated with a toothbrush, the PCNA-positive basal cell ratio is more sensitive to toothbrushing force than to duration.

Function of laminins and laminin-binding integrins in gingival epithelial cell adhesion

BACKGROUND

In human gingiva, epithelial cells attach to their adjacent tissues by means of specialized molecular adhesion complexes and a basement membrane. Little is known about the synthesis of adhesion proteins by gingival keratinocytes; we, therefore, studied how cultured immortalized gingival epithelial cells produce laminins and express laminin-binding integrins. We presumed that different laminins and integrins would be involved in the adhesion of gingival epithelial cells.

METHODS

We cultured gingival keratinocytes and studied their production of laminins and expression of integrins using immunofluorescence microscopy, immunoprecipitation, and immunoblotting methods and by quantitative cell adhesion experiments. We also studied how gingival tissue expresses these adhesion proteins in vivo by using immunofluorescence microscopy.

RESULTS

In immunofluorescence microscopy, the cells were seen to organize chains of laminin-5 (alpha3beta03gamma2) to extracellular patches, whereas the alpha5 chain of laminin-10 (alpha5betalgamma1) could only be seen intracellularly. Of the laminin-binding integrin subunits, integrin a6 subunit was organized to dotted arrays, typical of prehemidesmosomal adhesions, whereas integrin alpha3 subunit was located at cell-cell junctions, in prehemidesmosomal structures, and at some locations also in small focal-contact like patches. Integrin beta1 subunit was found at cell-cell junctions and in focal contacts. Immunoprecipitation experiments showed that the cells synthesize and secrete chains of laminin-5 and laminin-10. In quantitative cell adhesion experiments, the cells adhered efficiently to these laminins by using cooperatively integrin alpha3beta1 and alpha6beta1 integrin complexes. None of the other known laminin-binding integrin subunits appeared to be significantly involved in cell adhesion to these laminin isoforms.

CONCLUSIONS

Our results provide new information on gingival epithelial cell adhesion and extracellular matrix production and may thus aid in the understanding of periodontal physiology.

Microscopic, immunocytochemical, and ultrastructural properties of peri-implant mucosa in humans

BACKGROUND

Microscopic and immunocytochemical studies have demonstrated both similarities and differences between the gingival mucosa and the peri-implant mucosa restored around dental implants.

METHODS

This study was performed on 10 samples of peri-implant mucosa from 10 patients who had undergone implant treatment 16 to 18 months before. Microscopic, ultrastructural, and immunocytochemical investigations were performed to characterize the epithelial and connective layers of the peri-implant mucosa.

RESULTS

All specimens showed the morphologic characteristics of well restored tissues. The immunocytochemical reactions used to detect cytokeratins demonstrated that the restored peri-implant mucosa had a non-keratinized epithelium. The apical part of the inner epithelium was a few cell layers thick, like the corresponding junctional epithelium, but it stained positively with the markers for the cytokeratins expressed by the stratified epithelia. Ultrastructurally the keratinocytes adjacent to the implant displayed nuclei containing a rich cytoplasm with filaments and specialized intercellular junctions right up to the more superficial strata. Immunocytochemical reactions and ultrastructural observations demonstrated the presence of non-keratinocyte cells; i.e., Langerhans cells, melanocytes, and Merkel cells. Several cells were found to be proliferating by immunoreaction with mAb anti-PCNA, while immunoreactions with mAbs to detect von Willebrand factor, CD34, and vascular endothelial growth factor marked the well-developed networks of blood and lymphatic vessels in the connective tissue. S-100 and protein gene product 9.5 positive nerve fibers were marked. Immunocytochemical reactions with mAbs anti-vimentin, anti-laminin were also performed.

CONCLUSIONS

Our results demonstrated that all the epithelial and connective components of the mucosa are involved in the substantial regrowth of the peri-implant tissue and subsequently in the success of the implant.

Influence of anti-CD49f and anti-CD29 monoclonal antibodies on mitotic activity of epithelial cells (HaCaT) and gingival fibroblasts in vitro

A major complication in the treatment of periodontitis marginalis is the reepithelization of periodontal defects inhibiting collagen fiber attachment and periodontal regeneration. In this study we investigated the possibility of a molecular blockade of epithelial mitosis in vitro. Monoclonal antibodies against the VLA-6 laminin receptor subunit alpha6 interrupted interactions between epithelial cells (HaCaT cells) and their extracellular matrix and thus resulted in reduction of proliferation rates by more than 50%. The same effect was observed with anti alpha1-antibodies. In contrast, collagen-producing and -secreting gingival fibroblasts, which play an important role in periodontal regeneration, remained unaffected by the applied anti alpha6 antibodies. Correspondingly, these cells were found to lack VLA-6 laminin receptors. Selective molecular inhibition of epithelial proliferation and apical migration by monoclonal anti alpha6 antibody application may provide an adjuvant periodontitis therapy resulting in an enhanced periodontal regeneration.

