Protein production by human gingival fibroblasts is enhanced by guanidine EDTA extracts of cementum

Autologous transplantation of gingival fibroblast-like cells and a hydroxylapatite complex graft in the treatment of periodontal osseous defects: cell cultivation and long-term report of cases

Autogenous cell transplantation via hydroxylapatite (HA) vehicle has been reported to have beneficial effects on the treatment of human periodontal osseous defects. The aim of this study was to explore the possibility of using gingival fibroblast-like cells in the therapy of osseous defects caused by inflammatory periodontitis by reporting long-term results of gingival fibroblast-coated hydroxylapatite (GF-HA) grafting for healing these defects. Gingival fibroblasts were cultured from healthy gingivae of treated subjects. Growth of cells on HA particles was established in vitro, and then the GF-HA complex was transplanted into the periodontal osseous defects. Clinical parameters of gingival and plaque indices, probing depth, and periapical x-ray were monitored at baseline and at various periods from 50 months to 6 years after surgery. Grafting with only HA in the osseous defects of the same patient was used for comparison. The present study shows that GF-HA-treated sites could achieve marked pocket reduction and probing attachment gain at reentry and later recalls. Good clinical bone filling of osseous defects in GF-HA-treated sites was also demonstrated in periapical radiographs (increased bone height and reappearance of the crestal cortex) and in some reentry sites. One HA-treated site was filled with connective tissue only, and the absence of new bone formation was noted during a reentry operation. Another HA-treated site exhibited a comparable increase in radiographic density, while part of HA particles were gradually lost in longer recalls. These limited observations conclude that GF-HA grafting may provide a treatment modality leading to regeneration of periodontal tissues in periodontitis-affected osseous defects. Further studies including more cases and demonstration of the deposition of differentiated periodontal tissues are necessary before further application of this therapy.

Biological effects of cementum and bone extracts on human periodontal fibroblasts

BACKGROUND

Non-collagenous proteins of mineralized tissues play important roles in bone induction during mineralization and in regulating the activity of many types of mesenchymal cells. This study was conducted to determine the effects of acetic acid extracts of bone and cementum on alkaline phosphatase (ALPase) activity and in vitro mineralization of cultured human periodontal fibroblasts (hPF).

METHODS

Alveolar bone and cementum obtained from clinically healthy subjects were extracted by a solution containing 0.5 M acetic acid and enzyme inhibitors. Osteoblastic phenotypes of hPF were assayed by ALPase activity, gene expression of bone marker proteins, and the ability to produce in vitro mineralization in culture media containing 50 microg/ml ascorbic acid, 10 mM sodium beta-glycerophosphate, and 10(-7) M dexamethasone. The effects of cementum and bone extracts on the expression of osteoblastic phenotypes in hPF were also determined.

RESULTS

Many protein components, varying in molecular weight from 10 to 14 to 120 kDa, were detectable in 10% SDS-PAGE of both cementum and alveolar bone extracts. The hPF cells were found to exhibit a moderate ALPase activity when compared with rat osteosarcoma (ROS) 17/2.8 cells under the same experimental conditions. Gene expression for ALPase, osteocalcin bone sialoprotein, osteopontin, and BMP-7 at mRNA message was detected by RT-PCR in hPF and ROS 17/2.8 cells. The confluent hPF and ROS 17/2.8 cells showed evidence of calcium deposition in the extracellular milieu at 30 and 15 to 30 days' cultures, respectively, under a mineralization medium. The hPF appeared to form mineralized foci with morphological characteristics different from the mineralized nodules produced by ROS 17/2.8 cells. The addition of low concentrations (5 microg/ml) of either cementum or bone extract produced an increase in the size and number of mineralization spots, as well as greater ALPase activity in both hPF and ROS 17/2.8 cultures during the observation periods.

CONCLUSIONS

These results suggest that hPF possess certain mineralizing phenotypes, and that acetic acid extracts of bone and cementum contain components capable of stimulating osteogenic differentiation of hPF.

Employing a transgenic animal model to obtain cementoblasts in vitro

BACKGROUND

Proper formation of cementum, a mineralized tissue lining the tooth root surface, is required for development of a functional periodontal ligament. Further, the presence of healthy cementum is considered to be an important criterion for predictable restoration of periodontal tissues lost as a consequence of disease. Despite the significance of cementum to general oral health, the mechanisms controlling development and regeneration of this tissue are not well understood and research has been hampered by the lack of adequate in vitro experimental models.

