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Selected restoration and tooth conditions: United States, 1988-1991.

The DMF index provides one source of information on past and present dental caries experience; however, important limitations hinder its ability to characterize fully the impact of dental caries. The purpose of this paper is to describe a measure of selected restoration and tooth conditions that supplements information from the DMF index and to report on the application of this measure as part of the Third National Health and Nutrition Examination Survey, Phase 1, conducted between 1988 and 1991. Data from this survey were used to estimate the prevalence and severity of selected disaggregated physical and biological oral conditions among dentate adults aged 18 to 74 years. Trained, standardized, and calibrated dentist examiners assessed 28 permanent teeth or tooth spaces for each of 6,767 subjects. Teeth or tooth spaces were classified based on criteria for: defective intracoronal restorations, crowns, or bridges; gross loss of tooth structure associated with a restoration; pulpal involvement; or retained roots. Approximately 40.5%, or 61.6 million, dentate adults had at least one tooth or tooth space that met the criteria. Among all persons, an average of 0.9 teeth or tooth spaces met the criteria for at least one category. Adults with at least one scored tooth or tooth space had an average of 2.2 such teeth or tooth spaces. Data from this assessment supplement information available from the DMF index to provide a broader profile of the impact of dental caries on permanent teeth of US adults.

Adolescent↗

[An example of "leveling extraction" for repair of the 21st tooth supraposition].

A supercomplect retained tooth, situated under the 21st tooth, was removed in order to eliminate the supraposition (vestibular position) of the 21st tooth under conditions of lack of place in the dental arch. The 14th tooth on the contralateral side of the jaw was removed in order to maintain the symmetry and order of the anterior part of the maxillary dental arch and for creating place for the 21st tooth. Further transposition of the 13th tooth to the place previously occupied by 14th tooth, 11th tooth instead of 12th tooth, and establishment of the 21st tooth into correct position in the dental arch were carried out using orthodontic devices.

Adolescent↗

The prevalence, aetiology and clinical appearance of tooth wear: the Nigerian experience.

OBJECTIVE: To establish the prevalence and severity of tooth wear among Nigerians and to compare the pattern and aetiology with findings of earlier studies in Western populations. DESIGN: Clinical examinations for tooth wear using the tooth wear index (TWI). SETTING: The Federal Republic of Nigeria. PARTICIPANTS: Patients attending the Dental Hospital, Obafemi Awolowo University Teaching Hospital's Complex Ile-Ife. OUTCOME MEASURES: Attrition, abrasion and erosion. RESULTS: Of the 126 patients with tooth wear 81 had attrition, 20 had abrasion, 9 had erosion and 16 had attrition and abrasion combined. A total of 15,480 tooth surfaces were examined. 2,229 (14.4%) surfaces had tooth wear out of which 1,007 (6.5%) were pathologically worn down. The frequency of tooth wear increased with the age of patients. Most of the pathologically worn surfaces were just one point above maximum acceptable value. CONCLUSIONS: The aetiological factors associated with tooth wear are not different from those encountered in Western cultures but the pattern of wear differs. Pathological tooth wear presents as an age related phenomenon and is probably more severe in Nigerians.

Adult↗

[An analysis of the effect of adult tooth-brushing].

OBJECTIVE: This study observed plaque distribution on permanent dentition before and after brushing to analyze the effect of adult tooth-brushing. METHODS: 81 undergraduate were included in this study. Recorded the time of tooth-brushing, stained with disclosing tablets, plaque deposits on all permanent teeth were recorded using plaque index (PLI) before and after tooth-brushing. RESULTS: The time of tooth-brushing was from 28 s to 2 min 32 s, the mean time was 57 s, the males' was 49 s, the females' was 64 s. Statistically significant differences (P < 0.05) were found between males and females. The mean PLI of maxillary tooth was 0.41 +/- 0.03, for mandibular tooth was 0.47 +/- 0.03, there was significant difference between maxillary and mandibular. After brushing, the mean PLI of males was 0.532 +/- 0.04, of females was 0.295 +/- 0.03, there was significant difference of PLI between males and females (P < 0.05). These tooth PLI score were higher than other's mandibular and maxillary molars, these surface PLI score were higher than other's, buccal surface of maxillary molars and palatal site of maxillary molars. CONCLUSION: People should spend more time on brushing tooth. Tooth brushing should be emphasized on these tooth and surfaces with higher PLI score. Man should pay more attention to tooth brushing.