An organotypic in vitro model that mimics the dento-epithelial junction

BACKGROUND

The dento-epithelial junction forms the primary periodontal defense structure against oral microbes. The cells of the junctional epithelium (JE) attach both to a basement membrane (BM) facing the connective tissue and to a hard dental tissue by structurally similar but molecularly distinct mechanisms. Here we describe a new organotypic cell culture model for the dento-epithelial junction comprising not only epithelial and mesenchymally derived components, but also a tooth surface equivalent.

METHODS

Rat palatal keratinocytes were seeded on fibroblast-collagen gels. A tooth slice was placed on top of the epithelial cells and the multilayer cultures were grown at the air-liquid interface. Formation of the epithelial structures, BM components, and the epithelial attachment to the tooth surface were studied by immunofluorescence and light and electron microscopy. The findings were compared to the structure of the dento-epithelial junction in vivo.

RESULTS

A well-differentiated stratified epithelium was formed. Under the tooth slice the epithelium remained thin and non-differentiated. Attachment of the epithelial cells to the tooth surface was mediated by hemidesmosomes (HDs) as in vivo. Laminin-5 (Ln-5) was present in the extracellular matrix (ECM) between the tooth and the epithelium as well as in the BM structure between the epithelium and the fibroblast-collagen matrix. Instead, Ln-10/11 was present only at the mesenchymal tissue side as is known to be the case in vivo.

CONCLUSIONS

The organotypic model presented expresses the characteristic structural and molecular features of the dento-epithelial junction and may be applied for studying physiological and pathological processes in the epithelial attachment.

The junctional epithelium around murine teeth differs from gingival epithelium in its basement membrane composition

It is not known whether epithelial differentiation patterns are reflected in the composition of gingival basement membranes (BMs). We have investigated the expression of laminin isoforms and associated BM components in the murine dento-epithelial junction by using immunofluorescence microscopy. Our results show that chains of laminins 5/6/7/10/11 are expressed in the BM of outer gingival epithelium. The external BM between junctional epithelium (JE) and connective tissue differs from gingival BM by lacking laminin-7 and -11 chains. The internal basal lamina (IBL) between JE and tooth contains only laminin-5. Collagen chains alpha1,2(IV) and nidogen-1 are present in other BMs except the IBL. The dento-epithelial junction thus has a unique BM composition, suggesting that epithelial cells are able to secrete two extracellular matrices in a polarized manner. The exclusive expression of the non-self-polymerizing laminin-5 indicates that the IBL is not a BM by definition, but rather a simple extracellular matrix lacking network structure.

Localized antimicrobial peptide expression in human gingiva

The stratified epithelia of the oral cavity are continually exposed to bacterial challenge that is initially resisted by innate epithelial factors and by the recruitment of neutrophils. Antimicrobial peptides from phagocytes and epithelia contribute to this antimicrobial barrier. Using antibodies and in situ hybridization, we explored antimicrobial peptide expression in the varied epithelia of the periodontium and in cultured gingival epithelial cells. In gingival tissue, mRNA for the beta-defensins, human beta-defensin 1 (hBD-1) and human beta-defensin 2 (hBD-2) was predominately localized in suprabasal stratified epithelium and the peptides were detected in upper epithelial layers consistent with the formation of the stratified epithelial barrier. In cultured epithelial cells, both hBD-1 and -2 peptides were detected only in differentiating, involucrin-positive epithelial cells, although hBD-2 required stimulation by proinflammatory mediators or bacterial products for expression. Beta-defensins were not detected in junctional epithelium (JE) that serves as the attachment to the tooth surface. In contrast, alpha-defensins and cathelicidin family member LL-37 were detected in polymorphonuclear neutrophils (PMNs) that migrate through the JE, a localization that persists during inflammation, when the JE and surrounding tissue are highly infiltrated with PMNs. Thus, the undifferentiated JE contains exogenously expressed alpha-defensins and LL-37, and the stratified epithelium contains endogenously expressed beta-defensins. These findings show that defensins and other antimicrobial peptides are localized in specific sites in the gingiva, are synthesized in different cell types, and are likely to serve different roles in various regions of the periodontium.