METHODS

In an effort to establish cementoblast cell populations, without the trappings of a heterogeneous population containing periodontal ligament (PDL) cells, cells were obtained from the root surface of first mandibular molars of OC-TAg transgenic mice. These mice contain the SV40 large T-antigen (TAg) under control of the osteocalcin (OC) promoter. Therefore, only cells that express OC also express TAg and are immortalized in vitro. Based on results of prior in situ studies, OC is expressed by cementoblasts during root development, but not by cells within the PDL. Consequently, when populations are isolated from developing molars using collagenase/trypsin digestion, only cementoblasts, not PDL cells, are immortalized and thus, will survive in culture.

RESULTS

The resulting immortalized cementoblast population (OC/CM) expressed bone sialoprotein (BSP), osteopontin (OPN), and OC, markers selective to cells lining the root surface. These cells also expressed type I and XII collagen and type I PTH/PTHrP receptor (PTH1R). In addition to expression of genes associated with cementoblasts, OC/CM cells promoted mineral nodule formation and exhibited a PTHrP mediated cAMP response.

CONCLUSIONS

This approach for establishing cementoblasts in vitro provides a model to study cementogenesis as required to enhance our knowledge of the mechanisms controlling development, maintenance, and regeneration of periodontal tissues.

Periodontal-derived cells attach to cementum attachment protein via alpha 5 beta 1 integrin

A specific collagenous cementum attachment protein (CAP) has been identified in human cementum which promotes selective cell migration towards and attachment of various periodontal derived cell populations to root surfaces in vitro. The CAP is known to support attachment of periodontal-derived cell via an RGD motif, which suggests an integrin-mediated mode of attachment. The purpose of the present study was to ascertain which integrin(s) are involved in the attachment of periodontal-derived cells to CAP. The integrins examined comprised subunits of the major receptors for fibronectin (alpha 5) and collagen (alpha 2, alpha 3), as well as the common beta 1 subunit which is present in many extracellular matrix receptors. The wells of 48-well non-tissue culture treated plates were coated with CAP (2 micrograms/ml). For negative and positive controls the wells were coated with bovine serum albumin and fibronectin (5 micrograms/ml), respectively. Human gingival fibroblasts and periodontal ligament fibroblasts were labeled with [3H]-proline, incubated with anti-integrin antibodies and added to the precoated wells. Attachment was assessed after incubating the cells for 1 h at 37 degrees C in the presence of the antibodies. Antibodies to alpha 5 and beta 1 inhibited the attachment of both human gingival fibroblasts and human periodontal ligament fibroblasts to CAP, while anti alpha 2 and alpha 3 antibodies did not affect the attachment. The binding of the fibroblasts to fibronectin was also inhibited by anti-alpha 5 and beta 1 antibodies, both of which are components of the "classical" fibronectin receptor and remained unaffected by the addition of anti-alpha 2 and alpha 3 antibodies. Proteins migrating in SDS-polyacrylamide gels in positions similar to the alpha 5 and beta 1 integrin subunits were present in fractions bound to a column of CAP coupled to Sepharose CL-4B. These results indicate that the attachment to CAP of the periodontal-derived cells, human gingival fibroblasts and human periodontal ligament fibroblasts, is mediated primarily via the integrin alpha 5 beta 1.

The proteoglycans of human cementum: immunohistochemical localization in healthy, periodontally involved and ageing teeth

