Expression of bone associated markers by tooth root lining cells, in situ and in vitro

Periodontal disease is marked by inflammation and subsequent loss and/or damage to tooth-supporting tissues including bone, cementum, and periodontal ligament. A key tissue in the initial process of periodontal development as well as regeneration following periodontal disease is cementum. Research efforts aimed toward understanding mechanisms involved in periodontal development and regeneration, and in particular the formation of root cementum, have been hampered by an inability to isolate and culture cells involved in cementum production (i.e., cementoblasts). Much has been learned regarding the processes and mechanisms involved in bone formation and function from experiments using bone cell cultures. Therefore, the purpose of this study was to develop a strategy whereby cementoblasts could be isolated, cultured, and characterized. As a first step, using in situ hybridization, we determined the timed and spatial expression of mineral-associated proteins during first molar root development in CD-1 mice. These proteins included dentin sialoprotein (DSP), osteopontin (OPN), bone sialoprotein (BSP), osteocalcin (OCN), and type I collagen. During root development in mice BSP, OPN, and OCN mRNAs were expressed selectively by cells lining the tooth root surface--cementoblasts--with high levels of expression at day 41. Importantly, at this time point BSP, OPN, and OCN mRNAs were not expressed throughout the periodontal ligament. These findings provided us with markers selective to root-lining cells, or cementoblasts, in situ, and established the time (day 41) for isolating cells for in vitro studies. To isolate cells from tissues adherent to the root surface, enzymatic digestion was used, similar to what are now considered classical techniques for isolation of osteoblasts. To determine whether cells in vitro contained root-lining cells and cementoblasts, cultured cells were analyzed for expression of mineral-associated proteins. Cells within this heterogeneous primary population expressed type I collagen, BSP, OPN, and OCN as determined by in situ hybridization. In contrast, cells within this population did not express dentin sialoprotein, an odontoblast-specific protein. These procedures have provided a means to obtain root-lining cells in vitro that can now be cloned and used for studies directed at determining the properties of root-lining cells, or cementoblasts, in vitro.

Comparative analysis of transforming growth factor-beta isoforms 1-3 in human and rabbit dentine matrices

Previous studies have implicated transforming growth factor-beta (s)(TGF-beta) in both development. Here TGF-beta isoforms in dentine extracellular matrix were analysed because these molecules may participate in dental issue repair. EDTA-soluble and collagenase-released fractions were isolated from human crown and root and rabbit incisor dentine samples and analysed for TGF-beta isoforms. TGF-beta(1) was the major isoform detected in all samples and the only isoform detected in human dentine samples. TGF-beta(2) was detected only in the collagenase-released fraction of rabbit incisor dentine and was present at low levels. TGF-beta(3) was detected in both EDTA-soluble and collagenase-released fractions of rabbit dentine. Greater levels of the TGF-beta(1) isoform were detected in the rabbit than human dentine samples and some differences in distribution amongst the two tissue fractions were observed between these species. The presence of these isoforms of TGF-beta in dentine may provide a reservoir of growth factor in the matrix that could participate in processes leading to tissue repair after injury.

Effects of chelating agents and sodium hypochlorite on mineral content of root dentin

Effects of combined and single use of EDTA, RC-Prep, and NaOCl on mineral content of root dentin were evaluated in vitro using energy dispersion spectrometric microanalysis. Thirty-six standardized midroot dentin specimens obtained from human anterior teeth were used. Specimens were polished and divided into six experimental groups. The first two groups were treated with EDTA or RC-Prep followed by NaOCl irrigation. Groups 3 to 5 were treated with EDTA, RC-Prep, and NaOCl, respectively. The last group was irrigated with saline solution as a control. Levels of calcium, phosphorus, and magnesium were measured in the root dentin after treatments. The results showed that (i) EDTA combined with NaOCl irrigation as final flush and NaOCl alone changed the calcium/phosphorus ratio of root dentin significantly (p < 0.05); and (ii) there was a significant increase in the magnesium level after the use of chelating agent combined with NaOCl (p < 0.05). It was concluded that using NaOCl irrigation as final flush altered the effectiveness of chelating agents on root dentin.

Tubular sclerosis rather than the smear layer impedes dye penetration into the dentine of endodontically instrumented root canals

AIM

To evaluate the effect of different root canal irrigating regimes on dentine penetration of Patent Blue dye.

