Antagonism of fluoride toxicity by high levels of calcium but not of inorganic phosphate during secretory amelogenesis in the hamster tooth germ in vitro

The impact of fluoride on ameloblasts and the mechanisms of enamel fluorosis

Intake of excess amounts of fluoride during tooth development cause enamel fluorosis, a developmental disturbance that makes enamel more porous. In mild fluorosis, there are white opaque striations across the enamel surface, whereas in more severe cases, the porous regions increase in size, with enamel pitting, and secondary discoloration of the enamel surface. The effects of fluoride on enamel formation suggest that fluoride affects the enamel-forming cells, the ameloblasts. Studies investigating the effects of fluoride on ameloblasts and the mechanisms of fluorosis are based on in vitro cultures as well as animal models. The use of these model systems requires a biologically relevant fluoride dose, and must be carefully interpreted in relation to human tooth formation. Based on these studies, we propose that fluoride can directly affect the ameloblasts, particularly at high fluoride levels, while at lower fluoride levels, the ameloblasts may respond to local effects of fluoride on the mineralizing matrix. A new working model is presented, focused on the assumption that fluoride increases the rate of mineral formation, resulting in a greater release of protons into the forming enamel matrix.

Effect of calcium, given before or after a fluoride insult, on hamster secretory amelogenesis in vitro

We tested the hypothesis that high-calcium medium given prior to or immediately after exposure to fluoride (F) reduces the negative effects of F on secretory amelogenesis. Hamster molar tooth germs were grown in organ culture in media with different calcium levels. Deposition of enamel matrix and matrix mineralization were monitored by incorporation of [3H]proline and uptake of 45Ca and acid-soluble 32PO4. Ameloblast structure and the occurrence of a fluorotic enamel matrix were examined by light and electron microscopy. A preculture of explants in high-calcium medium partially prevented the formation of fluorotic (non-mineralizing) enamel matrix, increased matrix secretion but could not prevent F-induced hypermineralization of the pre-exposure enamel. High-calcium medium, applied after F insult, accelerated the recovery of fluorotic matrix, improved ameloblast structure, enhanced amelogenin secretion, and increased enamel thickness. The data indicate that it might be the balance between the amount of mineral deposition and that of matrix secretion which is critical for the mineralization of newly secreted enamel. Exposure to F disturbs this balance by enhancing mineralization of the pre-exposure enamel, probably generating an excess of protons. High calcium may protect against F exposure by enhancing amelogenin secretion into the enamel space, thereby increasing the local buffering capacity at the mineralization front.

Interleukin-1 (IL-1) bioactivity and inhibition of IL-1 bioactivity in supernatant fluid from cultured microphthalmic (mi) mice teeth of different ages

A functioning dental follicle and bone resorption are necessary for tooth eruption. In the microphthalmic (mi) mouse, bone resorption is defective and teeth fail to erupt. Local bone metabolism involves the production of cytokines such as interleukin-1 alpha (IL-1 alpha) and transforming growth factor-beta (TGF-beta). The production of these cytokines by dental tissues during eruption may be fundamental to tooth movement. Molars from mi mice were cultured and supernatants tested for the presence of these cytokines using bio-dot blotting and ELISA. A thymocyte bioassay was used to test supernatants for IL-1 bioactivity and IL-1 inhibition bioactivity. IL-1 alpha and TGF-beta were detected in all supernatants. Supernatants demonstrated no IL-1 bioactivity but inhibited IL-1 bioactivity which varied with concentration of supernatant, age and animal. This study demonstrated that cultured developing teeth secrete IL-1 alpha and TGF-beta however, concentrations varied in normal and pathological states. While IL-1 alpha was present in the supernatants, all demonstrated a variable ability to inhibit IL-1 bioactivity. This ability may influence local bone metabolism and hence tooth eruption.

Enamel formation and the effects of fluoride

The exact biochemical events which result in enamel lesions from excess fluoride ingestion are still unknown. A number of effects of fluoride on enamel organs and on the enamel matrix components of developing teeth are, however, known. These are briefly reviewed, making reference to more recent studies. Two major influences of chronic, low-level fluoride exposure are proposed: fluoride interferes with the processes responsible for the efficient removal of organic matrix components, resulting in protein retention and disorganized enamel crystal formation, or fluoride disrupts the activities of the enamel organ cells which indirectly interferes with normal crystal formation.