Root-analogue versus crown-analogue dentin: a radioautographic and ultrastructural investigation of the mouse incisor

The present paper reports on differences between the root- and crown-analogue dentin portions of the continuously growing mouse incisor. Conventional light microscopy and radioautography were used to study dentin formation and the uptake of [3H]-proline and [3H]-serine. It was found that, although the dentin apposition rate along the crown-analogue part (covered by enamel) equalled or slightly exceeded that along the root-analogue part (covered by cementum), the processing of predentin into dentin was considerably faster in the root aspect. Comparison of the two dentin portions at the ultrastructural level revealed that differences occurred in the morphology of the secretory granules of the odontoblast layer. Two types of granules were observed: those that were and those that were not loaded with electron-dense particles of 30 nm diameter. While the former type was most frequent along the crown-analogue aspect of the incisor, the latter type was particularly found along its root-analogue aspect. This difference may reflect differences between the two dentin portions in the composition of the noncollagenous matrix.     

Radioautographic study of [3H]mannose utilization during cementoblast differentiation,formation of acellular cementuum,and development of periodontal ligament principal fibers

The formation of acellular cementum and the deposition of [³H]mannose-labeled extracellular matrix were studied in 14-day-old Sprague-Dawley rats. The sequential events of cementogenesis and periodontal ligament formation observed by light and electron microscopy were described from the stage of an intact root sheath to postcementogenesis. Ultrastructural examination of cementoblasts and periodontal ligament fibroblasts revealed [³H]mannose labeling of the Golgi apparatus at 10 minutes, collagen secretion granules at 30 minutes, and the extracellular matrix beginning at 30 minutes. The extracellular matrix between cementoblasts and dentin was heavily labeled at 1 and 4 hours. Newly formed principal fibers of the periodontal ligament were also heavily labeled at 4 hours. Fully differentiated cementoblasts exhibited the largest sectional profiles and the highest number of silver grains per unit area of cytoplasm. The morphologic and radioautographic data suggest that during the formation of acellular cementum, the cementoblast phenotype is expressed for a short period of time, after which cementoblasts appear to mix with the fibroblasts of the periodontal ligament.     

Models for the Study of Cementogenesis

Cementum is a mineralized tissue that acts to connect the periodontal ligament to the tooth root surface. Its composition is very much like bone, being comprised mainly of type I collagen, inorganic mineral and noncollagenous proteins, however the origin of the cells and factors necessary for cementum formation have yet to be elucidated.

Our laboratory has focused on the role that adhesion molecules, and their cell surface receptors, play in the formation of cementum and tooth root. In order to study this, we used a mouse molar as a model system. This system enabled us to study the formation of four distinct mineralized tissues; bone, cementum, dentin and enamel at various stages of their development. For these studies, we initiated experiments to examine potential cementoblast progenitor cells, in vitro. As a first step, we show that dental papilla and dental follicle cells, n vitro, obtained from molar tissues at day 21 of development, induce mineralized nodules, in vitro

In addition, we obtained tissues from mice where defects in root development may exist and determined bone sialoprotein (BSP) protein expression, a mineralized tissue specific adhesion molecule, in such tissues. As discussed here, we found that osteopetrotic (op/op) mice have delayed and/or defective root development and BSP does not localize in the dental tissues, at day 33 of development. In addition, dentin formation was defective and odontoblasts appeared immature, based on morphological examination. In contrast, the day 33 control molars demonstrated positive staining for BSP localized to root cementum, with normal formation of dentin.     

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.     

Cementum and periodontal ligament-like tissue formation induced using bioengineered dentin

Stem cell-mediated root regeneration offers opportunities to regenerate a bio-root and its associated periodontal tissues to restore tooth loss. Periodontal ligament (PDL) and cementum complex and dentin pulp complex have been tissue engineered using human dental pulp stem cells and PDL stem cells, respectively. The aim of this study was to explore whether dentin formation could be induced using an inductive substrate and whether bioengineered dentin could induce cementum and PDL formation. First, dentin was bioengineered from tooth papillae of Sprague-Dawley (SD) rats with an inductive substrate, and its phenotype was characterized; then primarily cultured human PDL cells were seeded on the surface of dentin and transplanted under the skin of immunocompromised mice. Histological, immunohistochemical, and scanning electronic microscopy examinations results showed that bioengineered dentin could induce cementogenesis and PDL formation, and condense PDL arranged perpendicularly on the dentin surface via a layer of cementum-like tissue. The results indicated that tissue-engineered dentin could be induced using an inductive substrate and could be used as a further substrate for cementum and PDL tissue engineering.     

