Ultrastructure of altered rat enamel beneath fluoride-induced cysts

Short exposure to high levels of fluoride induces stage-dependent structural changes in ameloblasts and enamel mineralization

We tested the hypothesis that the sensitivity of forming dental enamel to fluoride (F-) is ameloblast developmental stage-dependent and that enamel mineralization disturbances at the surface of fluorotic enamel are caused by damage to late-secretory- and transitional-stage ameloblasts. Four-day-old hamsters received a single intraperitoneal dose of 2.5-20 mg NaF/kg body weight and were examined, 24 h later, by histology and histochemistry. A single dose of >or=5 mg of NaF/kg induced the formation of a hyper- followed by a hypomineralized band in the secretory enamel, without changing the ameloblast structure. At 10 mg of NaF/kg, cystic lesions became apparent under isolated populations of distorted late-secretory- and transitional-stage ameloblasts. Staining with von Kossa stain showed that the enamel under these lesions was hypermineralized. At 20 mg of NaF/kg, cystic lesions containing necrotic cells were also found in the early stages of secretory amelogenesis and were also accompanied with hypermineralization of the enamel surface. We concluded that the sensitivity to F- is ameloblast developmental stage-dependent. Groups of transitional ameloblasts are most sensitive, followed by those at early secretory stages. These data suggest that a F-induced increase in cell death in the transitional-stage ameloblasts accompanies the formation of cystic lesions, which may explain the formation of enamel pits seen clinically in erupted teeth.

Morphological and immunocytochemical analyses on the effects of diet-induced hypocalcemia on enamel maturation in the rat incisor

During the maturation stage of amelogenesis, the loss of matrix proteins combined with an accentuated but regulated influx of calcium and phosphate ions into the enamel layer results in the "hardest" tissue of the body. The aim of the present investigation was to examine the effects of chronic hypocalcemia on the maturation of enamel. Twenty-one-day old male Wistar rats were given a calcium-free diet and deionized water for 28 days, while control animals received a normal chow. The rats were perfused with aldehyde and the mandibular incisors were processed for histochemical and ultrastructural analyses and for postembedding colloidal gold immunolabeling with antibodies to amelogenin, ameloblastin, and albumin. The maturation stage enamel organ in hypocalcemic rats exhibited areas with an apparent increase in cell number and the presence of cyst-like structures. In both cases the cells expressed signals for ameloblastin and amelogenin. The content of the cysts was periodic acid-Schiff- and periodic acid-silver nitrate-methanamine-positive and immunolabeled for amelogenin, ameloblastin, and albumin. Masses of a similar material were also found at the enamel surface in depressions of the ameloblast layer. In addition, there were accumulations of glycoproteinaceous matrix at the interface between ameloblasts and enamel. In decalcified specimens, the superficial portion of the enamel matrix sometimes exhibited the presence of tubular crystal "ghosts." The basal lamina, normally separating ameloblasts and enamel during the maturation stage, was missing in some areas. Enamel crystals extended within membrane invaginations at the apical surface of ameloblasts in these areas. Immunolabeling for amelogenin, ameloblastin, and albumin over enamel was variable and showed a heterogeneous distribution. In contrast, enamel in control rats exhibited a homogeneous labeling for amelogenin, a concentration of ameloblastin at the surface, and weak reactivity for albumin. These results suggest that diet-induced chronic hypocalcemia interferes with both cellular and extracellular events during enamel maturation.

Disturbed enamel formation in wild boars (Sus scrofa L.) from fluoride polluted areas in Central Europe