METHODOLOGY

Eighty extracted single-rooted human mandibular premolar teeth with narrow root canals were prepared using ProFile instruments. After each instrument, canals were irrigated with 1% sodium hypochlorite. Subsequently, teeth were randomly assigned to receive a 10 mL rinse of aqueous 17% (w/v) ethylenediaminetetraacetic acid or tap water for 2 or 10 min, followed by a final rinse with a 2% Patent Blue dye solution for 2 or 10 min (eight groups, n = 10 teeth per group). Teeth were then horizontally sectioned 3, 6 and 9 mm from the apex. Sections were digitally photographed and dye penetration was calculated as percentage of total dentine area using NIH Image J. Values were compared using one-way anova and Bonferroni correction with the alpha-type error set at <0.05. Representative tooth sections from all groups were further analysed using scanning electron microscopy.

RESULTS

No significant impact of irrigating protocols on dye penetration was found. Dye penetration was significantly (P < 0.001) greater in the coronal than middle, and in middle than in apical root thirds. When observed microscopically, irrigant penetration was independent of the presence of a smear layer, but was rather a function of tubular sclerosis.

CONCLUSIONS

Tubular sclerosis, a physiological phenomenon that starts in the third decade of life in the apical root region and advances coronally with age, was the main factor influencing penetrability of root dentine.

Developmental appearance and distribution of bone sialoprotein and osteopontin in human and rat cementum

BACKGROUND

Bone sialoprotein (BSP) and osteopontin (OPN), two major noncollagenous proteins (NCPs) in collagen-based mineralized tissues, have been implicated in mineral deposition and cell- and matrix-matrix interactions during root development. However, their role in cementogenesis is still a subject of debate. Since distribution of proteins is indicative of function, we have analyzed their temporo-spatial appearance in relation to that of cementum collagen.

METHODS

Human premolars and rat molars at various stages of root development characterized by differing rates of formation were fixed in aldehyde and embedded in epoxy and LR White resin. Sections were processed for ultrastructural analysis and postembedding colloidal gold (immuno)cytochemistry.

RESULTS

Incubations with antibodies against BSP and OPN and with lectins recognizing prominent sugars in these proteins generally revealed similar labeling patterns in both human and rat teeth, with gold particles accumulating mainly in the interfibrillar spaces. The lectin Helix pomatia, specific for N-acetyl-D-galactosamine, was distinctive in that it consistently reacted with human cementum, but only sporadically labeled rat cementum. Regardless of both the species and the stage of root development, mineralization initiated in mantle predentin in association with distinct foci immunoreactive for BSP and OPN. In human teeth, the deposition of cementum collagen began before the start of dentin mineralization and thus prior to any detectable labeling for BSP and OPN. However, at early stages of root formation in the rat, cementum collagen appeared after BSP and OPN accumulated on the root surface, whereas at advanced stages the deposition of cementum collagen, BSP and OPN coincided.

CONCLUSIONS

The temporo-spatial differences in the appearance of BSP and OPN relative to cementum collagen correlate well with known differences in the speed of root elongation and explain the variable appearance of the dentino-cemental junction. The data reveal no causal relationship between BSP and OPN and the differentiation of cementoprogenitor cells and indicate that the distribution of collagen fibrils ultimately determines the amount and pattern of accumulation of these NCPs. There also is no consistent planar accumulation of BSP and OPN between dentin and cementum such as the cement lines found between "old" and "new" bone. It is concluded that the interlacement of collagen fibrils at the dentino-cemental junction, across which mineralization spreads, represents the primary attachment mechanism between cementum and dentin.

Immunolocalization of osteopontin, osteocalcin, and dentin sialoprotein during dental root formation and early cementogenesis in the rat

Using immunohistochemical methods we studied the tissue localization of the extracellular matrix proteins osteopontin (OPN), osteocalcin (OC), and dentin sialoprotein (DSP) during the formation of acellular and cellular cementum in newly born rats. In the layer of acellular cementum of developing incisor and molar teeth we found a very strong staining for OPN but not for DSP or OC. Many cells immediately adjacent to acellular cementum and PDL cells were also positive for OPN but not for DSP or for OC. In contrast, cellular cementum in molar teeth stained strongly for OPN and OC but not for DSP. Consistent with these observations, the cells engaged in the formation of cellular cementum (cementoblasts and cementocytes) reacted strongly for OPN and OC but not for DSP. In advanced stages of dentinogenesis, both crown and root odontoblasts and dentin stained for OPN, OC, and DSP. Cells and matrices of surrounding alveolar bone stained for OPN and OC but not for DSP. We conclude that cementoblasts and cementocytes of cellular cementum produce OPN and OC but not DSP and thus express an osteoblast-like, not an odontoblast-like, phenotype. The cells responsible for the production of acellular cementum are likely cells of the PDL in close contact with the dental root surface. These fibroblast-like cells express OPN but not OC or DSP and accordingly express only a partial osteoblastic phenotype.