Radioautographic study of [3H]mannose utilization during cementoblast differentiation, formation of acellular cementum, and development of periodontal ligament principal fibers

The formation of acellular cementum and the deposition of [3H]mannose-labeled extracellular matrix were studied in 14-day-old Sprague-Dawley rats. The sequential events of cementogenesis and periodontal ligament formation observed by light and electron microscopy were described from the stage of an intact root sheath to postcementogenesis. Ultrastructural examination of cementoblasts and periodontal ligament fibroblasts revealed [3H]mannose labeling of the Golgi apparatus at 10 minutes, collagen secretion granules at 30 minutes, and the extracellular matrix beginning at 30 minutes. The extracellular matrix between cementoblasts and dentin was heavily labeled at 1 and 4 hours. Newly formed principal fibers of the periodontal ligament were also heavily labeled at 4 hours. Fully differentiated cementoblasts exhibited the largest sectional profiles and the highest number of silver grains per unit area of cytoplasm. The morphologic and radioautographic data suggest that during the formation of acellular cementum, the cementoblast phenotype is expressed for a short period of time, after which cementoblasts appear to mix with the fibroblasts of the periodontal ligament.     

Periodontal ligament stem/progenitor cells with protein-releasing scaffolds for cementum formation and integration on dentin surface

ABSTRACT

Purpose/Aim: Cementogenesis is a critical step in periodontal tissue regeneration given the essential role of cementum in anchoring teeth to the alveolar bone. This study is designed to achieve integrated cementum formation on the root surfaces of human teeth using growth factor–releasing scaffolds with periodontal ligament stem/progenitor cells (PDLSCs). Materials and methods: Human PDLSCs were sorted by CD146 expression, and characterized using CFU-F assay and induced multi-lineage differentiation. Polycaprolactone scaffolds were fabricated using 3D printing, embedded with poly(lactic-co-glycolic acids) (PLGA) microspheres encapsulating connective tissue growth factor (CTGF), bone morphogenetic protein-2 (BMP-2), or bone morphogenetic protein-7 (BMP-7). After removing cementum on human tooth roots, PDLSC-seeded scaffolds were placed on the exposed dentin surface. After 6-week culture with cementogenic/osteogenic medium, cementum formation and integration were evaluated by histomorphometric analysis, immunofluorescence, and qRT-PCR. Results: Periodontal ligament (PDL) cells sorted by CD146 and single-cell clones show a superior clonogenecity and multipotency as compared with heterogeneous populations. After 6 weeks, all the growth factor–delivered groups showed resurfacing of dentin with a newly formed cementum-like layer as compared with control. BMP-2 and BMP-7 showed de novo formation of tissue layers significantly thicker than all the other groups, whereas CTGF and BMP-7 resulted in significantly improved integration on the dentin surface. The de novo mineralized tissue layer seen in BMP-7-treated samples expressed cementum matrix protein 1 (CEMP1). Consistently, BMP-7 showed a significant increase in CEMP1 mRNA expression. Conclusion: Our findings represent important progress in stem cell–based cementum regeneration as an essential part of periodontium regeneration.     

Effect of enamel matrix proteins on the periodontal connective tissue-material interface after wound healing

The periodontal ligament has the potential to regenerate a complete periodontal connective tissue attachment, starting with the deposition of cementum, on pathologically exposed root surfaces as well as several materials including titanium oxide. However, most commonly used dental materials result in a fibrous encapsulation or a chronic inflammatory response after periodontal wound healing rather than the formation of a periodontal connective tissue attachment. Recently, an extract of porcine enamel matrix (Emdogain(R), EMD) has been reported inductive of cementum formation in both in vivo and in vitro studies. The aim of this study was to determine the effect of EMD, when applied to materials previously reported not supportive of periodontal connective tissue formation, on the periodontal connective tissue-material interface obtained with these materials in vivo. Bilateral osteotomies were performed on the mandible of a Yucatan minipig exposing the buccal root surface of four premolars. A series of four preparations were placed in each root surface that were subsequently filled with calcium hydroxide, gutta percha, mineral trioxide aggregate (MTA), or left unfilled. One side, in addition, received an application of EMD prior to surgical closure. A bioabsorbable surgical barrier membrane was placed over the osteotomy sites to exclude gingival connective tissue from the wound-healing environment. The mucoperiosteal flaps were then readapted and sutured in position. The animal was euthanized 10 weeks after the procedure, block sections obtained and prepared for light microscopy. Results demonstrated complete regeneration of alveolar bone and periodontal ligament in all four teeth from the EMD-treated side. Fibers from the periodontal ligament were observed to insert into a mineralized matrix consistent with cementum on all four root preparations. In contrast, massive root resorption without regeneration of alveolar bone was found on all teeth from the side not treated with EMD. The results of this pilot study suggest that the application of EMD to material surfaces that normally do not support periodontal connective tissue attachment formation can alter the type of periodontal connective tissue interface obtained with these materials.     