The pathological alterations of enamel structure in the teeth of wild boars from fluoride polluted areas in N-Bohemia (Czech Republic) and S-Saxony (Germany) were studied on a macroscopic and a microscopic level. Mandibular bone fluoride concentration (mg F(-)/kg, dry wt; mean +/-SD, individuals <24 months of age) in the specimens from N-Bohemia (754.3+/-149.6) and S-Saxony (490.8+/-135.1) was significantly higher than that of controls (free of dental fluorosis), originating from the western part of Germany (304.7+/-91.0). Fluoride content in bulk enamel (mg F(-)/kg, ash wt) of fluorotic permanent teeth from N-Bohemia (382.1+/-165.2) and S-Saxony (125.0+/-38.3) was likewise significantly increased over that of non-fluorotic control teeth from W-Germany (33.6+/-26.7). Macroscopically, fluorosed wild boar enamel exhibited opacity and discoloration of varying extent, accentuated perikymata as well as hypoplastic and posteruptive surface defects. Microradiographic and scanning electron microscopic analyses revealed enamel subsurface hypomineralization, accentuated Retzius lines and occurrence of broad, hypomineralized incremental bands of abnormal structure underlying hypoplastic enamel surface defects. The presence of zones of aprismatic enamel was associated with these bands. Incremental bands with altered enamel structure and enamel surface hypoplasias, both denoting a severe disturbance during the secretory stage of amelogenesis, have previously been observed in rodents following acute parenteral fluoride dosing. It is concluded that in the chronically fluoride exposed wild boars periods of especially elevated plasma fluoride levels exerted an acute toxic effect on the secretory ameloblasts. A feature not previously reported from fluorosed enamel was the occurrence of canal-like structures that originated at the broad incremental bands and extended into the external enamel. The presence of these canals presumably results from a delay in the resumption of secretory activity by groups of ameloblasts following a fluoride insult. Based on experimental evidence in domestic pigs and in sheep, the overall subsurface hypomineralization of fluorosed wild boar enamel is attributed to a disturbance of enamel maturation. The distribution of fluorotic enamel changes within the dentition of the wild boars could be related to the developmental sequence of tooth formation in the species. Teeth whose crown formation took place prenatally (deciduous teeth) or largely pre-weaning (permanent first molars) exhibited no or only moderate fluorotic enamel alterations. Based on the extension of enamel surface hypoplasias along the coronoapical axes of the tooth crowns, the timing of excess fluoride exposure that caused a marked disruption of enamel matrix secretion was estimated in specimens with a known date of death. The results indicate that the wild boars had been exposed to a particularly severe fluoride impact during autumn and winter of their first year of life.

Fluoride-induced lesions in the teeth of the short-tailed field vole (Microtus agrestis): a description of the dental pathology

The effect of fluoride on the appearance of the teeth of the short-tailed field vole, Microtus agrestis, was investigated in both wild animals collected from field sites affected by different levels of industrial fluoride contamination and laboratory-reared animals consuming experimental grass diets of known fluoride concentration or with known fluoride concentrations in drinking water. The extent and severity of lesions on the surface and structure of both incisors and molars are described as six lesion types and related to the amount of biologically available orally ingested fluoride. In the incisors of voles consuming relatively low fluoride diets, lesions are mainly confined to those resulting from disruption of enamel pigmentation expressing itself as concentric bands of pigmentation-free areas on incisor surfaces. The visible effects on molars at low fluoride levels are confined to minor alterations in surface appearance. At higher levels of available dietary fluoride, effects on enamel pigmentation are superseded by alterations in the formation, composition, and strength of both enamel and dentine. The incisors exhibit a marked to severe increase in the cutting tip erosion rates with comparable increases in the extent of abnormal surface changes (enamel hypoplasia) and the loss of enamel pigmentation. The grinding surfaces of molars from animals exposed to high levels of dietary fluoride exhibit increasingly severe erosion of outer enamel regions, combined with cavitation and staining of the exposed central dentine. The mechanisms through which fluoride elicits increasingly visible and pathological alterations to the surface and subsurfaces of rodent teeth are discussed.

Fluoride-induced developmental changes in enamel and dentine of European roe deer (Capreolus capreolus L.) as a result of environmental pollution

Using macroscopic, microradiographic and scanning electron-microscopic methods, the effects of increased fluoride exposure on enamel and dentine formation were studied in fluorosed mandibular premolars and molars of roe deer from the heavily industrialized Ruhr area, Germany. Macroscopically, fluorosed teeth were characterized by opaque and stained enamel and in more severe cases also by enamel surface lesions, reduction or loss of enamel ridges on their occlusal surfaces and increased wear. Microradiographically, fluorosed enamel exhibited different degrees of subsurface hypomineralization, in part apparently indicating a fluoride effect during enamel maturation. In some specimens, a pronounced but varying enhancement of the pattern of Retzius lines was observed throughout the enamel, denoting strongly intermittent fluoride exposure during enamel matrix secretion. This variation in exposure was also reflected histologically in dentine, by bands of interglobular dentine and marked accentuation of incremental lines. Microradiography of sections through enamel surface hypoplastic lesions showed the enamel forming the bottom and partly also the walls of the lesions to be highly mineralized. Scanning electron microscopy showed that the outer enamel along the more pronounced hypoplastic lesions consisted of stacked, thin layers of 'aprismatic' enamel, indicating that the ameloblasts in these areas had lost the distal (rod-forming) regions of their Tomes' processes. These observations demonstrate that the origin of enamel hypoplasias in deer clearly differs from that in rodents, where fluoride induces the formation of subameloblastic cysts. The differences in the degree of fluorotic alteration between the teeth of a single tooth row could be related to the developmental sequence of the dentition in roe deer. The roe deer is thus considered to be a very sensitive and useful bioindicator of environmental pollution by fluorides.