The tooth attachment mechanism defined by structure, chemical composition and mechanical properties of collagen fibers in the periodontium

In this study, a comparison between structure, chemical composition and mechanical properties of collagen fibers at three regions within a human periodontium, has enabled us to define a novel tooth attachment mechanism. The three regions include, (1) the enthesis region: insertion site of periodontal ligament (PDL) fibers (collagen fibers) into cementum at the root surface, (2) bulk cementum, and (3) the cementum-dentin junction (CDJ). Structurally, continuity in collagen fibers was observed from the enthesis, through bulk cementum and CDJ. At the CDJ the collagen fibers split into individual collagen fibrils and intermingled with the extracellular matrix of mantle dentin. Under wet conditions, the collagen fibers at the three regions exhibited significant swelling suggesting a composition rich in polyanionic molecules such as glycosaminoglycans. Additionally, site-specific indentation illustrated a comparable elastic modulus between collagen fibers at the enthesis (1-3 GPa) and the CDJ (2-4 GPa). However, the elastic modulus of collagen fibers within bulk cementum was higher (4-7 GPa) suggesting presence of extrafibrillar mineral. It is known that the tooth forms a fibrous joint with the alveolar bone, which is termed a gomphosis. Although narrower in width than the PDL space, the hygroscopic CDJ can also be termed as a gomphosis; a fibrous joint between cementum and root dentin capable of accommodating functional loads similar to that between cementum and alveolar bone. From an engineering perspective, it is proposed that a tooth contains two fibrous joints that accommodate the masticatory cyclic loads. These joints are defined by the attachment of dissimilar materials via graded stiffness interfaces, such as: (1) alveolar bone attached to cementum with the PDL; and (2) cementum to root dentin with the CDJ. Thus, through variations in concentrations of basic constituents, distinct regions with characteristic structures and graded properties allow for attachment and the load bearing characteristics of a tooth.

Cell attachment activity of cementum: bone sialoprotein II identified in cementum

Considerable research effort has been directed at preparing root surfaces in a fashion that would promote cell attachment leading to periodontal regeneration; however, no methods have proven to be clinically predictable. Identification of attachment protein(s) associated with the root surface matrix of cementum may prove valuable for developing effective clinical treatments. In this study cementum proteins were extracted from bovine and human teeth by sequential chaotropic extraction using guanidine followed by guanidine/EDTA. The guanidine/EDTA extract, but not guanidine extract, was found to promote attachment of fibroblasts. This attachment activity was inhibitable with synthetic peptide containing the attachment sequence arginine-glycine-aspartic acid (RGD). Fractionation of the guanidine/EDTA extract revealed several fractions with attachment activity. Immunoblot analysis demonstrated that two of these fractions contain the bone-associated RGD containing attachment protein, bone sialoprotein-II (BSP-II). In addition, attachment activity was also noted in other fractions that could not be attributed to BSP-II or fibronectin. These studies indicate that a component of the attachment activity of cementum is likely to be due to BSP-II and that cementum contains additional, as yet undetermined, attachment proteins.

Collagen Cross-linking and Ultimate Tensile Strength in Dentin

Several studies have indicated differences in bond strength of dental materials to crown and root dentin. To investigate the potential differences in matrix properties between these locations, we analyzed upper root and crown dentin in human third molars for ultimate tensile strength and collagen biochemistry. In both locations, tensile strength tested perpendicular to the direction of dentinal tubules (undemineralized crown = 140.4 ± 48.6/root = 95.9 ± 26.1; demineralized crown = 16.6 ± 6.3/root = 29.0 ± 12.4) was greater than that tested parallel to the tubular direction (undemineralized crown = 73.1 ± 21.2/root = 63.2 ± 22.6; demineralized crown = 9.0 ± 3.9/root = 16.2 ± 8.0). The demineralized specimens showed significantly greater tensile strength in root than in crown. Although the collagen content was comparable in both locations, two major collagen cross-links, dehydrodihydroxylysinonorleucine/its ketoamine and pyridinoline, were significantly higher in the root (by ~ 30 and ~ 55%, respectively) when compared with those in the crown. These results indicate that the profile of collagen cross-linking varies as a function of anatomical location in dentin and that the difference may partly explain the site-specific tensile strength.