Cementum formation in rat molar roots

Cementum is the calcified tissue covering roots of teeth and serves as attachment sites of the periodontal ligament. Although recent studies have suggested that extracellular matrix of cementum is very similar to that of bone, cementogenesis on a biological basis is still poorly understood. There are variations in the distribution and mineral contents of cementum depending on animal age, tooth species and position within the tooth roots. This paper reviews the formation and age-related changes of cellular and acellular cementum in rat molar roots, and discusses the effect of mechanical stress to the cementum formation.     

Intermittent inhibition of dentin mineralization of rat incisors under continual infusion of 1-hydroxyethylidene-1, 1-bisphosphonate (HEBP) using a subcutaneous mini osmotic pump.

The inhibitory effect of the continual administration of 1-hydroxyethylidene-1, 1-bisphosphonate (HEBP) (8 mgP/kg/day) through a mini osmotic pump on dentin mineralization was examined in relation to the diurnal rhythm of the rat and compared with that of daily injections of same amounts of HEBP known to inhibit dentin mineralization. After daily injections of HEBP, a series of alternating rows of mineralized and non-mineralized dentin islands appeared in the newly formed portion of the crown-analogue of rat incisors. A similar phenomenon occurred under the continual administration of HEBP in rats raised either under regular environmental photofraction or constant lighting conditions. The average distance between the adjacent mineralized dentin islands was 521.0 +/- 51.3 microns in the injected rats. After continual HEBP administration, this was 426.0 +/- 13.2 microns and 416.5 +/- 19.4 microns under ordinary photofraction and constant light, respectively. Although the pattern of individual mineralized dentin islands tended to become irregular in nocturnal rats, no statistical difference was noted between the two values. Rows of mineralized and non-mineralized dentin islands also appeared in the root analogue dentin. No sign of the intermittent inhibition of mineralization was recognized in mesodermal hard tissues other than dentin in the HEBP-affected animals. These data implicate the presence of intrinsic cycles in dentin mineralization at the growing end of rat incisors independent of environmental photofraction as well as the ameloblast function.     

Healing of periodontal defects treated with enamel matrix proteins and root surface conditioning--an experimental study in dogs

Application of enamel matrix proteins has been introduced as an alternative method for periodontal regenerative therapy. It is claimed that this approach provides periodontal regeneration by a biological approach, i.e. creating a matrix on the root surfaces that promotes cementum, periodontal ligament (PDL) and alveolar bone regeneration, thus mimicking the events occurring during tooth development. Although there have been numerous in vitro and in vivo studies demonstrating periodontal regeneration, acellular cementum formation and clinical outcomes via enamel matrix proteins usage, their effects on the healing pattern of soft and hard periodontal tissues are not well-established and compared with root conditioning alone. In the present study, the effects of Emdogain (Biora, Malm?, Sweden), an enamel matrix derivative mainly composed of enamel matrix proteins (test), on periodontal wound healing were evaluated and compared with root surface conditioning (performed with 36% orthophosphoric acid) alone (control) histopathologically and histomorphometrically by means of the soft and hard tissue profile of periodontium. An experimental periodontitis model performed at premolar teeth of four dogs were used in the study and the healing pattern of periodontal tissues was evaluated at days 7, 14, 21, 28 (one dog at each day), respectively. At day 7, soft tissue attachment evaluated by means of connective tissue and/or epithelial attachment to the root surfaces revealed higher connective tissue attachment rate in the test group and the amount of new connective tissue proliferation in the test group was significantly greater than the control group (p<0.01). New bone formation by osteoconduction initiated at day 14 in the test and control group. At day 21, the orientation of supra-alveolar and PDL fibers established, and new cementum formation observed in both groups. At day 28, although regenerated cementum was cellular in all of the roots in the control samples, an acellular type of cementum (1.32+/-0.83 mm in length and 3.16+/-0.23 microm in width) was also noted in six roots of test samples with an inconsistent distribution on the root surfaces. The amount of new cementum was significantly higher in the test group than the control group samples (p<0.01). The width of the cellular cementum in the control group was more than the cellular cementum in the test group, but the difference was not statistically significant (p>0.05). A firm attachment of acellular cementum to the root dentin with functional organization of its collagen fibers was noted, and, the accumulation and organization of cellular cementum in the control group was more irregular than the cellular cementum formed in the test group. The amount of new bone was 2.41+/-0.75 mm in the test and 1.09+/-0.46 mm in the control group at day 28. The rate of bone maturation (the number of osteons) was found higher in the test group (10.75+/-0.85) than the control group (5.50+/-0.86). Under the limitations of the study, our results reveal that when compared with root surface conditioning, enamel matrix proteins have more capacity for stimulating periodontal regeneration via their positive effects on root surfaces, i.e. inhibition of gingival epithelium down growth and stimulation of connective tissue proliferation and attachment to the root surfaces during wound healing. An acellular type of cementum regeneration and new alveolar bone formation by an accelerated osteoconductive mechanism are also achieved with application of enamel matrix proteins.     

