Excess NF-κB induces ectopic odontogenesis in embryonic incisor epithelium.

Nuclear factor kappa B (NF-κB) signaling plays critical roles in many physiological and pathological processes, including regulating organogenesis. Down-regulation of NF-κB signaling during development results in hypohidrotic ectodermal dysplasia. The roles of NF-κB signaling in tooth development, however, are not fully understood. We examined mice overexpressing IKKß, an essential component of the NF-κB pathway, under keratin 5 promoter (K5-Ikkß). K5-Ikkß mice showed supernumerary incisors whose formation was accompanied by up-regulation of canonical Wnt signaling. Apoptosis that is normally observed in wild-type incisor epithelium was reduced in K5-Ikkß mice. The supernumerary incisors in K5-Ikkß mice were found to phenocopy extra incisors in mice with mutations of Wnt inhibitor, Wise. Excess NF-κB activity thus induces an ectopic odontogenesis program that is usually suppressed under physiological conditions.

Evc regulates a symmetrical response to Shh signaling in molar development.

Tooth morphogenesis involves patterning through the activity of epithelial signaling centers that, among other molecules, secrete Sonic hedgehog (Shh). While it is known that Shh responding cells need intact primary cilia for signal transduction, the roles of individual cilia components for tooth morphogenesis are poorly understood. The clinical features of individuals with Ellis-van Creveld syndrome include various dental anomalies, and we show here that absence of the cilial protein Evc in mice causes various hypo- and hyperplasia defects during molar development. During first molar development, the response to Shh signaling is progressively lost in Evc-deficient embryos and, unexpectedly, the response consistently disappears in a buccal to lingual direction. The important role of Evc for establishing the buccal-lingual axis of the developing first molar is also supported by a displaced activity of the Wnt pathway in Evc mutants. The observed growth abnormalities eventually manifest in first molar microdontia, disruption of molar segmentation and symmetry, root fusions, and delayed differentiation. Analysis of our data indicates that both spatially and temporally disrupted activities of the Shh pathway are the primary cause for the variable dental anomalies seen in patients with Ellis-van Creveld syndrome or Weyers acrodental dysostosis.

The Prx1 homeobox gene is critical for molar tooth morphogenesis.

The paired-related homeobox genes, Prx1 and Prx2, encode transcription factors critical for orofacial development. Prx1(-/-)/Prx2(-/-) neonates have mandibular hypoplasia and malformed mandibular incisors. Although the mandibular incisor phenotype has been briefly described (ten Berge et al., 1998, 2001; Lu et al., 1999), very little is known about the role of Prx proteins during tooth morphogenesis. Since the posterior mandibular region was relatively normal, we examined molar tooth development in Prx1(-/-)/Prx2(-/-) embryos to determine whether the tooth malformation is primary to the loss of Prx protein or secondary to defects in surrounding tissues. Three-dimensional (3D) morphological reconstructions demonstrated that Prx1(-/-)/Prx2(-/-) embryos had molar malformations, including cuspal changes and ectopic epithelial projections. Although we demonstrate that Prx1 protein is expressed only mesenchymally, 3D reconstructions showed important morphological defects in epithelial tissues at the cap and bell stages. Analysis of these data suggests that the Prx homeoproteins are critical for mesenchymal-epithelial signaling during tooth morphogenesis.

Increased apoptosis during morphogenesis of the lower cheek teeth in tabby/EDA mice.

In wild-type (WT) mice, epithelial apoptosis is involved in reducing the embryonic tooth number and the mesial delimitation of the first molar. We investigated whether apoptosis could also be involved in the reduction of tooth number and the determination of anomalous tooth boundaries in tabby (Ta)/EDA mice. Using serial histological sections and computer-aided 3D reconstructions, we investigated epithelial apoptosis in the lower cheek dentition at embryonic days 14.5-17.5. In comparison with WT mice, apoptosis was increased mainly mesially in Ta dental epithelium from day 15.5. This apoptosis showed a similar mesio-distal extent in all 5 morphotypes (Ia,b,c and IIa,b) of Ta dentition and eliminated the first cheek tooth in morphotypes IIa,b. Apoptosis did not appear to play any causal role in positioning inter-dental gaps. Analysis of the present data suggests that the increased apoptosis in Ta mice is a consequence of impaired tooth development caused by a defect in segmentation of dental epithelium.

The supernumerary cheek tooth in tabby/EDA mice-a reminiscence of the premolar in mouse ancestors.