Cementum is believed to play a regulatory role in periodontal regeneration through a variety of macromolecules present in its extracellular matrix (ECM), among which are the proteoglycans (PG). The PG of human cementum have not been fully characterized. This study has used a standard indirect immunoperoxidase technique to investigate the presence and distribution of PG species within the ECM of human cementum. Freshly extracted human permanent teeth were separated into 8 age groups; each group was subdivided to include healthy and periodontally involved teeth, which were then fixed, demineralized and wax-embedded. Sections were incubated with polyclonal antibodies recognizing protein core epitopes in the large chondroitin sulphate PG versican and the small interstitial PG decorin, biglycan, fibromodulin and lumican. Immunoreactivity to versican, decorin, biglycan and lumican was evident at the borders and lumina of a proportion of lacunae and canaliculi surrounding cementocytes in cellular cementum, as well as on inserted periodontal ligament (PDL) fibres. Biglycan was also present along incremental lines in cellular cementum, whereas staining for fibromodulin was negative. In acellular cementum, no immunoreactivity was evident with any of the antibodies used except on inserted PDL fibres. These results indicate that versican, decorin, biglycan and lumican are components of the ECM of cellular, but not of acellular cementum. Neither age nor periodontal diseases appear to qualitatively influence the PG population of cementum. The distribution of PG epitopes around a proportion of cementocytes suggests the existence of different cementocyte subpopulations, or a differential response of these cells to yet undefined stimuli.

Immunolocalization of glycosaminoglycans in ageing, healthy and periodontally diseased human cementum

The distribution of glycosaminoglycans in the extracellular matrix of human cementum was investigated in periodontally involved and periodontal disease-free teeth separated into eight different age groups (from 12 to 90 years), to investigate possible changes in the distribution of glycosaminoglycan species associated with ageing and periodontal disease. A standard indirect immunoperoxidase technique was used, with a panel of monoclonal antibodies, 2B6, 3B3, 5D4, and 7D4, that recognize epitopes in chondroitin-4-sulphate/dermatan sulphate (C-4S/DS), chondroitin-6-sulphate (C-6S), keratan sulphate (KS) and a novel sulphated chondroitin sulphate (CS) epitope, respectively. Intense positive staining for C4-S/DS was observed at the margins and lumina of almost all the lacunae and canaliculi in cellular cementum in all sections. Immunoreactivity to C6-S, KS and novel CS epitopes was limited to a proportion of lacunae and canaliculi in all sections, although C6-S and the novel CS epitopes were more widely distributed than KS. In acellular cementum, there was no demonstrable staining for any of the glycosaminoglycans except where periodontal ligament (Sharpey's) fibres insert; periodontal ligament fibres inserting in cellular cementum also demonstrated positive immunoreactivity. In addition, the cementoblasts on the outer root surface, as well as the pericellular areas around a proportion of these cells, demonstrated positive immunoreactivity. These results indicate that glycosaminoglycan species present in human cementum include C4-S, DS, C6-S, and novel sulphated CS epitopes. KS is also present in cementum but is limited to a more restricted proportion of lacunae and canaliculi. Regional differences in the distribution of glycosaminoglycans exist between the two cementum types, but no qualitative differences in that distribution were observed between the various age groups or between periodontally involved and periodontal disease-free teeth. The immunoreactivity observed in a proportion of lacunae after staining for C6-S, KS, and novel sulphated CS epitopes could suggest the existence of different cementocyte subpopulations.

In vitro studies on periodontal ligament cells and enamel matrix derivative

The recognition that periodontal regeneration can be achieved has resulted in increased efforts focused on understanding the mechanisms and factors required for restoring periodontal tissues so that clinical outcomes of such therapies are more predictable than those currently being used. In vitro models provide an excellent procedure for providing clues as to the mechanisms that may be required for regeneration of tissues. The investigations here were targeted at determining the ability of enamel matrix derivative (EMD) to influence specific properties of periodontal ligament cells in vitro. Properties of cells examined included migration, attachment, proliferation, biosynthetic activity and mineral nodule formation. Immunoassays were done to determine whether or not EMD retained known polypeptide factors. Results demonstrated that EMD under in vitro conditions formed protein aggregates, thereby providing a unique environment for cell-matrix interaction. Under these conditions, EMD: (a) enhanced proliferation of PDL cells, but not of epithelial cells; (b) increased total protein production by PDL cells; (c) promoted mineral nodule formation of PDL cells, as assayed by von Kossa staining; (d) had no significant effect on migration or attachment and spreading of cells within the limits of the assay systems used here. Next, EMD was screened for possible presence of specific molecules including: GM-CSF, calbindin D, EGF, fibronectin, bFGF, gamma-interferon, IL-1 beta, 2, 3, 6; IGF-1,2; NGF, PDGF, TNF, TGF beta. With immunoassays used, none of these molecules were identified in EMD. These in vitro studies support the concept that EMD can act as a positive matrix for cells at a regenerative site.