Effects of ascorbate-deficiency on collagen secretion and resorption in cultured mouse incisor germs.

The effects of ascorbic acid deficiency on mouse incisors, grown in vitro, has been investigated at the histological and cytological levels. In this model, continuously growing mouse incisors are characterized by the existence of different type of predentin-dentin matrix on its lingual (root-analogue) and labial (crown-analogue) surface and the absence of enamel on the lingual surface. Our observations indicated that ascorbate-deficiency affected the behavior of mouse tooth germs in vitro: odontoblast differentiation was disturbed and morphological evidence for odontoblast-mediated collagen resorption were observed. An abnormal amorphous predentin-dentin matrix existed and the basement membrane was prematurely disrupted. The dentin mineralization, as well as functional differentiation of ameloblasts were strongly hampered. Chronic deficiency led to disorganization of the dental tissues.     

PrPc is temporospatially expressed in molar development of rats

Odontogenesis, tooth development, is derived from two tissue components: ectoderm and neural crest‐derived mesenchyme. Cyto‐differentiation of odontogenic cells during development involves time‐dependent and sequential regulation of genetic programs. This study was conducted to detect molecules implicated in cyto‐differentiation of developing molar germs of rats. Differential display‐PCR revealed that PrP^c was differentially expressed between cap/early bell‐staged germs (maxillary 3rd molar germs) and root formation‐staged germs (maxillary 2nd molar germs) at postnatal day 9. Both levels of PrP^c mRNA and protein expression were higher in the root formation stage than the cap/early bell stage and increased in a time‐dependent manner. Immunofluorescence revealed for the first time that PrP^c was not localized in the enamel organ, but localized in dental follicular cells for the development of the periodontal ligament and cementum as well as odontoblasts, both of which are of neural crest origin. These results suggest that the physiological functions of the PrP^c in tooth development may be implicated in the differentiation of neural crest‐derived mesenchyme including the periodontal tissues for root formation rather than epithelial tissue. Anat Rec, 296:1929–1935, 2013. © 2013 Wiley Periodicals, Inc.     

Effects of ascorbate-deficiency on collagen secretion and resorption in cultured mouse incisor germs

The effects of ascorbic acid deficiency on mouse incisors, grown in vitro, has been investigated at the histological and cytological levels. In this model, continuously growing mouse incisors are characterized by the existence of different type of predentin-dentin matrix on its lingual (root-analogue) and labial (crown-analogue) surface and the absence of enamel on the lingual surface. Our observations indicated that ascorbate-deficiency affected the behavior of mouse tooth germs in vitro: odontoblast differentiation was disturbed and morphological evidence for odontoblast-mediated collagen resorption were observed. An abnormal amorphous predentin-dentin matrix existed and the basement membrane was prematurely disrupted. The dentin mineralization, as well as functional differentiation of ameloblasts were strongly hampered. Chronic deficiency led to disorganization of the dental tissues.     