Cytokine expression in rat molar gingival periodontal tissues after topical application of lipopolysaccharide

It is well known that proinflammatory cytokines produced by host cells play an important role in periodontal tissue destruction. However, the localization of the cytokines in in vivo periodontal tissues during development of periodontal disease has not been determined. Immunohistochemical expression of proinflammatory cytokines including IL-1alpha, IL-1beta, and TNF-alpha was examined at 1 and 3 h, and 1, 2, 3, and 7 days after topical application of lipopolysaccharide (LPS; 5 mg/ml in physiological saline) from E. coli into the rat molar gingival sulcus. In the normal periodontal tissues, a small number of cytokine-positive epithelial cells were seen in the junctional epithelium (JE), oral sulcular and oral gingival epithelium, in addition to macrophages infiltrating in the subjunctional epithelial area and osteoblasts lining the alveolar bone surface. Epithelial remnants of Malassez existing throughout periodontal ligament were intensely positive for IL-1beta but negative for the other two cytokines. At 3 h after the LPS treatment, almost all cells in the JE were strongly positive for the cytokines examined. In addition, several cytokine-positive cells, including neutrophils, macrophages, and fibroblasts, were seen in the subjunctional epithelial connective tissue. At day 2, expression of the cytokines in the JE gradually decreased, while cytokine-positive cells in the connective tissue increased in number. Positive staining of the cytokines was seen in osteoclasts and preosteoclasts which appeared along the alveolar bone margin in this period. The number of cytokine-positive cells decreased by day 7. These findings indicate that, in addition to macrophages, neutrophils, and fibroblasts, the JE cells are a potent source of TNF-alpha, IL-1alpha, and IL-1beta reacting to LPS application, and suggest that JE cells may play an important role in the first line of defense against LPS challenge, and the proinflammatory cytokines transiently produced by various host cells may be involved in the initiation of inflammation and subsequent periodontal tissue destruction.

The dento-epithelial junction: cell adhesion by type I hemidesmosomes in the absence of a true basal lamina

BACKGROUND

The junctional epithelium (JE) is a unique structure that makes contact with both a non-renewable hard tooth surface and with a basement membrane (BM) facing the connective tissue. Ultrastructurally, this attachment occurs through hemidesmosomes (HD) and a basal lamina-like extracellular matrix which, on the tooth side, is termed the internal basal lamina. In this study we investigated the expression of basal cell markers in the tooth-facing (TF) cells of JE.

METHODS

Samples of healthy marginal gingiva were removed by careful dissection. The expression of laminin-5 was used to indicate TF cell preservation in double immunofluorescence labeling and confocal laser scanning microscopy.

RESULTS

The results show that integrin alpha6beta4 and laminin-5 colocalize unequivocally in the TF cells. The results also show the specific expression of the basal cytokeratin 14 and the alpha(v) integrin subunit in the TF cells. All 3 major hemidesmosomal components BP180, BP230, and HD1 antigen are likewise present. On the other hand, type IV collagen, laminin-1/10, type VII collagen, and the BM proteoglycan perlecan are all absent from the dento-epithelial junction.

CONCLUSIONS

The results indicate that the epithelium-tooth interface is a unique structure wherein epithelial cells adhere by means of bona fide hemidesmosomes to an epithelium-derived extracellular matrix lacking most of the common BM components. Moreover, TF cells differ from connective tissue facing (CTF) cells, not only by their cell surface molecules and their production of extracellular matrix, but also by their cytoskeletal architecture.

The characteristic cellular organization and CEACAM1 expression in the junctional epithelium of rats and mice are genetically programmed and not influenced by the bacterial microflora

BACKGROUND

The epithelial cell adhesion molecule CEACAM1 exhibits an interesting dynamic expression during tooth development. It is first expressed in the reduced enamel epithelium, its expression then increases in the orally faced reduced epithelium and the overlying oral epithelium that then fuse to give rise to the junctional epithelium. The expression of CEACAM1 remains at high levels in the junctional epithelium, in contrast to the surrounding oral sulcular epithelium which shows much lower expression levels. We investigated if the high expression levels of CEACAM1 and the loosely organized cells characteristic of the junctional epithelium are genetically programmed or result from bacterial infiltration.

METHODS

Oral tissues from germ-free rats and mice and animals with conventional bacterial flora were analyzed by transmission electron microscopy and immunohistochemical staining for CEACAM1.

RESULTS

The junctional epithelium of both germ-free and conventional animals was identical with respect to both CEACAM1 expression and morphology. Also the presence of leukocytes was the same in both types of animals.

CONCLUSIONS

The results indicate that the characteristic morphology and the high expression levels of CEACAM1 in the junctional epithelium are genetically programmed and not a result of bacterial infiltration. This suggests that CEACAM1 has an important role for the structural integrity of the junctional epithelium. This conclusion was supported by the observation that the junctional epithelium does not express any E-cadherin, which is another abundant epithelial cell adhesion molecule.