The modulatory role of cementum matrix on osteoblastic cells in vitro

The formation of new cementum is an important issue in clinical periodontology, as cementum is required to provide attachment for newly formed periodontal tissues to the root surface. In this study a model of cementogenesis in vitro was used in order to test the effects of root surface demineralization on the migration, attachment and formation of a cementum-like tissue by osteoblastic cells cultured on cementum and to test the specificity of cementum matrix in modulating those effects by comparison of root co-cultures with bone co-cultures. It was demonstrated that root surface demineralization did not significantly alter the orientation, number and attachment of cells to the root co-cultures. The results also demonstrated that cementum and bone matrix appear to behave differently in culture, as seen by their distinct action on the morphological profile of the attached cells and the extracellular matrix deposited by these cells. These results demonstrate that although cementum matrix appears to stimulate the production of cementum-like tissue, this action is not confined to cementum matrix alone, since a similar material was also deposited on dentine and bone surfaces. Thus, these results do not support a specific action of cementum matrix on the modulation of the cementoblast phenotype. The use of co-cultures of neonatal rat calvaria cells with root slices represents a promising model of cementogenesis in vitro; however, studies should be undertaken towards the identification of markers to distinguish between cementoblast and osteoblast phenotypes in order to further validate this model.

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.

Specific cementum attachment protein enhances selectively the attachment and migration of periodontal cells to root surfaces

A specific cementum attachment protein (CAP) was identified in human cementum and found to bind with high affinity to non-demineralized root surfaces, hydroxyapatite and fibronectin. Attempting to elucidate the biological function of this protein and its possible role in cementogenesis the capacity of CAP to promote selective cell migration towards and attachment of various periodontal derived cell populations to root surfaces in vitro was assessed. Human gingival fibroblasts (HGF), periodontal ligament cells (HPC), and alveolar bone cells (HABC) were labeled with [3H]Thymidine during their exponential growth phase. Root slices, 300 microns thick, were incubated with increasing concentrations of CAP. Untreated and fibronectin (FN) treated root slices served as negative and positive controls, respectively. Migration was assessed by placing root slices on confluent layers of labeled cells maintained in serum free medium and determining the number of cells migrated onto the root surface 3 days thereafter. Attachment was assessed by incubating root slices with labeled cell suspensions for 2 h and determining the number of attached cells. CAP promoted both cell migration and attachment dose dependently. HABC responded better than HPC and HGF to CAP treated root slices, and HPC response was higher than that of HGF. Cell attachment was dose dependently inhibited by synthetic RGD peptides. FN did not affect the migration of HGF, barely enhanced that of HABC, and was less potent than CAP at enhancing the migration of HPC. FN was more effective than CAP in promoting the attachment of HGF to root slices, but it was as potent as CAP in supporting the attachment of HPC and HABC.(ABSTRACT TRUNCATED AT 250 WORDS)

Commercially-prepared allograft material has biological activity in vitro

The well-established finding that implantation of demineralized bone matrix at non-skeletal sites results in formation of cartilage and bone has been attributed to bone morphogenetic proteins/factors. Commercially-available demineralized bone allograft materials are being used currently to reconstruct/regenerate bone. The studies described here focused on establishing biological activity of protein extracts prepared from commercially obtained bone graft material in vitro. Furthermore, the biological activity of these protein extracts in vitro was compared with similar extracts prepared from freshly obtained human bone. Biological activities of bone matrix proteins examined included their ability to promote proliferation, attachment, and migration of gingival fibroblasts using an in vitro system. Guanidine followed by guanidine/EDTA was used to separate bone matrix proteins into proteins associated with soft tissues of bone and proteins retained within the mineral compartment, respectively. Two preparations of each starting material were tested and the biological activity of each preparation was evaluated in triplicate at least three times. Slot blot analysis revealed that commercially-prepared material contained type I collagen; fibronectin; BSP; and BMP-2, 4, and 7. However, the freshly prepared bone extracts appeared to have higher BMP concentrations. The ability of commercial extracts to promote cell proliferation, while significant, was limited and significantly less when compared with similar extracts prepared from freshly obtained bone. All extracts promoted cell attachment significantly, while none of the extracts promoted cell migration. Thus, commercially-prepared material retained proteins having the capacity to influence cell behavior in vivo. However, some biological activity as measured in vitro was lost as a result of tissue processing.