Bone formation and resorption around developing teeth transplanted into the femur

Seven of 24 newborn hamsters developing maxillary molars which were transplanted to the femur for 28 days showed growth and development of crowns and roots. Enamel, dentin, pulp, cementum, periodontal ligament and alveolar bone proper developed in their normal locations just as they had done previously in molars transplanted into subcutaneous connective tissues. Several relationships were observed between alveolar bone proper, developed in the foreign body environment and under the inductive influence of the tooth root, and femoral bone. Femoral bone was continuous with alvolar bone and supported the tooth socket. In some areas near transplanted molar roots, femoral bone was built out to join and support alveolar bone. In other areas, femoral bone was resorbed by the development of a molar root or the molar root was diverted from its normal direction of development. Despite the effort to orient transplanted molars for eruption, the orientation was altered and no evidence for tooth eruption was observed.     

Ca-binding domains in the odontoblast layer of rat molars and incisors under normal and pathological conditions

We recently reported the presence of high concentrations of a Ca-binding matrix in the circumpulpal dentin of rat incisors which had been prevented from mineralization by a systemic administration of 1-hydroxyethylidene-1,1-bisphosphonate (HEBP), a type of bisphosphonates, thus suggesting the role of the putative Ca-binding matrix in the appositional mineralization of circumpulpal dentin (TAKANO et al., 1998, 2000; OHMA et al., 2000). In this study, we examined the distribution of Ca-binding domains in the pulp tissue of normal rat teeth and its changes under the influence of HEBP, in order to identify and clarify the role of the Ca-binding matrix in the physiological process of dentin mineralization. Observation of the normal rat tooth pulp showed occasional, tiny extracellular deposits of Ca-enriched material in the odontoblast layer, associated primarily with pericapillary regions. Such deposits were immunopositive for dentin sialoprotein (DSP), displayed high levels of X-ray peaks for calcium and phosphorus, and showed a drastic increase in amount by daily injections of HEBP. A brief vascular perfusion of high Ca-containing solution in normal animals caused the extensive deposition of Ca-P complexes along the basolateral membranes of odontoblasts but not in the other regions of the pulp tissue. These data suggest the existence of DSP-enriched extracellular Ca-binding domains in the odontoblast layer and also indicate a novel Ca-binding property of the basolateral membranes of odontoblasts. Since DSP is primarily synthesized as dentin sialophosphoprotein (DSPP) and later cleaved into dentin phosphophoryn (DPP) and DSP in odontoblasts, and since DSP has no notable affinity for Ca, the sites of DSP-immunopositive Ca-P deposits in the odontoblast layer may also contain DPP, a highly phosphorylated acidic protein having a strong binding property for calcium. Characteristic Ca-binding properties seen in the odontoblast layer appear to be related to the regulation of the appositional mineralization of circumpulpal dentin.     

Healing of artificial fenestration defects by seeding of fibroblast-like cells derived from regenerated periodontal ligament in a dog: a preliminary study

The purpose of this study was to assess the seeding of fibroblast-like cells to promote periodontal healing in artificial fenestration defects in a dog. Fibroblast-like cells were cultured by incubating regenerated periodontal ligament tissue, that had been surgically taken, underneath a Teflon membrane. Fenestration defects were surgically induced on the maxillary canine and first molar teeth at a spacing of 5 to 5 mm. Passage 4 cells (2 x 10(5) cells) in autologous blood coagulum were placed on root surfaces in two defects; the remaining two defects were used as controls. Healing was evaluated histomorphometrically on postoperative day 42. The main periodontal healing pattern consisted of connective tissue adaptation in three of the four specimens including one control, with cementum formation at 9-12%; one control specimen that exhibited 100% cementum formation. New bone formation was greater in the cell-seeding group (84%) compared with control (39%). In the cell-seeding group, one specimen exhibited total regeneration of bone (100%); however, the connective tissue located between newly formed bone and the root surface was observed to adapt to the dentin surface, with limited cementum formation. Seeding of cells from periodontal ligament may be promising to promote periodontal regeneration, but needs to be investigated in further studies.     