Adult↗

[Fundamental and practical study for DNA analysis using tooth as a source of DNA].

Degree of degradation and the yield of DNA extracted from dental pulp tissues were examined on the tooth samples (n = 50) stored at room temperature and the method of DNA extraction from tooth hard tissues was also investigated. The DNA samples obtained were also applied to forensic odontological material examination including DNA fingerprinting using a probe Myo and VNTR (variable number of tandem repeat) analysis in D4S43 locus by PCR. The amount of DNA obtained from the dental pulp tissue of a single tooth varied approximately from 3 to 40 micrograms. In most cases, high molecular weight DNA was still present in samples stored at room temperature for at least 336 days. When the dental pulp tissue samples were less than 5 mg in weight, the amount DNA extracted was usually less than 10 micrograms, however when the samples were more than 5 mg in weight, the amount of DNA extracted was more than 10 micrograms. No correlation was observed between the storage period of the tooth samples and the DNA extraction ratio (the amount of extracted DNA weight, micrograms/pulp weight, mg). The efficiency of DNA extraction from tooth hard tissues was investigated under different conditions using 0.005 M and 0.5 M EDTA solutions for decalcification. DNA was efficiently extracted from the tooth samples which were decalcified for one week without changing the 0.5 M EDTA solution or by changing the solution once within a week. Rapid decalcification using formic acid buffer was not suitable for DNA extraction from tooth hard tissues. Southern blot hybridization of DNA samples extracted from pulp tissues using Myo probe gave multiple bands. Finger print patterns obtained from DNA recovered from dental pulp and tooth hard tissues samples were identical, however, the number of hybridizing bands obtained from tooth hard tissues was less than that obtained from blood and dental pulp tissues. The D4S43 typing using DNA recovered from blood stains, dental pulp tissues and tooth hard tissues of the same individuals was in agreement with each other and the 184bp fragment was efficiently amplified in all the samples tested. The DNA obtained from dental pulp tissues usually contains high molecular weight DNA and was suitable for multilocus probe and PCR analysis. However, the DNA obtained from tooth hard tissues was suitable only for PCR analysis.

Adolescent↗

LEF1 is a critical epithelial survival factor during tooth morphogenesis.

LEF1 is a cell-type-specific transcription factor and mediates Wnt signaling pathway by association with its co-activator beta-catenin. Wnt signaling is known to be critical for the specification of cranial neural crest (CNC) cells and may regulate the fate diversity of the CNC during craniofacial morphogenesis. Loss of Lef1 results in arrested tooth development at the late bud stage and LEF1 is required for a relay of a Wnt signaling to a cascade of FGF signaling activities to mediate the epithelial-mesenchymal interaction during tooth morphogenesis. It remains unclear, however, what is the cellular mechanism of LEF1 signaling in regulating tooth morphogenesis. To test the hypothesis that LEF1 signaling regulates the fate of the dental epithelial and the CNC-derived mesenchymal cells during tooth morphogenesis, we investigated and compared the cellular migration, proliferation, and apoptotic activity within the tooth germ between the wild-type and Lef1 null mutant mice. Using the Wnt1-Cre/R26R transgenic system for indelibly marking the progenies of CNC cells, we show that there is no CNC migration defect in the Lef1 null mutant mice, indicating that the arrest in tooth development is not the result of shortage of the CNC contribution into the first branchial arch in the Lef1 mutant. Furthermore, there is no alteration in cell proliferation or condensation of the CNC-derived dental mesenchyme in the Lef1 null mutant, suggesting that LEF1 may not affect the cell cycle progression of the multipotential CNC cells during tooth morphogenesis. Importantly, apoptotic activity is significantly increased within the dental epithelium in the Lef1 null mutant mice. As the result of this increased cell death, the bud stage tooth germ fails to advance to the cap stage in the absence of Lef1. Inhibition of apoptotic activity by FGF4 rescues the tooth development in the Lef1 null mutant. Our studies suggest that LEF1 is a critical survival factor for the dental epithelial cells during tooth morphogenesis.