Effect of short chain fatty acids on human gingival epithelial cell keratins in vitro

Hemidesmosomal attachment of the junctional epithelial cells to the tooth and the ability of the attached cells to divide are essential features of the healthy dentogingival junction. Short chain fatty acids are bacterial metabolites associated with gingival inflammation and periodontal pockets. In vitro, short chain fatty acids have been shown to inhibit epithelial cell division and increase the density of their keratin filaments. This study examined these keratin changes by making use of human gingival keratinocyte cultures, gel electrophoresis and Western blot. Short chain fatty acids, butyrate and propionate, increased the relative amount of keratin proteins in the cells, most strikingly keratin K17. The distribution of K17 was further studied in a culture model for human junctional epithelium and in gingival biopsies. In butyrate-treated cultures of junctional epithelium, K17 expression was markedly increased and extended to the basal cells and to the cells mediating the attachment of the explant to the substratum. In clinically healthy gingiva, K17 was expressed predominantly in sulcular epithelium. The dividing basal cells and the cells attached to the tooth were negative. In advanced periodontitis, a strong reaction for K17 was localised to the pocket epithelium. The inhibition of epithelial cell division and the simultaneous upregulation of K17 in vitro, and the strong expression of this protein in detached pocket epithelium suggest a role for the short chain fatty acids in the degenerative process that leads to subgingival advancement of pathogens and, eventually, to periodontal pocket formation.

Proliferative response of cells of the dentogingival junction to mechanical stimulation

The aim of this research was to study the proliferative response of junctional epithelium (JE) and gingival connective tissue (GCT) to mechanical stimulation in vivo with regard to the potential occurrence of apical migration of JE and loss of GCT attachment during orthodontic tooth movement. Elastic bands were inserted between the maxillary first and second molars of male rats aged 8 weeks, which were pulse-labelled with 3H-thymidine and subsequently killed in groups, together with labelled control animals (a total of 98 rats) after periods of 1-168 hours. Autoradiographs were prepared from plastic mesiodistal sections, and parameters of cell proliferation for JE and GCT of the papilla between the second and third molars were determined. Although the distance between the apical limit of JE and the most coronal periodontal ligament (PDL) fibres decreased on the pressure and increased on the tension sides of mechanically stimulated animals, the total cross-sectional area of JE remained unchanged compared with controls. In the basal and suprabasal layers of JE, cell proliferation was reduced on the pressure side and showed no change on the tension side. In the apical JE compartments on both sides, mechanical stressing resulted in lower proliferative activity. Cell proliferation in GCT adjacent to JE in stimulated animals did not differ from the corresponding controls. JE rapidly adapted to mechanical stimulation by means of differential local adjustments of cell proliferation without an occurrence of apical migration or hyperplasia. GCT cells in the vicinity of JE maintained their steady-state proliferative activity. These results do not support the concept that orthodontic tooth movement might per se have detrimental effects on the stability of the dentogingival junction.

Distribution and synthesis of elastin in porcine gingiva and alveolar mucosa

Histologically, there are variations in the distribution of the types of elastic fibers within the tissues of the masticatory mucosa. For example, the alveolar mucosa has heavy deposits of elastin which decrease in quantity and size as it merges with the attached gingiva. These differences in elastin content may result from the tissues' different physiological workload modulating the expression of tropoelastin mRNA. Alternatively, these differences could be due to the presence of phenotypically different fibroblasts that have different basal levels of tropoelastin mRNA expression. The aim of this study was to determine whether the differences in the distribution of elastin between alveolar mucosa and attached gingiva could be due to phenotypic differences between fibroblasts derived from these tissues. Histochemical (Miller's elastin stain) and immunohistochemical staining were used to localize elastin within these tissues. Elastin production by cultured fibroblasts derived from alveolar mucosa and attached gingiva was assessed by Western blot analyses, and Northern blot analyses were used to detect levels of elastin mRNA by these cells. The results from this study have confirmed that elastin is richly expressed in oral mucosa and poorly expressed in attached gingiva. In vitro, the cells demonstrated a capacity to synthesize and secrete tropoelastin, however this was not found to differ between cells from the two different sources. These findings indicate that while some heterogeneity in fibroblast populations may exist within various tissues of the periodontium, other factors, such as functional requirements of the tissues in which they reside, may also play an important role in the phenotypic expression of these cells.

Role of interactions between integrins and extracellular matrix components in healthy epithelial tissue and establishment of a long junctional epithelium during periodontal wound healing: a review

Following the surgical treatment of adult periodontitis, the epithelial regeneration of the periodontal attachment is non-physiological and thus unsatisfactory, if membranes or artificial bone material are not used. Re-epithelialization is based on the proliferation, migration, and differentiation of basal epithelial cells which are in contact with a wound matrix and whose molecular makeup differs from the extracellular matrix of intact regions. Interactions between basal epithelial cells and the extracellular matrix are mediated by special receptors on the cell surface which are known as integrins and belong to the family of cellular adhesion molecules (CAM). Various studies indicate that integrin-mediated interaction plays a decisive role in regulating the proliferation, migration, and differentiation of the epithelial cells. This review provides an overview of the in vivo and in vitro expression of integrins by epithelial cells and the interaction between integrins and extracellular matrix (ECM) in the case of a stationary epithelium and during wound healing. The regulation of these cell-cell and cell-matrix interactions may represent a method for inhibiting non-physiological epithelial regeneration on the molecular level.