The effects of a pulsed Nd:YAG laser on subgingival bacterial flora and on cementum: an in vivo study

The purpose of this study was to compare the effects of scaling and Nd:YAG laser treatments with that of scaling alone on cementum and levels of Actinobacillus actinomycetemcomitans, Bacteroides forsythus, Porphyromonas gingivalis, and Treponema denticola. Study samples consisted of 14 patients, age 30 to 75 years, 8 females and 6 males, with a total of 150 periodontally involved sites with probing depth > or = 5 mm. Group A consisted of 100 pockets that were subdivided into 4 equal groups that were treated with conventional scaling and pulsed Nd:YAG laser using an optic fiber of 300 microns and 4 different power levels as follows: Group 1: P = 0.8 W, f = 10 Hz, E = 100 mJ/pulse; Group 2: P = 1.0 W, f = 1.0 Hz, E = 100 mJ/pulse; Group 3: P = 1.2 W, f = 12 Hz, E = 100 mJ/purse; and Group 4: P = 1.5 W, f = 15 Hz, E = 100 mJ/pulse. The time of each treatment was 60 sec per pocket in all 4 groups. Group B consisted of 50 pockets that were treated by conventional scaling alone and served as a control group. Microbiological samples from group A were collected before scaling; after scaling = before laser, just after laser, 2 weeks later, 6 weeks later, and 10 weeks later. Microbiological samples from group B were collected before scaling, after scaling, 6 weeks later, and 10 weeks later. Microbiological analysis of all samples was done by the Institute Für Angewandte Immunologie (IAI) method. The effects of laser on root surfaces were assessed by SEM examination and the sample consisted of 13 teeth from 5 different patients. Four sets of 3 teeth each were treated with Nd:YAG laser using 0.8, 1.0, 1.2, and 1.5 W, respectively. One tooth was just scaled and not treated with laser to serve as a control. Microbiological analysis of Group A samples indicated posttreatment reduction in levels of all 4 bacterial types tested compared to pretreatment levels and Group B controls. SEM examination of the specimens treated with Nd:YAG laser at different levels exhibited different features of root surface alterations.

Influence of the endodontic treatment on mechanical properties of root dentin

This study evaluated the effect of endodontic treatment and storage time on the flexural and ultimate tensile strength of root dentin. Eighty bovine teeth were divided into endodontically treated (ET) and endodontically untreated (NT) teeth. The ET canals were instrumented and irrigated with sodium hypochlorite 1.0%. Roots were filled with gutta-percha and zinc-oxide/eugenol cement by the lateral condensation technique. Tests were performed as follows: t1, immediately; t2, 7 days; t3, 15 days; and t4, 30 days after extraction for NT groups or after extraction and endodontic treatment for ET groups (n= 0). Roots were axially cut into two halves, one half was used to obtain bars for performing the four-bending flexural test and the other half to obtain slices that were trimmed resulting in hourglass-shaped specimens for microtensile testing. Samples were submitted to the tests, and the data were statistically analyzed. Results indicated that endodontic treatment potentiated by time elapsed after endodontic treatment can affect the physical properties of dentin.

Structure, chemical composition and mechanical properties of human and rat cementum and its interface with root dentin

This work seeks to establish comparisons of the physical properties of rat and human cementum, root dentin and their interface, including the cementum-dentin junction (CDJ), as a basis for future studies of the entire periodontal complex using rats as animal models. In this study the structure, site-specific chemical composition and mechanical properties of cementum and its interface with root dentin taken from 9- to 12-month-old rats were compared to the physiologically equivalent 40- to 55-year-old human age group using qualitative and quantitative characterization techniques, including histology, atomic force microscopy (AFM), micro-X-ray computed tomography, Raman microspectroscopy and AFM-based nanoindentation. Based on results from this study, cementum taken from the apical third of the respective species can be represented as a woven fabric with radially and circumferentially oriented collagen fibers. In both species the attachment of cementum to root dentin is defined by a stiffness-graded interface (CDJ/cementum-dentin interface). However, it was concluded that cementum and the cementum-dentin interface from a 9- to 12-month-old rat could be more mineralized, resulting in noticeably decreased collagen fiber hydration and significantly higher modulus values under wet conditions for cementum and CDJ (E(rat-cementum)=12.7+/-2.6 GPa; E(rat-CDJ)=11.6+/-3.2 GPa) compared to a 40- to 55-year-old human (E(human-cementum)=3.73+/-1.8 GPa; E(human-CDJ)=1.5+/-0.7 GPa). The resulting data illustrated that the extensions of observations made from animal models to humans should be justified with substantial and equivalent comparison of data across age ranges (life spans) of mammalian species.