Animals↗

Computer-generated study of the correlation between tooth, face, arch forms, and palatal contour.

STATEMENT OF PROBLEM: Several factors have been suggested as aids for artificial tooth selection. Numerous methods have been devised for the evaluation of reliable esthetic factors in determining artificial tooth form. There is no universally accepted single esthetic factor that can be used reliably to aid artificial tooth selection. PURPOSE: This article describes a new method incorporating a computer program to analyze four esthetic factors: form of the face, arch form, palatal contour, tooth shape, and to determine whether there was correlation between tooth, face, and arch forms and palatal contour. MATERIAL AND METHOD: Impressions were made of the maxillary dentition of 50 dentate undergraduate dental students with irreversible hydrocolloid impression material and casts formed. A standardized photographic procedure was used to record portrait slides of each subject's face and of maxillary dental arches and central incisors made from dental casts. A comprehensive computer program was developed to correlate esthetic factors by superimposition. RESULTS: Superimposing outline form between face, tooth, and arch showed that for tooth to face form nearly half the comparisons were dissimilar and only 22% corresponded. This is the lowest level of correspondence in this group. Highest correspondence (28%) occurred between arch to face form, followed by arch to tooth form (24%). Arch to tooth showed the lowest level of dissimilarity (32%). For correlation among the four factors across the sample group based on a comparison of classifications in each subject, men tended to dominate tapering classes, whereas women dominated square and ovoid classes. CONCLUSION: Correspondence of outline forms through superimposition revealed an insignificant correlation between face, tooth, and arch forms. Although this method applies high technology, it does not improve the accuracy of determining shape and size of teeth in an edentulous patient. The cost and complexity of the method of measurement may also make it impractical for common application.

Adult↗

Disturbed tooth development in parathyroid hormone-related protein (PTHrP)-gene knockout mice.

Parathyroid hormone-related protein (PTHrP) is involved in epithelial-mesenchymal cell interactions during development of various tissues and organs. Tooth germ development is a classical model for this interaction. In tooth germs, PTHrP is expressed in the enamel organ (epithelial component), whereas its major receptor, the type I PTH/PTHrP receptor is expressed in cells of the alveolar bone and dental follicle (mesenchymal components). To clarify the role of PTHrP during fetal tooth germ development, PTHrP gene-knockout mice were used for histochemical and ultrastructural analysis. In wild-type mice, osteoclastic cells were aligned predominantly in the inner aspects of the alveolar bone surrounding the developing tooth germs throughout the late embryonic (after embryonic, 17.5 days) and neonatal animals examined. In contrast, osteoblasts were predominant in corresponding areas of fetal homozygous PTHrP-gene knockout mice with only occasional osteoclasts. In such areas, cell-free surfaces showing cement line-like tartrate-resistant acid phosphatase (TRAP) reactions were frequently observed. In neonatal homozygous mice, bone spicules were often shown to penetrate and/or compress the enamel organ and caused partial destruction of the tooth germs. Osteoclasts were few in number in the inner aspects of the alveolar bone, and had poorly developed ruffled border. No morphological abnormality was noted in cells of the tooth germs proper. On bone surfaces away from developing tooth germs, functional osteoclasts with structural features similar to those in wild-type mice were observed in homozygous mice. These observations suggest that PTHrP is required to maintain an appropriate spatiotemporal arrangement of bone cells and osteoclast function, which are necessary for the normal development of tooth germ and alveolar bone encasing the tooth germ. The observation also demonstrates that PTHrP deficiency affects the structure and function of osteoclasts exclusively those located in the vicinity of the growing tooth germ.