Collagen formation at the tooth-cell interface: comparative ultrastructural study on the effect of partial demineralization of cementum with dentin

In order to compare the effect of partial demineralization with root planing and partial demineralization of cementum with that of dentin on healing, the ultrastructural morphology of the interface between the layer of human periodontal ligament-derived, fibroblast-like cells (HPF) and the treated root surface was studied in an in vitro culture system. Sixty (60) pairs made from transversally-cut root slices, 500 microns thick, were obtained from extracted human periodontally diseased teeth. Thirty (30) pairs of the root slices were preliminarily root planed (RP). The remaining half were root planed and then partially demineralized in a solution of citric acid (RP+CA). The opposite surface of paired slices was made uniform by using either cementum or dentin. Consequently, all root slices were classified into four experimental groups: RP-cementum and RP-cementum pairs (group 1), RP-dentin and RP-dentin pairs (group 2), RP+CA-cementum and RP+CA-cementum pairs (group 3), and RP+CA-dentin and RP+CA-dentin pairs (group 4). Each pair of root slices was placed on the floor of a 35-mm culture dish. HPF were seeded at a concentration of 4 x 10(5) cells/dish. Co-cultures of HPF and the root slices were examined using phase contrast and electron microscope after 4, 6, and 10 weeks. Electron-dense material covered non-demineralized root surfaces and the lining cells in accumulating cell layers were oriented parallel to the root surface and attached to the material in groups 1 and 2.(ABSTRACT TRUNCATED AT 250 WORDS)

Binding of a cementum attachment protein to extracellular matrix components and to dental surfaces

Cementum proteins (CP) have been shown to mediate cell attachment. Among these, a 55 kDa protein was isolated. The purpose of the present study was to assess the capacity of CP to bind to non-demineralized and demineralized root surfaces and to support cell attachment to dentin. CP were prepared by sequential extraction of bovine cementum with 25 mM EDTA, 0.5 M acetic acid followed by 4 M guanidine HCl. The latter was subjected to ion exchange chromatography on a DEAE-3SW column and eluted stepwise with a 0-0.5 M NaCl gradient. CP were labelled with 125I and the capacity of 125I-CP to bind to mineralized and partially demineralized dentin, synthetic hydroxyapatite, collagen, fibronectin and fibrillar collagen-fibronectin complex was assessed. It was found that CP bind specifically to mineralized dentin and synthetic hydroxyapatite but not to demineralized dentin. The specific binding was 60% of the total binding. SDS-PAGE analysis of the proteins bound to dentin indicated that the main bound protein had a molecular weight of 55 kDa. CP exhibited high affinity for fibronectin (kD = 1.56 x 10(-10) M) and fibronectin-collagen complex, but their binding to either molecular or fibrillar collagen was negligible. It is suggested that CP may play an important role in the attachment of cells of the periodontium to cementum extracellular matrix during homeostasis and regeneration.

Isolation and partial characterization of a growth factor from human cementum

Cementum is the mineralized interface through which collagen fibers of periodontal connective tissues are anchored onto the tooth surface. We have isolated and partially characterized a mitogenic factor from human cementum which has properties different from other growth factors. Cementum was harvested from healthy human teeth, extracted in 1.0 M CH3COOH and mitogenic activities were fractionated by heparin-affinity chromatography. Proteins eluted by 0.4-0.6 M NaCl, which contained most of the cementum mitogenic activity, were precipitated by trichloroacetic acid and resolved by HPLC through ion-exchange and reverse-phase columns. NaDodSO4-polyacrylamide gel electrophoresis revealed that the purified preparation contained a M(r) 23,000 protein and this protein was associated with mitogenic activity. The purified cementum-derived growth factor (CGF) was active alone, but at suboptimal concentrations its activity was potentiated by small quantities of plasma-derived serum and epidermal growth factor (EGF). The activity was resistant to heat, but it was destroyed by trypsin digestion. Reduction and alkylation destroyed the mitogenic activity, however electrophoretic mobility was not affected. Binding of EGF to fibroblast membranes was not affected by the CGF and assays to detect platelet-derived growth factor were negative. These characteristics indicated that CGF is a distinct molecular species. Our data show that cementum contains several mitogenic factors and that CGF is the major cementum mitogen.

