Search

Objective Hemifacial microsomia (HFM) is a congenital anomaly characterized by unilateral underdevelopment of the mandible and ear. This study was conducted to characterize maxillofacial morphology and dental development in Japanese patients with HFM. Design This is a retrospective hospital-based study. Patients The subject population comprised 12 boys and 12 girls (average age, 9.3 years) diagnosed with HFM. Main Outcome Measures We used posteroanterior (PA) and lateral cephalograms obtained at the first visit to analyze maxillofacial morphology and orthopantomograms to compare dental development between the affected and unaffected sides. Dental development was graded according to Nolla's stages of tooth calcification. Results PA cephalogram analysis showed that the occlusal plane inclined upward on the affected side in each patient. The mandibular body and ramus were smaller on the affected side than on the unaffected side. Lateral cephalogram analysis showed that the patients tended to have steep mandibles, large gonial angles, and a slightly convex facial structure. The affected side/unaffected side ratio of the mandibular body and ramus correlated with SNB, ANB, convexity, and mandibular plane. The difference in dental development between the affected and unaffected sides was significant at the mandibular molars and the mandibular canine. Conclusions This study demonstrates a correlation between lateral and frontal measurement parameters in patients with HFM. The data also showed delayed calcification in the mandibular molars on the affected side.

This study attempted to identify appropriate materials for restoration of enamel defects in the primary dentition, which were classified by severity and region with the modified developmental defects of enamel index. To identify the most appropriate materials, we used restorative materials to protect teeth and evaluated clinical outcomes of restoration. Three materials were used for restoration or repair after dislodgement of restorations. Our findings in this case suggest that, because of its durability and esthetic advantages, adhesive resin is beneficial for patients with enamel defects, particularly for restorations of less than two-thirds of the extent of the defect.

Tooth induction by xenogenic graft of reconstructed human tooth germ components has never been attempted. Here we report our first attempt at a transplantation of human tooth germ components, heterologously recombined with mouse dental epithelia, into immunocompromised animals. Human third molar tooth germs enucleated from young patients as prophylactic treatment for orthodontic reasons were collected. The whole or minced human dental papilla was reconstructed with human- or mouse molar enamel epithelium, and transplanted in the dorsal aspect of C.B-17/Icr-scid Jcl mice. The transplant of human dental papilla reconstructed with human enamel epithelium formed thin dentin and immature enamel layers by 3 to 4 weeks, but remained extremely small in quantity due to a shortage of epithelial components in the graft. The addition of E16 mouse molar enamel organs (n=10-12) to each graft augmented the formation of tooth germ-like structures, but the differentiation of mouse molar ameloblasts was suppressed. However, once a solid layer of mineralized dentin was established, mouse ameloblasts accelerated their differentiation, and completed the enamel matrix formation and maturation within the following 4 weeks, whereas human ameloblasts, which had interacted with human dental papilla, remained in the stage of matrix formation during the same period. These data imply that, in reconstructed transplants, the differentiation of mouse dental epithelia is restrained by putative suppressive factors derived from human dental papilla until they are separated by mineralized dentin layers that serve as a diffusion barrier. The mouse enamel organ nevertheless retains its own phenotypic characteristics and intrinsic timing of cell differentiation and function.

The concentration and distribution of alpha 2HS glycoprotein in teeth from patients with heritable dentin disorders were examined utilizing immunological techniques. ELISA for the quantitative determination showed lower concentrations of alpha 2HS glycoprotein in dentins of patients with heritable disorders than in the control; some cases contained very low and others intermediate concentrations. Immunohistochemical findings indicated that the concentration of this protein was correlated to the regularity of the dentinal tubules. This result suggests that alpha 2HS glycoprotein is incorporated into dentin in concomitance with the development of the dentinal tubule, especially with the deposition of peritubular dentin. Incorporation of this protein into dentin is thought to involve the function of odontoblasts.

We examined the isolation of mesenchymal stem cells from human wisdom tooth germs (hWTGs) or human periodontal ligament (hPDL) and compared their characteristics. Collection rate of STRO-1 positive cells from WTGs was 6.01% but from PDL was 2.22%. After 7 days’ culture, alkaline phosphatase activity of stem cells derived from WTGs was increased and it was statistically higher than those of PDL stem cells. After 14 days, protein content of stem cells derived from WTGs became statistically higher than those of PDL stem cells. It is suggested that hWTGs are useful for stem cell treatment and tissue engineering.

We examined the immunohistochemical localization and isolation of mesenchymal stem cells in human wisdom tooth germs. Pericytes of blood vessels in the dental papilla and ameloblasts were stained strongly, but odontoblasts reacted weakly with STRO-1 and CD146. The STRO-1 positive cells represented approximately 7% of the total cell population. It is suggested that human wisdom tooth germs are useful for the stem cell treatment and the tissue engineering.