Acid Phosphatase↗

Biomechanical behavior of the periodontium before and after orthodontic tooth movement.

This study was designed to investigate the biomechanical behavior of the periodontium including the periodontal ligament (PDL) in terms of tooth mobility. Tooth mobility was measured in the canines of 10 adolescent patients before and after distal movement. Distal movement of the canines was carried out by use of a calibrated sectional archwire exerting an initial retraction force of 200 g. Tooth mobility was measured immediately before and after canine retraction by use of a noncontact displacement sensor when varying distal forces of 0 to 500 g were applied to the mesial of the canine. Before tooth movement, tooth mobility exhibited a substantial increase in loading with forces ranging from 50 to 150 g. The rate of increase gradually decreased up to 500 g. A nonlinear change in tooth mobility was similarly observed at the end of tooth movement or 24 days after the initiation of movement. Tooth mobility, however, was significantly greater when forces above 200 g were loaded. The periodontal tissues--the PDL and alveolar bone in particular--become more flexible at the end of tooth movement, indicating reduced support by the periodontal tissues. These findings suggest that the elastic nature of the PDL and alveolar bone may decrease substantially at the end of tooth movement.

Adolescent↗

Periodontal disease and tooth loss.

Numerous epidemiological studies have shown that caries is the main reason for tooth loss. More recent epidemiological data seem to show an increasing trend of tooth loss due to periodontal reasons rather than caries. In considering the issue of periodontal disease and tooth loss the following observations were made. The presence of initial attachment loss, bone height and the habit of smoking significantly increase the risk of tooth mortality. There is a strong correlation between smoking, the severity of periodontal disease and tooth mortality. Cross-sectional population surveys of tooth loss reported lower anterior teeth to be the most frequently extracted due to periodontal reasons, followed by upper anteriors and upper second molars. However, in long term maintenance studies, molars were lost most frequently. Periodontal reasons for tooth loss were mainly mobility followed by furcation involvement. Periodontal surgery did not significantly enhance tooth retention in high risk groups. Ethnic differences observed were not significant and would need further investigations to address variables such as cultural differences, health habits, diet and socio-economic status. In conclusion, periodontal tooth mortality was found to be associated with the loss of periodontal attachment and risk groups with advanced periodontitis contributing to major tooth loss in a minority of the population.

Alveolar Bone Loss↗

Sonic hedgehog regulates growth and morphogenesis of the tooth.

During mammalian tooth development, the oral ectoderm and mesenchyme coordinate their growth and differentiation to give rise to organs with precise shapes, sizes and functions. The initial ingrowth of the dental epithelium and its associated dental mesenchyme gives rise to the tooth bud. Next, the epithelial component folds to give the tooth its shape. Coincident with this process, adjacent epithelial and mesenchymal cells differentiate into enamel-secreting ameloblasts and dentin-secreting odontoblasts, respectively. Growth, morphogenesis and differentiation of the epithelium and mesenchyme are coordinated by secreted signaling proteins. Sonic hedgehog (Shh) encodes a signaling peptide which is present in the oral epithelium prior to invagination and in the tooth epithelium throughout its development. We have addressed the role of Shh in the developing tooth in mouse by using a conditional allele to remove Shh activity shortly after ingrowth of the dental epithelium. Reduction and then loss of Shh function results in a cap stage tooth rudiment in which the morphology is severely disrupted. The overall size of the tooth is reduced and both the lingual epithelial invagination and the dental cord are absent. However, the enamel knot, a putative organizer of crown formation, is present and expresses Fgf4, Wnt10b, Bmp2 and Lef1, as in the wild type. At birth, the size and the shape of the teeth are severely affected and the polarity and organization of the ameloblast and odontoblast layers is disrupted. However, both dentin- and enamel-specific markers are expressed and a large amount of tooth-specific extracellular matrix is produced. This observation was confirmed by grafting studies in which tooth rudiments were cultured for several days under kidney capsules. Under these conditions, both enamel and dentin were deposited even though the enamel and dentin layers remained disorganized. These studies demonstrate that Shh regulates growth and determines the shape of the tooth. However, Shh signaling is not essential for differentiation of ameloblasts or odontoblasts.