Crystal morphology and decalcification patterns compared in rat and human enamel and synthetic hydroxyapatite

The purpose of this investigation was to compare morphology and dissolution patterns by ultrastructural examination of rat and human enamel crystals as well as synthetic apatite crystals. Mature enamel crystals were of particular interest, since crystal maturation appears to be inhibited in amelogenesis imperfecta. Specimens were isolated from developing and mature rat incisor enamel. Rat enamel, mature human enamel, and synthetic apatite were thin-sectioned without decalcification and examined by transmission electron microscopy. Some sections were exposed to acid, and selected synthetic apatite sections were further treated for removal of embedding plastic, followed by vacuum-shadow-coating with carbon. Results showed that cross-sections of rat, human, and synthetic crystals had a distortion in the flattened hexagonal outline in regions where the growth of one crystal impinged on another. Crystal dissolution occurred preferentially along the c-axis, producing a central defect or hole in the crystals. Preliminary studies with weak acid on mature human enamel indicate that the relatively soluble crystal core is quickly dissolved, while the outer shell remains intact over a much longer period of time. In the mature rat and human enamel, this crystal hole formation had a consistent dimension of approximately 10-nm thickness. The crystal hole dimension was the same size as crystals that are formed during the early secretory phase in rat amelogenesis. Acid-treated synthetic apatite also showed dissolution of the crystal core along the c-axis, but dimensions of the hole were not consistent.(ABSTRACT TRUNCATED AT 250 WORDS)

Ultrastructural effects of diphosphonates on dental enamel

Initial experiments were designed to test the effects of two diphosphonates on acid dissolution of mature human enamel. Polished facets of enamel were treated with 10 mmol/L of EHDP or Cl2MDP (pH 7.4) for five min, H20-washed, acid-etched with 0.01 N lactic acid (pH 5.4) for 15 min, and examined in the scanning electron microscope. Controls were run with distilled H2O substituted for diphosphonates. In addition, the experimental window was outlined with lacquer, thus providing a reference to the original polished enamel surface. Results showed that EHDP markedly reduced enamel dissolution, with less than 1 μm of enamel removed, while Cl2MDP was similar to controls, with approximately 4-5 μm of enamel dissolved. It was decided to initiate further experiments with the objective of determining effects of diphosphonates on developing enamel during the secretory stage in rat molars.

Five-day-old animals were injected s.c. with one of the following: EHDP, ADP, Cl2MDP, or NaCl (0.9% control). The diphosphonate dosages were 2.5, 5, 10, and 20 mg P/kg. Rat incisors were also examined in initial experiments on older rats (21-day) following daily s.c. injections of EHDP. Twenty-four hr after the injections, all rats were killed by perfusion fixation and routinely prepared with and without decalcification for light and transmission electron microscopy.

Light microscopic examination of developing maxillary first molars frequently revealed subameloblastic cyst formation, which was used as an indicator of severe cellular alteration of overlying secretory ameloblasts. By this criterion, the EHDP- and ADP-treated rats showed more severe cellular effects at lower dosages (2.5 and 5 mg P/kg) than did the Cl2MDP-treated rats. In addition, when undecalcified sections were examined in the transmission electron microscope, disturbances in crystal formation were observed. Since both the cyst formation and the disturbed enamel beneath the cyst had many similarities to previous results reported on the effects of high doses of fluoride, the majority of results observed may be due to a non-specific cellular toxicity. However, some crystal growth effects appear to be specific for diphosphonates, as indicated by preliminary results with daily injections of EHDP. In the rat incisor, a definitive banding that shows both inhibition and return to more normal development within a 24-hour cycle has been detected. In the ultrastructure examination of undecalcified sections, the reaction to EHDP is clearly defined as bands of normal crystal size, electron density, and orientation alternating with disturbed bands of small crystal size and decreased electron density. The bands are approximately 2-3 μm in width.