Age-dependent changes in the distribution of BrdU- and TUNEL-positive cells in the murine gingival tissue

BACKGROUND

Age-dependent morphological and cell kinetic changes of the gingival tissue seem to be related to the occurrence of periodontal disease. The purpose of this study was to investigate the age-dependent changes in the distribution of BrdU- and TUNEL-positive cells in murine gingival tissue.

METHODS

Gingival tissue of the lower first molar region of 2-, 3-, 5-, 7-, 10-, 15-, 20-, 30-, 40-, 50-, 60-, 70- and 80-week-old mice was used in this study. BrdU- and TUNEL-positive cells were evaluated at the following 4 sites: 1) gingival epithelium (GE); 2) junctional epithelium (JE); 3) submucosal connective tissue of the gingival epithelium (GECT); and 4) submucosal connective tissue of the junctional epithelium (JECT).

RESULTS

No significant differences in the mean number of BrdU-positive cells at each site were demonstrated among the various age groups. No significant change in the mean number of TUNEL-positive cells was demonstrated in either the GE or JE groups among the various age groups. Meanwhile, a significant increase in the TUNEL-positive cells was observed in the GECT of mice 40 weeks or older, and in the JECT of mice 20 weeks or older.

CONCLUSIONS

These results indicate that no age-dependent change in the cell proliferation or cell death occurred in the gingival and junctional epithelial layers as well as in the cell proliferation in the submucosal connective tissue. Meanwhile, a significant decrease in the cellular component of the submucosal connective tissue of both gingival and junctional epithelial layers caused by apoptosis occurred with aging. The decreased cellular component in the submucosal connective tissue thus seems to be related to either gingival recession or to the apical migration of the JE with aging. These morphological changes with aging possibly occur in humans and may be related to the susceptibility to periodontal disease in aged individuals.

In vitro stimulation of human gingival epithelial cell attachment to dentin by surface conditioning

BACKGROUND

Chemical root conditioning is widely used to improve the outcome of regenerative periodontal therapies by favoring the attachment of the regenerated periodontal structures. Although the effect of root conditioning on periodontal mesenchymal cells is well documented, very little is known about its potential effect on the re-formation of the junctional epithelium, a crucial event for the protection of the wound. The goal of the present study was to test in vitro the consequences of dentin conditioning with citric acid or minocycline on the attachment kinetics and morphology of human gingival keratinocytes (HGK).

METHODS

The attachment kinetics of HGK to samples of powdered human dentin (particle size 44 to 76 microm) were examined by use of 3H-labeled cells. The morphology of attached epithelial cells was then determined by scanning electron microscopy (SEM).

RESULTS

When the initial adhesion kinetics of cells on untreated dentin were tested, the percentage of attached HGK proved to be dependent on the number of plated cells and the time of incubation (from 0 to 12 hours). Conditioning the dentin by 3% citric acid or by minocycline-HCl (at 0.01, 0.1, or 2.5%) significantly increased (P <0.005) keratinocyte attachment beyond 6 hours, without notable differences between the 2 substances at any concentration. The attachment kinetics of HGK preincubated for 24 hours by 10 microg/ml minocyline-HCl on untreated dentin was found to be similar to that observed for non-preincubated cells. These results are in agreement with the SEM observations: indeed, the surface conditioning of dentin significantly modified the morphology of attached HGK, whereas the preincubation of these cells with minocyline-HCl did not.

CONCLUSIONS

These results suggest that minocycline-HCl does not exert a direct effect on human gingival epithelial cells. In contrast, conditioning the dentin by citric acid or by minocycline stimulates the attachment of HGK, which could lead to a rapid periodontal healing by favoring the re-formation of a junctional epithelium.

Multi-layered periodontal pocket epithelium reconstituted in vitro: histology and cytokeratin profiles

BACKGROUND

In order to study inter-individual differences in bacterial adhesion/invasion of periodontal tissues, an in vitro model for culturing multi-layered pocket epithelium without feeder layers or stromal equivalents (including the evaluation of their cytokeratin profiles) was developed.

METHODS

Pocket epithelium was collected and grown until confluent in Falcon flasks using keratinocyte-serum free medium (KSFM), without a feeder layer. In the second passage, oral keratinocytes were re-grown in a 2 compartment system using either a clear polyester (transwell-clear [TCL]) or a collagen (transwell-col [TCO]) membrane as culture surface. After the first week, the calcium concentration was raised to 1.2 mM and in half the wells, the KSFM was supplemented with 10% fetal calf serum (FCS). Histology and immunohistochemistry were performed after 1, 2, and 3 weeks of additional growth.

RESULTS

In general, all conditions resulted in a structured epithelium consisting of 3 to 5 layers, but important differences were observed between the membrane types and between the media. CK4 was rarely and only lightly expressed while CK18 and 19 (characteristic of junctional epithelium) were very strongly expressed in the older (2 and 3 weeks) cultures. CK13 and 14 (characteristic of any stratifiable epithelial cell) also tended to increase over time; CK13 seemed to be stronger in KSFM with FCS while the contrary was true for CK14. The multi-layer created by the combination TCL/KSFM + 10% FCS resembled a junctional epithelium most, while that grown on TCO without FCS mimicked the sulcular epithelium.