Animals↗

Growth factors and tooth development.

The effects of various growth factors on tooth development were studied in organ cultures of mouse embryonic tooth germs. Transferrin was shown to be a necessary growth factor for early tooth morphogenesis. Transferrin was required for the development of bud- and early cap-staged teeth, and it was shown to be the only serum protein that was needed by early cap-staged teeth in organ culture. Promotion of tooth morphogenesis and dental cell differentiation was shown to be based on the stimulation of cell proliferation. The roles of polypeptide growth factors in tooth development were studied by adding these factors to the transferrin-containing chemically-defined culture medium which supports early tooth morphogenesis and cell differentiation. Fibroblast growth factor or platelet-derived growth factor did not affect cell proliferation or morphogenesis of tooth germs in culture. On the contrary, epidermal growth factor (EGF) stimulated cell proliferation in tooth explants, but at the same time inhibited tooth morphogenesis and dental cell differentiation. Autoradiographic localization of proliferating cells revealed that dental tissues responded to EGF with different proliferation rates. The responsiveness to EGF was stage-dependent, early cap-staged teeth were sensitive to EGF but late cap-staged and bell-staged teeth developed normally in the presence of EGF in the culture medium. The presence and distribution of receptors for both transferrin and EGF were studied in mouse embryonic teeth at various developmental stages by incubating freshly-separated tooth germs with 125Iodine-labeled transferrin or EGF, and then processing the tissues for autoradiography.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

Autotransplantation and replantation of tooth germs in monkeys. Effect of damage to the dental follicle and position of transplant in the alveolus.

The effect of damage to the follicle and of superficial positioning of tooth germs after replantation or autotransplantation was studied in green Vervet monkeys. Radiographs were taken immediately after surgery and 3, 6 and 9 months postoperatively, whereafter the animals were sacrificed. The tissue blocks were sectioned in step serial sections along a frontal plane and histologic and radiographic evaluation was made. Tooth germs whose follicle was either damaged or removed showed no sign of eruption, while tooth germs which were replanted with an intact follicle were fully erupted within 3 months. Non-operated control teeth were fully erupted within 6 months. Histologic examination revealed that roots of replanted teeth were only slightly shorter than the non-operated control teeth. Transplantation of tooth germs in different positions in relation to the alveolar crest showed that teeth placed in their original position attained an average tooth length of 12.5 mm, whereas teeth placed in a semi-erupted position achieved an average length of only 9.7 mm. A control group of non-operated incisors demonstrated an average tooth length of 13.7 mm. This study indicates that damage to the follicle at the time of replantation of tooth germs is of major importance for tooth eruption and that placing tooth germs in a semi-erupted position adversely influences later root development.

Alveolar Process↗

Remaining tooth structure associated with various preparation designs for the endodontically treated maxillary second premolar.

Existing literature suggests a relationship between the amount of remaining tooth structure and the fracture resistance of the restored endodontically treated tooth. This study investigated the amount of tooth structure remaining following various tooth preparations used in the restoration of the endodontically treated maxillary second premolar. Illustrations of the maxillary second premolar in buccopalatal, mesiodistal and occlusal sections were drawn to scale. Outlines of various intra- and extracoronal preparations were superim-posed on the illustrations to reveal the amount of tooth tissue remaining in each case. Preparations for a ceramic inlay, inlay with palatal cusp coverage and onlay left 2.0-2.5mm of tooth structure buccally and palatally. Following preparation for a metal-ceramic crown, approximately 1.0mm of tooth structure remained buccally, and between 1.6mm-1.8mm palatally. Preparation for an all-ceramic crown was observed to leave 1.0mm-1.2mm of tooth structure surrounding what remained of the endodontic access cavity. It was concluded that decisions as to the type of definitive restoration to restore the endodontically treated maxillary second premolar may be influenced, amongst other factors, by information on the amount of tooth tissue remaining following preparation.