Effects of different pH values of citric acid solutions on the calcium and phosphorus contents of human root dentin

In a group of mandibular incisors, the calcium and phosphorus contents of the cervical, middle, and apical thirds of the roots were determined using an electron microprobe analyzer, before and after treatment with citric acid solutions of different concentrations. The treated surfaces were examined using a scanning electron microscope. The relative calcium and phosphorus loss values obtained from the samples treated with pH 0.8, 1.1, 1.3, 1.5, and 1.7 solutions were significantly different from those obtained in the control group. The demineralizing effect of the pH 0.8 and pH 1.3 solutions was the same, with both of these being less effective than the pH 1.1 solution.

Compositional analysis of root cementum and dentin after Er:YAG laser irradiation compared with CO2 lased and intact roots using Fourier transformed infrared spectroscopy

The present study examines the dental root after Er:YAG laser irradiation, compared with CO2 lased and non-treated surfaces, using Fourier Transformed Infrared (FTIR) spectroscopy. Freshly extracted human teeth were irradiated by Er:YAG laser at an energy output of 40 mJ/pulse, 10 Hz (0.4 watts), with or without water coolant, and by CO2 laser at an energy output of 0.5 watts in continuous wave mode without coolant. The surfaces were chalky and smooth after irradiation by Er:YAG laser with water coolant, were charred and irregular after irradiation by Er:YAG laser without water coolant, and were completely carbonized after CO2 laser irradiation. The FTIR profiles from samples of the surfaces that were irradiated by Er:YAG laser with water coolant were similar to those from non-treated samples, except for a slight decrease on the OH and amide bands, which are mainly related to organic components. This decrease was observed to be extreme after CO2 laser irradiation and moderate after Er:YAG laser irradiation without coolant. The formation of new bands showing toxic substances was observed to a large extent after CO2 laser irradiation and to a smaller extent after Er:YAG laser irradiation without water coolant. In contrast, no such bands were detected after Er:YAG laser irradiation with water coolant. The present results show that these laser treatments selectively ablated more organic components than inorganic components and that Er:YAG laser irradiation with water coolant did not cause major compositional changes or chemically deleterious changes in either root cementum or dentin.

Immunolocalization of epithelial and mesenchymal matrix constituents in association with inner enamel epithelial cells

After crown formation, the enamel organ reorganizes into Hertwig's epithelial root sheath (HERS). Although it is generally accepted that HERS plays an inductive role during root formation, it also has been suggested that it may contribute enamel-related proteins to cementum matrix. By analogy to the enamel-free area (EFA) in rat molars, in which epithelial cells express not only enamel proteins but also "typical" mesenchymal matrix constituents, it has been proposed that HERS cells may also have the potential to produce cementum proteins. To test this hypothesis, we examined the nature of the first matrix layer deposited along the cervical portion of root dentin and the characteristics of the associated cells. Rat molars were processed for postembedding colloidal gold immunolabeling with antibodies to amelogenin (AMEL), ameloblastin (AMBN), bone sialoprotein (BSP), and osteopontin (OPN). To minimize the possibility of false-negative results, several antibodies to AMEL were used. The labelings were compared with those obtained at the EFA. Initial cementum matrix was consistently observed at a time when epithelial cells from HERS covered most of the forming root surface. Cells with mesenchymal characteristics were rarely seen in proximity to the matrix. Both the EFA matrix and initial cementum exhibited collagen fibrils and were intensely immunoreactive for BSP and OPN. AMEL and AMBN were immunodetected at the EFA but not over the initial cementum proper. These two proteins were, however, present at the cervical-most portion of the root where enamel matrix extends for a short distance between dentin and cementum. These data suggest that epithelial cells along the root surface are likely responsible for the deposition of the initial cementum matrix and therefore, like the cells at the EFA, may be capable of producing mesenchymal proteins.

Anisotropy of tensile strength of root dentin

An effect of dentinal tubule orientation on mechanical properties of dentin has been difficult to demonstrate. We have tested the hypothesis that ultimate tensile strength (UTS) of dentin is affected by tubule (and hence collagen fibril) orientation. The UTS of human root dentin was investigated by direct tensile and diametral testing of specimens of known orientation prepared from extracted teeth. Dumbbell-shaped samples were machined for direct tensile testing (load parallel or perpendicular to tubule direction) and cylinders for diametral testing (load at 0 degrees, 45 degrees, 67.5 degrees, and 90 degrees). Fractured surfaces were examined by SEM. UTS was lowest when the tensile force was parallel to tubule orientation, and greatest at 90 degrees to tubule orientation (fracture parallel to tubule direction). SEM views of fractured surfaces suggested that microstructure contributes to fracture patterns. At least for properties involving disruption of the collagen matrix, root dentin shows a definite anisotropy.