CONCLUSIONS

It seems possible to create a histiotypic culture resembling either periodontal pocket or junctional epithelium without the use of stromal equivalents or feeder layers which make this approach more cumbersome. This multi-layered culture offers a model to investigate the permeability of pocket epithelium and the adhesion and penetration of bacteria under well-defined environmental conditions.

In vitro modulation of human gingival epithelial cell attachment and migration by minocycline-HCL

Although the influence of tetracyclines on periodontal connective tissue cells has been the topic of many in vitro and in vivo studies, data regarding their effects on gingival epithelial cells are scarce. The present in vitro study was designed to examine the influence of minocycline, a semi-synthetic analog of tetracycline, on human gingival keratinocyte (HGK) attachment and migration. Attachment tests were performed with HGK prelabeled by tritiated amino-acids. Increasing concentrations of minocycline (10, 50, 100 micrograms/ml) in the medium produced no significant modification of cell adhesion kinetics compared to control conditions, except for 100 micrograms/ml which statistically significantly (p < 0.05) reduced the number of attached cells beyond 6 h. A 24-h cell preincubation in 10 micrograms/ml of minocycline did not alter the kinetics of HGK attachment. Scanning electron microscopic observations of attached HGK showed that the presence of 10 micrograms/ml of minocycline in the "attachment medium" induced the production of multiple filopodial extensions. Migration tests in Boyden chambers for 40 h demonstrated that HGK preincubation for 24 h in a 10 micrograms/ml minocycline-HCl solution increased significantly (p < 0.005) cell migration towards a gradient of fetal calf serum. The presence of 10 micrograms/ml of minocycline in contact with the keratinocytes in the upper compartment of the migration chambers also produced a significant (p < 0.005) result. In contrast, the presence of minocycline in the lower compartments did not produce any chemoattractive effect. Within the limits of their significance, these results suggest that, at concentrations not beyond 50 micrograms/ml, minocycline could fasten the periodontal wound coverage by epithelial cells and allow the normal reformation of a junctional epithelium.

Morphologic studies on the biologic seal of titanium dental implants. Report II. In vivo study on the defending mechanism of epithelial adhesions/attachment against invasive factors

Clinical measurements on gingival indices and morphologic observations were performed in this study to verify the defending mechanism of gingival soft tissue against foreign invasions from the perspective of epithelial adhesion/attachment to implant surfaces in the monkey mandible. The following zones were observed using scanning electron microscopy: (1) plaque zone, suggesting susceptibility of the gingival tissue to bacterial invasion; (2) nude zone, demonstrating indirect adhesion of epithelial cells to the implant surface through the mucous layer and preventing bacterial invasion; and (3) epithelial cell attached zone, having greater bond strength of epithelial cells at the cell-implant interface as compared to cell-cell bonding within the epithelial cell layer. This study suggested that epithelial cell attachment/adhesion may play a dominant role in retaining the successful condition of a dental implant.

Transforming growth factor-beta response and expression in junctional and oral gingival epithelial cells

The junctional (JE) and oral gingival (OGE) epithelium show distinct morphological phenotypes and express different cell surface and keratin markers. Transforming growth factor-beta (TGF-beta) has been shown to stimulate extracellular matrix formation and inhibit proteolytic matrix degradation in periodontal wound healing. To elucidate potential roles of TGF-beta in gingival epithelial regeneration and reattachment, the present study examined the effects of TGF-beta on JE and OGE cell growth and determined the patterns of expression of mRNAs for the TGF-beta isotypes beta 1, beta 2 and beta 3 and TGF-beta receptor types I, II and III. Primary cell cultures were initiated from JE and OGE and the cell phenotypes confirmed using monoclonal antibodies to specific keratins. TGF-beta induced a significant growth inhibition in OGE cells derived from 6 different patients with a mean inhibition of 46% and a range of 16-70% (p = 0.031). Although responses varied between patients, in general maximum inhibition occurred at 10 ng/ml TGF-beta. JE cells from 5 patients showed no significant growth inhibition by TGF-beta (p = 0.125). Greater expression of TGF-beta 2 and receptor type I mRNA was found in OGE than JE cells and thus appeared to be associated with differentiating epithelial cells. JE cells expressed more TGF-beta type II receptor specific mRNA than did OGE cells, but TGF-beta 1 mRNA expression was similar in JE and OGE cells. JE or OGE cultures derived from 2 of 3 patients showed expression of mRNA for the TGF-beta type III receptor. TGF-beta 3 mRNA was not detected in any of the JE or OGE samples examined. The greater sensitivity of OGE than JE to the growth inhibiting effects of TGF-beta correlated with higher expression of receptor type I mRNA which, together with the type II receptor, is required for sensitivity to growth inhibition by TGF-beta. The results suggest that, in addition to structural differences, the development of functional differences in the responses of JE and OGE to TGF-beta may be associated with the formation of JE from OGE cells and the reformation of attachment after periodontal surgery.