Bicuspid↗

Associations of FGF-3 and FGF-10 with signaling networks regulating tooth morphogenesis.

The morphogenesis and cell differentiation in developing teeth is governed by interactions between the oral epithelium and neural crest-derived ectomesenchyme. The fibroblast growth factors FGF-4, -8, and -9 have been implicated as epithelial signals regulating mesenchymal gene expression and cell proliferation during tooth initiation and later during epithelial folding morphogenesis and the establishment of tooth shape. To further evaluate the roles of FGFs in tooth development, we analyzed the roles of FGF-3, FGF-7, and FGF-10 in developing mouse teeth. In situ hybridization analysis showed developmentally regulated expression during tooth formation for Fgf-3 and Fgf-10 that was mainly restricted to the dental papilla mesenchymal cells. Fgf-7 transcripts were restricted to the developing bone surrounding the developing tooth germ. Fgf-10 expression was observed in the presumptive dental epithelium and mesenchyme during tooth initiation, whereas Fgf-3 expression appeared in the dental mesenchyme at the late bud stage. During the cap and bell stage, both Fgf-3 and Fgf-10 were intensely expressed in the dental papilla mesenchymal cells both in incisors and molars. It is of interest that Fgf-3 expression was also observed in the primary enamel knot, a putative signaling center of the tooth, whereas no transcripts were seen in the secondary enamel knots that appear in the tips of future cusps of the bell stage tooth germs. Down-regulation of Fgf-3 and Fgf-10 expression in postmitotic odontoblasts correlated with the terminal differentiation of the odontoblasts and the neighboring ameloblasts. In the incisors, mesenchymal cells of the cervical loop area showed partially overlapping expression patterns for all studied Fgfs. In vitro analyses showed that expression of Fgf-3 and Fgf-10 in the dental mesenchyme was dependent on dental epithelium and that epithelially expressed FGFs, FGF-4 and -8 induced Fgf-3 but not Fgf-10 expression in the isolated dental mesenchyme. Beads soaked in Shh, BMP-2, and TGF-beta 1 protein did not induce either Fgf-3 or Fgf-10 expression. Cells expressing Wnt-6 did not induce Fgf-10 expression. Furthermore, FGF-10 protein stimulated cell proliferation in the dental epithelium but not in the mesenchyme. These results suggest that FGF-3 and FGF-10 have redundant functions as mesenchymal signals regulating epithelial morphogenesis of the tooth and that their expressions appear to be differentially regulated. In addition, FGF-3 may participate in signaling functions of the primary enamel knot. The dynamic expression patterns of different Fgfs in dental epithelium and mesenchyme and their interactions suggest existence of regulatory signaling cascades between epithelial and mesenchymal FGFs during tooth development.

3T3 Cells↗

Chick limbs with mouse teeth: an effective in vivo culture system for tooth germ development and analysis.