Combination of aligned PLGA/Gelatin electrospun sheets,native dental pulp extracellular matrix and treated dentin matrix as substrates for tooth root regeneration

In tissue engineering, scaffold materials provide effective structural support to promote the repair of damaged tissues or organs through simulating the extracellular matrix (ECM) microenvironments for stem cells. This study hypothesized that simulating the ECM microenvironments of periodontium and dental pulp/dentin complexes would contribute to the regeneration of tooth root. Here, aligned PLGA/Gelatin electrospun sheet (APES), treated dentin matrix (TDM) and native dental pulp extracellular matrix (DPEM) were fabricated and combined into APES/TDM and DPEM/TDM for periodontium and dental pulp regeneration, respectively. This study firstly examined the physicochemical properties and biocompatibilities of both APES and DPEM in vitro, and further investigated the degradation of APES and revascularization of DPEM in vivo. Then, the potency of APES/TDM and DPEM/TDM in odontogenic induction was evaluated via co-culture with dental stem cells. Finally, we verified the periodontium and dental pulp/dentin complex regeneration in the jaw of miniature swine. Results showed that APES possessed aligned fiber orientation which guided cell proliferation while DPEM preserved the intrinsic fiber structure and ECM proteins. Importantly, both APES/TDM and DPEM/TDM facilitated the odontogenic differentiation of dental stem cells in vitro. Seeded with stem cells, the sandwich composites (APES/TDM/DPEM) generated tooth root-like tissues after being transplanted in porcine jaws for 12 w. In dental pulp/dentin complex-like tissues, columnar odontoblasts-like layer arranged along the interface between newly-formed predentin matrix and dental pulp-like tissues in which blood vessels could be found; in periodontium complex-like tissues, cellular cementum and periodontal ligament (PDL)-like tissues were generated on the TDM surface. Thus, above results suggest that APES and DPEM exhibiting appropriate physicochemical properties and well biocompatibilities, in accompany with TDM, could make up an ECM microenvironment for tooth root regeneration, which also offers a strategy for complex tissue or organ regeneration.     

Cell density and cell generation in the periodontal ligament of mice

The number of cell nuclei per mm² and the volume density of cell nuclei and blood vessels in the periodontal ligament at different levels of the mesial root of the first mandibular molar of the adult mouse and in different areas of the ligament at each level have been examined in the light microscope. Significantly higher numbers of cell nuclei per mm² were observed adjacent to bone, cementum, and blood vessels than in the avascular body of the ligament at all levels and on all aspects of the root. This distribution of number of cell nuclei per mm² was constant over 41/2 months of aging and a doubling of body weight. The volume density of cell nuclei was significantly higher in cells adjacent to bone and cementum and in gingival connective tissue than in both the vicinity of blood vessels and the body of the ligament. The blood vessels, which were present predominantly in the bone-related half of the ligament, were absent from the zone immediately adjacent to cementum. The labeling indexes of periodontal ligament cells were determined from autoradiographs of the mesial root of the first mandibular molar of the mouse after pulse-labeling with ³H-Tdr. Labeling indexes were highest in zones adjacent to blood vessels, and the labeling index was significantly higher in the middle of the ligament than in zones adjacent to bone and cementum, and consequently was inversely related to cell density.     

Effect of enamel matrix proteins on the phenotype expression of periodontal ligament cells cultured on dental materials

Cells within the periodontal ligament have the potential to regenerate a periodontal connective tissue attachment on pathologically exposed root surfaces as well as on several material surfaces including titanium. However, rather than a periodontal connective tissue attachment, a fibrous encapsulation or chronic inflammatory response has been reported at the material connective tissue interface for most dental materials. Cementum is the first tissue of the periodontal connective tissue attachment to develop and the secretion of enamel matrix related proteins on the newly mineralized dentin surface precedes and is thought to induce cementum formation. Enamel matrix-related proteins may also function in the adult because the application of an acid extract of porcine enamel protein matrix (Emdogain(R), EMD) on pathologically exposed root surfaces has been shown to result in cementum regeneration. Therefore, the objective of the present study was to determine whether the application of EMD to materials that do not normally support cementogenesis in vivo would alter the in vitro phenotype of periodontal ligament (PDL) cells including the synthesis of cementum-associated extracellular matrix proteins. Primary PDL cells were established from 21-day-old Sprague-Dawley rats, and were cultured on four materials commonly encountered in dental practice (gutta percha, calcium hydroxide, amalgam, and super EBA cement) with and without the application of EMD. After 7 or 14 days of culture, total-DNA content, collagen synthesis, alkaline phosphatase activity, and the synthesis of a 42-kDa cementum-associated extracellular matrix protein were determined. PDL cells cultured on all materials had decreased total DNA content. The application of EMD further decreased total DNA content. PDL cells cultured on gutta percha and calcium hydroxide with the application of EMD had similar levels of collagen synthesis and alkaline phosphatase activity but also expressed a 42-kDa cementum extracellular matrix-associated protein when compared to the other groups. These results suggest that EMD can alter the phenotype of PDL cells when cultured on these dental materials.