Isolation of human tumor cells that produce cementum proteins in culture

We have cultured cells from explants of a human cementum tumor. The cells obtained were multipolar, they formed network-like structures and they were alkaline-phosphatase positive. Immunostaining and Western blots using specific antibodies revealed that these cells produced bone sialoprotein and collagen types I and V, and they also mineralized in vitro. Conditioned medium was mitogenic to fibroblasts and mitogens present were separated by heparin-affinity chromatography. Based on affinity to heparin and antibody-inhibition studies, the heparin fractions were shown to contain cementum-derived growth factor, platelet-derived growth factor and fibroblast growth factors. The cementum tumor cells, but not gingival fibroblasts, were stained positively by an antibody to cementum-derived attachment protein. The attachment protein was separated by immunoaffinity chromatography, and Western blots revealed that the preparation contained 56-kDa and 43-kDa proteins as major bands. Cells pulse-labeled with radioactive amino acids contained a 43-kDa protein as the major component; however, this protein was absent after a cold chase in the presence of cycloheximide, but 56-kDa, 39-kDa and 26-kDa species became prominent. These data indicated that the 56-kDa cementum attachment protein is derived from a 43-kDa precursor. Our data show that the cells cultured from the cementum tumor represent cementum cells capable of synthesizing and secreting cementum proteins in culture.

Cell attachment activity of cementum proteins and mechanism of endotoxin inhibition

Cementum occupies a unique anatomical location where soft connective tissues of the periodontium are attached to root surfaces. Cell attachment properties of proteins present in cementum were studied. Human and bovine cementum were extracted with 0.5 mol/L CH3COOH followed by 4 mol/L guanidine, and proteins were separated by ion-exchange chromatography and SDS-polyacrylamide gel electrophoresis. Cells were labeled with radioactive amino acids and added to tissue-culture plastic plates incubated with cementum proteins, and attachment was measured. Results showed that cementum proteins promoted the attachment of smooth muscle cells, endothelial cells, and fibroblasts, but not epithelial cells. Fibroblasts attached more efficiently than other cell types, and they manifested spreading with re-organization of actin filaments. No attachment occurred to plates incubated with endotoxin from A. actinomycetemcomitans. Fewer fibroblasts attached to plates treated with cementum proteins in the presence of endotoxin, but cells pre-treated with endotoxin attached normally. Attachment was not inhibited when plates were incubated first with attachment proteins and then with endotoxin; however, it was decreased when endotoxin or bovine serum albumin preceded cementum proteins. Cementum proteins with Mr 68,000, 61,000, 55,000, and 36,000 (p68, p61, p55, and p36, respectively) manifested attachment activity, while protein(s) with Mr 23,000-24,000 did not. Western blots revealed that guanidine extracts contained three bands cross-reacting with anti-bovine sialoprotein-II antibody, but the p61, p55, and p36 were negative. We conclude that cementum contains bovine sialoprotein-II and at least four other fibroblast attachment proteins, and that they do not support epithelial cell attachment.(ABSTRACT TRUNCATED AT 250 WORDS)

Human periodontal cells initiate mineral-like nodules in vitro

A primary objective in the treatment of periodontal diseases is the regeneration of the mineralized and soft connective tissue components of the attachment apparatus. Current theories suggest the cells of the periodontium have the capacity, when appropriately triggered, to actively participate in restoring connective tissues, including mineralized tissues. To evaluate further the role of such cells in periodontal homeostasis, periodontal ligament (PDL) cells and gingival fibroblasts (GF) were cultured and examined for alkaline phosphatase levels and for the ability to produce mineralized nodules in culture. These are two characteristics of osteoblast-like cells in vitro. The levels of alkaline phosphatase produced by these cells were determined by a modified kinetic assay and the ability of these cells to produce mineral-like nodules in vitro was evaluated by Von Kossa staining and light and electron microscopy. PDL cells had significantly higher levels of alkaline phosphatase when compared with gingival fibroblasts obtained from the same patient and the same passage, in vitro. Furthermore PDL cells, but not GF, were capable of producing mineral-like nodules in vitro. These results indicate differences in behavior between PDL cells and GF; such differences may prove important in designing appropriate clinical therapies directed at stimulating periodontal regeneration.