Immunolocalization of proliferating cell nuclear antigen in the peri-implant epithelium

The aim of the present study was to investigate the proliferating activity of peri-implant epithelium immunohistochemically using proliferating cell nuclear antigen (PCNA). Eight ITI (Internationale Team für Implantologie) implants were placed into simulated sockets in the mandibles of two beagle dogs two months following tooth extraction. As a control, junctional epithelium of the molar teeth in the same animals were used. The nature of staining and the distribution of PCNA immunoreactivity were determined by scoring a minimum of 100 cells on two sections from each of the implants. In the junctional epithelium, the immunoreactivity to PCNA was detected mainly in the basal cells, in some of the prickle cells, and in a few cells attached to the enamel. In peri-implant epithelium, only some of the basal cells were positive for PCNA. The PCNA score of the peri-implant epithelium was significantly lower than that of junctional epithelium. These results suggest that the peri-implant epithelium maintains a lower capacity to act as a proliferative defence mechanism than does the junctional epithelium.

Histomorphological and biochemical differentiation capacity in organotypic co-cultures of primary gingival cells

To establish a three-dimensional in vitro test system mimicking the physiological situation of the oral cavity, organotypic co-cultures consisting of primary gingival cells on a collagen matrix with fibroblasts were generated. The histomorphological development after 7 and 14 d revealed close similarity with the non-keratinized gingiva epithelium. Furthermore, as epithelial specific markers synthesis and localization of keratins as well as the deposition of basement membrane components were assessed on frozen sections by immunofluorescence and keratin expression by in situ hybridization. Primary keratinocytes in conventional culture strained positive for keratin K14 and the mucosal differentiation-specific keratins K4 and K13, while primary fibroblasts, isolated from the same tissue source, and also some keratinocytes, were positive for vimentin. In organotypic co-cultures the keratinocytes formed a multilayered epithelium within 14 d containing basal cells and flattened cells in the uppermost layers. Comparable to native non-keratinized gingiva keratin 14 gene expression was clearly detectable in the basal cell compartment but showed extending immunolocalization. In addition, particularly at the early stage (7 d), basally located keratinocytes were also vimentin positive. According to morphological differentiation K4 and K13 were detectable in suprabasal position a the RNA and protein level. The major basement membrane constituents collagen type IV and laminin increased with time revealing first an interrupted and later a fully extended staining underneath the basal cells. Maintenance of basal cell function was further demonstrated by cell proliferation (BrdU incorporation) which was initially high (7 d) but declined towards the later stages (14-21 d). The results demonstrate i) that this co-culture system leads to a stratified surface epithelium with morphological and biochemical characteristics of the non-keratinized gingiva epithelium and ii) that a state of physiological tissue balance was reached, thus rendering a suitable model for tissue compatibility studies.

Bacterial metabolites sodium butyrate and propionate inhibit epithelial cell growth in vitro

The structural and functional barrier preventing the free advancement of microbial plaque subgingivally along the tooth surface is formed by the junctional epithelial (JE) cells directly attached to the tooth (DAT cells). The mechanism leading to degeneration of the DAT cells is not known. In the present study we examined the possible role of short chain fatty acids (SCFAs) on epithelial cells by making use of 2 epithelial cell cultures (HaCaT and ERM) and an explant culture model of human JE. The SCFAs butyrate and propionate were used in concentrations found in human plaque and gingival crevicular fluid (0.25-16.0 mM). The SCFAs had no effect on primary cell adhesion nor on the epithelial attachment apparatus (EAA). By contrast, even 0.25 mM of butyrate significantly retarded epithelial cell growth. Similar effects with propionate were first observed at concentrations higher than 1.0 mM. The retardation of epithelial cell growth was found to be due to inhibition of cell division. Furthermore, after butyrate treatment dense accumulations of intermediate filaments and cytoplasmic vacuolization were characteristically seen in cells adjacent to cells of normal appearance. This suggests that some cells of the growing epithelial cell population are more sensitive to the SCFAs than others, and agrees with previous reports on the DAT cells of periodontally-involved teeth in vivo. The results suggest that SCFAs are microbial factors that play a role in the initiation and progression of periodontal pocket formation by impairing epithelial cell function rather than having a direct effect on the EAA.