Chemical characterization of lased root surfaces using Fourier transform infrared photoacoustic spectroscopy

Recently lasers have been recommended as an alternative or adjunctive therapy in the control and treatment of periodontally diseased root surfaces. The purpose of this in vitro investigation was to characterize the chemical structure of lased root surfaces using Fourier transform infrared photoacoustic spectroscopy (FTIR/PAS). Cementum samples, 6 mm x 2 mm, were cut from the root surface of extracted non-carious, unerupted human molars. The experimental samples were lased with a Nd:YAG laser at an average energy of 80 mJ at 10 pulses per second. Total lasing time ranged from 1 minute 45 seconds to 4 minutes. A non-lased cementum sample served as the control. All spectra were recorded from 4000 to 400 cm-1 using the photoacoustic cell attachment on an Analect RFX-65 FTIR Spectrometer. Photoacoustic FTIR spectra of lased cementum samples showed a decrease in the protein/mineral ratio in comparison to the control. Breakdown of protein at the root surface potentially contributed to an ammonium band at 2010 cm-1. The decreased protein/mineral ratio and the potential surface contamination with protein by-products, may ultimately affect cell reattachment at the cementum surface.

Morphology, chemical structure and diffusion processes of root surface after Er:YAG and Nd:YAG laser irradiation

OBJECTIVES

The aim of this in vitro study was to evaluate the effects of Er:YAG and Nd:YAG lasers on morphology, chemical structure and diffusion processes of the root surface.

MATERIAL AND METHODS

60 root samples were irradiated for 1 min each either with 60 mJ/p, 80 mJ/p and 100 mJ/p using Er:YAG laser or with 0.5W, 1.0W and 1.5W using Nd:YAG laser. Scanning electron microscopy (SEM) was used to determine the morphology, infrared (IR) spectroscopy to assess the alterations in chemical structure and one dimensional electron paramagnetic resonance imaging (1-D EPRI) was used to estimate the diffusion coefficients in dental root samples.

RESULTS

Er:YAG laser treatment resulted in deep crater formation with exposed dentin. Morphological alterations of root surface after Nd:YAG laser irradiation included cracks, crater formation, meltdown of the root mineral and resolidified porous globules formation. Er:YAG laser failed to alter the intensity of Amide peaks I, II or III. In contrast, treatment with Nd:YAG laser, using the highest power setting of 1.5W, reduced the intensity of Amide peak II and III in comparison to the control. The diffusion coefficients were increased significantly in all Er:YAG and Nd:YAG treated root samples.

CONCLUSION

This study demonstrated that Er:YAG laser influences only on morphology and diffusion processes of root surfaces, while Nd:YAG laser also alters the chemical structure of root proteins.

Effect of lactic acid and proteolytic enzymes on the release of organic matrix components from human root dentin

The mechanisms of organic matrix breakdown in the root caries process are not well understood. Therefore, the combined and separate effects of lactic acid and proteolytic enzymes on the degradation of human dentin collagen, glycoproteins, proteoglycans and phosphoproteins were investigated in the present study. Dentin powder was pretreated with lactic acid (pH 4.0), distilled and deionized (dd) water (pH 7.0) and EDTA/guanidine HCl (pH 7.4) for 24 h. Pellets of acid- or dd water-pretreated dentin powder were washed, dried, and then treated with trypsin, bacterial or mammalian tissue collagenase, or control buffer for 3 h. The released dentin proteins were analyzed by reducing sodium dodecyl sulfate-polyacrylamide gel electrophoresis and immunoblotting to identify degraded type I collagen, proteoglycans, glycoproteins and phosphoproteins. All water and acid pretreatment and enzyme treatment groups demonstrated two collagen fragment bands with molecular weights at approximately 79 kD. Further studies showed that the 79 kD proteins from acid-pretreated dentin collagen were degraded by tissue collagenase, suggesting that endogenous collagenase may be involved in the degradation of root dentin collagen. Dentin proteoglycans were detectable in all the treatment groups by protein slot blotting. Relatively few distinct glycoproteins and proteoglycans, and no phosphoproteins were detected by immunoblotting. Results from this study suggest that both acids and proteolytic enzymes from either host or microbial origin are important in the degradation of human dentin matrix and the mechanisms involved in the release of various noncollagenous proteins may be different.