Mouse tooth germ development is currently studied by three main approaches: in wild-type and mutant mouse lines, after transplantation of tooth germs to ectopic sites, and in organ culture. The in vivo approaches are the most physiological but do not provide accessibility to tooth germs for further experimental manipulation. Organ cultures, although readily accessible, do not sustain full tooth germ development and are appropriate for short-term analysis. Thus, we sought to establish a new approach that would combine experimental accessibility with sustained development. We implanted fragments of embryonic day 12 mouse embryo first branchial arch containing early bud stage tooth germs into the lateral mesenchyme of day 4-5 chick embryo wing buds in ovo. Eggs were reincubated, and implanted tissues were examined by histochemistry and in situ hybridization over time. The tooth germs underwent seemingly normal growth, differentiation, and morphogenesis. They reached the cap, bell, and crown stages in approximately 3, 6, and 10 days, respectively, mimicking in a striking manner native temporal patterns. To examine mechanisms regulating tooth germ development, we first implanted tooth germ fragments, microinjected them with neutralizing antibodies to the key signaling molecule Sonic hedgehog (Shh), and examined them over time. Tooth germ development was markedly delayed, as revealed by poor morphogenesis and lack of mature ameloblasts and odontoblasts displaying characteristic traits such as an elongated cell shape, nuclear relocalization, and amelogenin gene expression. These phenotypic changes began to be reversed upon further incubation. The data show that the limb bud represents an effective, experimentally accessible as well as economical system for growth and analysis of developing tooth germs. The inhibitory effects of Shh neutralizing antibody treatment are discussed in relation to roles of this signaling pathway proposed by this and other groups previously.

Animals↗

Prospects for tooth regeneration in the 21st century: a perspective.

The prospects for tooth regeneration in the 21st century are compelling. Using the foundations of experimental embryology, developmental and molecular biology, the principles of biomimetics (the mimicking of biological processes), tooth regeneration is becoming a realistic possibility within the next few decades. The cellular, molecular, and developmental "rules" for tooth morphogenesis are rapidly being discovered. The knowledge gained from adult stem cell biology, especially associated with dentin, cartilage, and bone tissue regeneration, provides additional opportunities for eventual tooth organogenesis. The centuries of tooth development using xenotransplantation, allotransplantation, and autotransplantation have resulted in many important insights that can enhance tooth regeneration. In considering the future, several lines of evidence need to be considered: (1) enamel organ epithelia and dental papilla mesenchyme tissues contain stem cells during postnatal stages of life; (2) late cap stage and bell stage tooth organs contain stem cells; (3) odontogenic adult stem cells respond to mechanical as well as chemical "signals"; (4) presumably adult bone marrow as well as dental pulp tissues contain "odontogenic" stem cells; and (5) epithelial-mesenchymal interactions are pre-requisite for tooth regeneration. The authors express "guarded enthusiasm," yet there should be little doubt that adult stem cell-mediated tooth regeneration will be realized in the not too distant future. The prospects for tooth regeneration could be realized in the next few decades and could be rapidly utilized to improve the quality of human life in many nations around the world.

Dentistry, Operative↗

Ultrastructure of basement membranes in developing shark tooth.

Based on studies of the tooth of largely mammalian species, the dental basement membranes are shown to be specialized for various roles significant in the development and maintenance of the tooth. Comparative studies with the nonmammalian tooth will facilitate further clarification of the mechanisms of mammalian tooth formation. In this study, basement membranes of the shark tooth in successive developmental stages was ultrastructurally examined for elucidation of their roles in odontogenesis. Teeth of a shark, Cephaloscyllium umbratile, were processed for thin section electron microscopy. Throughout the developmental stages the lamina densa of the basement membrane was made up of a fine network of "cords," irregular anastomosing strands known to be the major component of mammalian basement membranes. In the presecretory stage of the shark tooth, dental papilla cells were immobilized for their differentiation into odontoblasts by means of the binding of their processes to numerous narrow extensions of the lamina densa of the inner dental epithelium. In the secretory stage, a number of cords of the widened lamina densa were extended towards and bound to tubular vesicles of the forming enameloid. During the mineralization stage, fragments of the degrading enameloid matrix appeared to be moving through the lamina densa to the epithelial cells for processing. In the maturation stage, half of the lamina densa facing the enameloid was mineralized forming an advancing edge of mineralization of the enameloid. It provided strong binding and smooth transition of organic to mineral phase which may allow transportation of substances across the phases for enameloid maturation in a way similar to that reported in the mammalian tooth. These observations indicate that basement membranes of the developing shark tooth, as those in the mammalian tooth, play various roles, including anchoring, firm binding, and possible mediation of the transport of substances that are known to be vital for the development of the tooth.

Animals↗