Coating of titanium alloy with soluble laminin-5 promotes cell attachment and hemidesmosome assembly in gingival epithelial cells: potential application to dental implants

The formation of a biological seal around the transmucosal portion of dental implants may be crucial for the long-term success of these therapies. Data to date suggest that the gingival epithelium attaches to dental implants through the formation of hemidesmosomes. Biochemical and genetic data indicate that the laminin isoform, laminin-5, a component of basement membranes, plays a crucial role in the assembly and maintenance of hemidesmosomes. We report the use of soluble laminin-5 as a biological coating of titanium-alloy to promote cell attachment of the gingival epithelial cell line, IHGK. Monoclonal antibodies reactive with laminin-5 depleted the coating solution of all cell attachment activity and blocked cell attachment to laminin-5-coated disks. Immunodepletion with antibodies to fibronectin had no effect. Finally, we demonstrate that IHGK cells assembled hemidesmosomes within 24 h of attachment to laminin-5-coated titanium alloy but not to the titanium alloy alone. These results suggest that soluble laminin-5 may have clinical applications as a dental implant coating to promote the formation of a biological seal.

Culture and characterization of human junctional epithelial cells

This study was undertaken to establish a culture of junctional epithelial cells derived from gingival tissue attached to the tooth surface and to characterize these cells immunocytochemically and ultrastructurally. Primary cultures of cells were obtained from the junctional tissue explanted on type I collagen-coated dishes and immersed in Dulbecco's modified Eagle's medium containing 10% fetal bovine serum (FBS). Cells were subcultured with conditioned serum-free keratinocyte medium (keratinocyte-SFM + 5% FBS) on dishes coated with solubilized extract of the basement membrane. After 24 hours, the medium was changed to keratinocyte-SFM (0.09 mM Ca2+). The cell-doubling time was 40.5 hours. As a control, cells from gingival tissue were cultured by the same method. Cells from junctional tissue and gingival tissue were compared immunocytochemically using monoclonal antibodies to keratin, vimentin, and desmoplakins I and II and using Dolichos biflorus agglutinin (DBA). The keratin AE1 and AE3 was expressed by all of culture cells. The vimentin (specific for the intermediate filament of mesenchymal cells) was also expressed by all cells. The expression pattern of keratin 19 was observed not only by cells from junctional tissue but also by cells from gingival tissue. All keratin peptides were expressed in both cells. However, DBA reacted only with cells from the junctional tissue. Anti-desmoplakin I and II reacted with both cells, however, the staining patterns differed. DBA-positive cultured epithelial cells from the junctional tissue showed poor tonofilament bundles and were rich in cytoplasmic organelles. These findings suggest that junctional epithelial cells can be isolated from junctional tissue and cultured under improved conditions.

Some characteristics of the ridge mucosa before and after implant installation. A prospective study in humans

The aim of the present investigation was to study some tissue characteristics of the ridge mucosa before and after implant installation. 9 partially edentulous patients were included in the study. At the time of fixture installation, 1 recipient site in each patient was selected for soft tissue biopsy. Abutment connection and restorative therapy were performed after 3-6 months. When the implants had been in function for about 6 months, a soft tissue sample was obtained from the keratinized peri-implant mucosa at the 1 implant site from which the first biopsy was obtained. Each biopsy was divided into 1 mesial and 1 distal portion. The mesial tissue portion was fixed in a buffered fixative and embedded in EPON. Sections were produced, stained in PAS and toluidine blue and used for histometric and morphometric analyses. The distal portion of the biopsies were embedded, snap frozen in liquid nitrogen and stored in a freezer at -70 degrees C. From each tissue portion, 15 sections were prepared in a cryostat and exposed to immunohistochemical staining. A panel of monoclonal antibodies was used and the avidin-biotin method for staining was applied. The sections were examined morphometrically. Both tissues harbored a well keratinized oral epithelium and a connective tissue, the composition of which was close to identical in terms of collagen, cells and vascular structures. The peri-implant mucosa, however, also included a junctional epithelium which evidently allowed the penetration of products from the oral cavity. As a consequence, the periimplant mucosa in comparison to the masticatory mucosa was found to contain significantly enhanced numbers of different inflammatory cells.

The distribution of fibronectin and laminin in the murine periodontal membrane, indicating possible functional roles in the apical migration of the junctional epithelium

Periodontal tissue shows various morphological changes with ageing. A typical example of these changes is the apical migration of the junctional epithelium. The distribution of fibronectin and laminin was investigated by immunofluorescent and immunoelectron-microscope methods in mice to clarify any possible functional roles of these proteins in the apical migration of junctional epithelium. Apical migration begins in 20-week-old mice, and then progresses with increasing age until the mice reach 80 weeks. In the apical tip of the junctional epithelium, fibronectin was demonstrated in the sub-epithelial fibrillar matrix, preceding the progression of apical migration. Fibronectin was also demonstrated in association with the stromal side of focal contacts between epithelial cells and basement membrane. Therefore, these focal contacts are assumed to be fibronectin receptors. There was no apparent relation between the localization of laminin and the migration of the junctional epithelium. These results suggest that the fibronectin provides a provisional matrix for the apical migration of junctional epithelium, but laminin does not appear to play a major part in that migration.