The effects of CO2 laser and Nd:YAG with and without water/air surface cooling on tooth root structure: correlation between FTIR spectroscopy and histology

Morphologic and chemical characterization of root surfaces treated with either the CO2 laser, Nd:YAG, or Nd:YAG with water/air surface cooling (Nd:YAG-C) was completed using scanning electron microscopy (SEM) and FTIR photoacoustic spectroscopy (FTIR/PAS). Specimens for morphologic analysis consisted of 20 extracted single rooted teeth unaffected by periodontal disease. The specimens were exposed at varying energy densities to a single pass of the laser. SEM examination revealed, for all lasers, a direct correlation between increasing energy densities and depth of tissue ablation and width of tissue damage. The Nd:YAG-C required higher energy densities than either the CO2 or Nd:YAG lasers to achieve the same relative depth of tissue ablation. Regardless of energy density, and in contrast with other laser types, areas treated with the Nd:YAG-C did not exhibit collateral zones of heat damage. Specimens for spectroscopic examination consisted of 12 disks, 6 x 2 mm, cut from debrided root surfaces of extracted, unerupted human molars. The spectral results indicate a substantial reduction in the absorption bands attributable to protein and an additional band at 2015 cm-1 in specimens exposed to the Nd:YAG without water. In the presence of water/air coolant, the band at 2015 cm-1 appears only at a substanially higher energy density. The spectra of the CO2 treated specimens, with the char layer present, show a significant reduction in the protein bands and additional bands at 2015 and 2200 cm-1, that are tentatively assigned to the cyanamide and cyanate ions, respectively. These results suggest a reaction of the organic matrix and mineral with laser exposure.

Immunohistochemical localization of alpha-Smooth muscle actin during rat molar tooth development

The dental follicle contains mesenchymal cells that differentiate into osteoblasts, cementoblasts, and fibroblasts. However, the characteristics of these mesenchymal cells are still unknown. alpha-Smooth muscle actin (alpha-SMA) is known to localize in stem cells and precursor cells of various tissues. In the present study, to characterize the undifferentiated cells in the dental follicle, immunohistochemical localization of alpha-SMA was examined during rat molar tooth development. Rat mandibles were collected at embryonic days (E) 15-20 and postnatal days (P) 7-28. Immunohistochemical stainings for alpha-SMA, periostin, Runt-related transcription factor-2 (Runx2), tissue nonspecific alkaline phosphatase (TNAP), and bone sialoprotein (BSP) were carried out using paraffin-embedded sections. alpha-SMA localization was hardly detected in the bud and cap stages. At the early bell stage, alpha-SMA-positive cells were visible in the dental follicle around the cervical loop. At the late bell to early root formation stage (P14), these cells were detected throughout the dental follicle, but they were confined to the apical root area at P28. Double immunostaining for alpha-SMA and periostin demonstrated that alpha-SMA-positive cells localized to the outer side of periostin-positive area. Runx2-positive cells were visible in the alpha-SMA-positive region. TNAP-positive cells in the dental follicle localized nearer to alveolar bone than Runx2-positive cells. BSP was detected in osteoblasts as well as in alveolar bone matrix. These results demonstrate that alpha-SMA-positive cells localize on the alveolar bone side of the dental follicle and may play a role in alveolar bone formation.

Immunohistochemical study of hard tissue formation in the rat pulp cavity after tooth replantation

While mineralized tissue is formed in the pulp cavity after tooth replantation or transplantation, little is known of this hard tissue formation. Therefore, we conducted histological and immunohistochemical evaluations of hard tissue formed in the pulp of rat maxillary molars after tooth replantation. At 5 days after replantation, degenerated odontoblasts were lining the pulp cavity. At 14 days, dentin- or bone-like tissue was present in the pulp cavity. Immunoreactivity for osteopontin (OPN) and bone sialoprotein (BSP) was strong in the bone-like tissue, but weak in the dentin-like tissue. Conversely, dentin sialoprotein (DSP) was localized in the dentin-like tissue, but not in the bone-like tissue. Cells positive for BMP4, Smad4, Runx2, and Osterix were found around the blood vessels of the root apex at 5 days. At 14 days, these cells were also localized around the bone-like tissue. Cells expressing alpha-smooth muscle actin (SMA) were seen around the newly formed bone-like tissue, whereas no such cells were found around the newly formed dentin-like tissue. In an experiment involving the transplantation of a green fluorescent protein (GFP)-transgenic rat tooth into a wild-type rat tooth socket, GFP-positive cells were detected on the surface of the bone-like tissue and over all dentin-like tissue. These results indicate that the original pulp cells had the ability to differentiate into osteoblast-like cells as well as into odontoblast-like cells.