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.

Isolation of a fibroblast attachment protein from cementum

Cementum forms the interface through which soft connective tissue of the periodontium is attached to the root surface. The interactions between cementum and connective tissue are not completely understood and whether cementum influences periodontal connective tissue formation and regeneration is not clear. We have examined the effect of cementum components on the attachment of gingival fibroblasts. Cementum was harvested from healthy human and bovine teeth and extracted sequentially in 0.5 M CH3COOH, 4 M guanidine and bacterial collagenase. Fibroblast attachment was measured using 51Cr-labelled human gingival fibroblasts on tissue culture plates previously incubated with cementum components. Results showed that all three extracts mediated fibroblast attachment and attachment was dependent on concentration and incubation time. The attachment activity was not destroyed by digestion with bacterial collagenase or by antibodies to fibronectin and laminin. However, it was inhibited by a peptide containing the amino acid sequence RGD. By gel filtration or HPLC using a DEAE-cellulose column several proteins with attachment activity were fractionated. SDS-polyacrylamide gel electrophoresis revealed that HPLC fraction eluted by 0.2-0.3 M NaCl contained a protein with molecular weight 55 kDa as a major component. This protein was isolated and shown to promote fibroblast attachment, and optimal attachment occurred at a concentration of 2 micrograms/ml. We conclude that cementum contains substances capable of mediating fibroblast attachment and that these substances play an important role in periodontal connective tissue formation and regeneration by facilitating fibroblast attachment to root surfaces.

Effects of atelocollagen on the wound healing reaction following palatal gingivectomy in rats

Collagen membrane preparations have been manufactured with the aim of enhancing wound healing following periodontal surgery. After cross-linking by various processing methods (with ultraviolet radiation or hexamethylenediisocyanate) and to various extents, atelocollagen membranes were applied into dissection sites within palatal gingival tissue. Applied atelocollagen was histopathologically compared with applied lyophilized porcine dermis (LPD) and controls in rats, with regard to the time course of healing. The atelocollagen-applied group showed more satisfactory regeneration of the epithelium and connective tissue in an artificially created gingival defect than did the control group or the LPD-applied group. Epithelial downgrowth along the root surface was significantly suppressed by the use of atelocollagen. In addition, the post-operative inflammatory reaction and foreign body giant cell reaction subsided rapidly after surgery in the atelocollgen-applied group. Our results show that the use of atelocollagen membrane in periodontal wounds should be the method of choice.

Collagen linkage in periodontal connective tissue reattachment. An ultrastructural study in beagle dogs

Early stages of connective tissue reattachment to surgically denuded cementum and root dentin following citric acid application were studied in fenestration wounds. Block specimens were obtained after seven, 14, and 21 days. Continuity between newly deposited collagen fibrils in the granulation tissue and unmasked dental matrix collagen had been established within seven days by interdigitation of fibrils in an up to 0.5 micron-wide zone at the cementum or dentin surface. Splicing of collagen at the fibrillar level by direct attachment to the severed end of matrix fibrils or by juxtapositioning of new and old fibrils was seen in rare instances only. At 14 and 21 days, distinct bundles of collagen fibrils inserted deeply into the orifice of dentinal tubules. Arrested and reversed surface resorption was encountered at all time points. At these sites as well, new collagen fibrils interdigitated with denuded matrix collagen, while some resorbed surfaces were characterized by absence of collagen continuity. The results lend continued support to the concept of reattachment based on interdigitation of collagen fibrils. However, since attachment is established even in the absence of this feature, a significant role for specific attachment substances not shown can also be postulated.

A comparative study of human periodontal ligament cells and gingival fibroblasts in vitro

Both periodontal ligament and gingival tissue are thought to harbor cells with the ability to stimulate periodontal regeneration, i.e., formation of new bone, cementum, and connective tissue attachment. To understand further the role of these cells in the regenerative process, we compared human periodontal ligament cells and gingival fibroblasts, both derived from the same patient, same passage, in vitro. Protein and collagen production was significantly greater in periodontal ligament cells when compared with that of gingival fibroblasts. In addition, periodontal ligament cells had higher alkaline phosphatase levels when compared with those of gingival fibroblasts.