Effect of sodium hypochlorite treatment on remineralization of human root dentine in vitro

Dentine consists simplified of mineral and of several organic components. Sodium hypochlorite (NaOCl) is a well-known nonspecific proteolytic agent capable to remove organic material. The aim of this study was to investigate the influence of organic material removal from artificial dentine lesions by means of NaOCl pretreatment on subsequent remineralization with and without fluoride. Human root dentine samples were demineralized in an acidic gel (pH = 5) at 37 degrees C for 2 weeks. After 2 min of pretreatment with a 0.4, 2 or 10% NaOCl solution, the samples were remineralized in a 20 mM HEPES buffer (pH = 7) containing 1.5 mM Ca(2) and 0.9 mM phosphate with or without addition of 10 ppm F(-) as NaF at 37 degrees C for 8 days. Mineral profiles were assessed by means of transversal microradiography after diol treatment to avoid shrinkage caused by drying. In a separate experiments the dentine contraction caused by 10% NaOCl was assessed. The contraction (negligible for sound dentine) was found to be about 12% for the lesions. The remineralization results showed that pretreatment with a 10% NaOCl solution for 2 min, increased lesion remineralization. After NaOCl treatment, the amount of accumulated mineral increased by about 27% without F in the remineralization solution, and by about 4% with 10 ppm in solution. The in vitro results suggest that removal of organic materials from dentine lesions is an interesting approach to enhance remineralization.

Fluorescence spectroscopy of dental calculus

BACKGROUND

Correct diagnosis of the presence and extent of subgingival calculus is important for periodontal treatment planning and reassessment after periodontal therapy. Traditional tactile methods often lack sensitivity. The present investigation shall contribute to understanding the fundamental fluorescence properties that may be useful for optical detection of both supra- and subgingival calculus.

OBJECTIVES

The aim of this study was to investigate emission spectra from supra- and subgingival calculus under a wide range of excitation wavelengths.

METHODS AND RESULTS

Extracted human molars with either supragingival or subgingival calculus deposits on the root surface were selected (n = 3 each). Emission spectra were recorded from the calculus of each tooth and corresponding areas of clean root surfaces using a fluorescence spectrophotometer at excitation wavelengths from 360 nm up to 580 nm in steps of 20 nm. The spectra were corrected for the wavelength dependent instrument sensitivity and normalized to peak intensity (the highest peak was set at 1.0). Emission spectra of calculus exhibited distinct fluorescence bands between 570 and 730 nm not present in clean root surfaces. This fluorescence emission was strongest for excitation wavelengths from 400 to 420 nm. No differences were observed between supra- and subgingival calculus.

CONCLUSIONS

Human dental calculus can clearly be differentiated from clean root surfaces by emission spectrophotometry. The characteristic fluorescence emission of supra- and subgingival calculus may be due to a variety of porphyrin derivatives and may provide the basis for future diagnostic procedures.

Assessment of ultrasonic debridement of calculus-associated periodontally-involved root surfaces by the limulus amoebocyte lysate assay. An in vitro study

This investigation assessed the effectiveness of an in vitro ultrasonic debridement regime on periodontally involved teeth with visually-detectable calculus deposits, using the LAL assay for lipopolysaccharides (LPS) as a marker of bacterial products. 34 single rooted teeth with extensive amounts of calcified accretions were selected, of which 10 served as uninstrumented controls for the estimation of existing LPS levels. The periodontally involved roots of the 24 experimental teeth were debrided with a Cavitron TF-10 tip for a limited time using light pressure and overlapping strokes which ensured complete surface instrumentation without reference to the presence of calculus. Marked reductions in root surface area coverage by calculus were nevertheless achieved as assessed planimetrically from photographic records of the teeth before and after debridement. The root surfaces of each tooth were then stripped away and the harvested material subjected to 'Westphal' extraction and LAL assay for LPS. The resulting LPS yields from the experimental teeth ranged from less than 0.08 to 22.387 ng compared to 1,900 to 29,200 ng from the uninstrumented controls. The extremely small residual LPS yields from the experimental teeth not only confirm the efficacy of ultrasonic debridement but, when coupled with the lack of a relationship with the widely varying amounts of the remaining calculus, support the contention that bacterial plaque rather than calculus has the greater pathogenic potential. These results reinforce the growing impression of the superficial location of bacterial toxic products associated with periodontally involved root surfaces.