OBJECTIVE: A supernumerary cheek tooth occurs mesially to the first molar in tabby/EDA (Ta) mice affected by hypohidrotic ectodermal dysplasia. The supernumerary tooth (S) has been hypothetically homologized to the premolar, which has disappeared during mouse evolution. DESIGN: This hypothesis was tested using available morphological data on the lower cheek teeth in wild type (WT) and Ta mice. RESULTS: The presence of S is accompanied by a reduction in the mesial portion of the M(1) in mutant mice. 3D reconstructions suggest that the S in Ta homo/hemizygous embryos originates from a split off the mesial portion of the first molar (M(1)) cap. In WT embryos, two vestigial tooth primordia are transiently distinct in front of the M(1). The distal vestige has the form of a wide bud and participates during the development of the mesial portion of the M(1). This bud has been homologized with the vestigial primordium of the fourth premolar of mouse ancestors. The premolar disappearance coincided with a mesial lengthening of the M(1) during mouse evolution. The incorporation of the distal premolar vestige into the mesial part of the M(1) in WT embryos can be regarded as a repetition of the premolar disappearance during evolution. CONCLUSION: : Ontogenetic and phylogenetic data support that the S in Ta mice arises due to the segregation of the distal premolar vestige from the molar dentition and thus represents an evolutionary throwback (atavism).

[Effect of the Tabby mutation on the dentition of mice]. / Effets de la mutation Tabby sur la dentition chez la souris.

The X-linked hypohidrotic ectodermal dysplasia in man leads to dental defects and is homologous to the Tabby (Ta) mutation in mouse. We currently investigate the effects of the Ta mutation on odontogenesis. The incisor germ of Ta showed an abnormal size and shape, a change in the balance between prospective crown- and root-analogue tissues and retarded cytodifferentiation. Although the enamel organ in Ta incisors was smaller, a larger proportion of the dental papilla was covered by preameloblasts-ameloblasts. The independent development of the labial and lingual parts of the enamel organ in rodent lower incisor might reflect their heterogeneous origin, as demonstrated for the upper incisor. The mandibular cheek dentition in Ta mice exhibits large variations classified in five morphotypes, based on the tooth number, shape, size and position. In Ta embryos, the mesio-distal extent of the dental epithelium was similar to that in WT, but its segmentation was altered. These morphotypes could be explained by a tentative model suggesting that 1) the positions of tooth boundaries differ in Ta and WT molars and among the Ta morphotypes; 2) the tooth patterns are determined by the distal boundary of the most mesial tooth primordium while the distal teeth take advantage of the remaining dental epithelium; 3) one tooth primordium in Ta mice might derive from adjacent parts of two primordia in WT.

Postnatal lower jaw dentition in different phenotypes of tabby mice.

The tabby (Ta) syndrome in mouse is homologous to human anhidrotic ectodermal dysplasia, including defective development of hair, teeth, and glands. To complete the available data on the functional dentition in the Ta mice, we analyzed the mandibular cheek teeth in 261 postnatal specimens arranged in several phenotype/genotype groups: 51 Ta-hemizygous males, 56 Ta-homo/hemizygous females, 64 Ta-heterozygous females, and 40 and 50 wild-type control males and females, respectively. We evaluated tooth number, size, shape and eruption and compared these parameters in the different groups. In any individual group of Ta mice, there was variability mainly in the size and shape of the most mesial tooth and in the tooth patterns. The incidence of a reduction in tooth number in homozygous and hemizygous mice was dependent on the breeding scheme.

Different morphotypes of functional dentition in the lower molar region of tabby (EDA) mice.

OBJECTIVES: To sort and classify the highly variable lower molar dentition in tabby (Ta) mice postnatally. The Ta syndome is homologous to the anhidrotic (hypohidrotic) ectodermal dysplasia (EDA) in human and includes severe developmental defects of teeth, hair and sweat glands. DESIGN: Analysis of tooth shape and cusp pattern and measurement of the mesio-distal crown length. SETTING AND SAMPLE POPULATION: Institute of Experimental Medicine, Academy of Sciences, Prague. Fixed heads of 107 tabby (Ta) homozygous and hemizygous mice and 90 wild type mice aged from post-natal day 11 to adulthood, collected during 1995-2001. OUTCOME MEASURE: Identification of distinct morphotypes of Ta dentition. Reduced tooth length in Ta teeth and specific differences in tooth length between distinct morphotypes. RESULTS: The variable dentitions in the lower molar region of Ta mice were classified in two basic morphotypes I and II. The morphotype I was further subdivided into particular morphotypes Ia, Ib and Ic. Proportion of the basic morphotypes I and II was different in the offspring of heterozygous (84% and 12%) compared with homozygous + hemizygous (45% and 52%) mothers. The proportions of particular morphotypes within a basic morphotype were similar in both offspring groups. CONCLUSION: The identification of the distinct morphotypes made possible to classify the structural variability of the mandibular functional dentition in Ta mice.

Different morphotypes of the tabby (EDA) dentition in the mouse mandible result from a defect in the mesio-distal segmentation of dental epithelium.

OBJECTIVES: Prenatal identification of the different dentition morphotypes, which exist in the lower molar region of tabby (Ta) adult mice, and investigation of their origin. The mouse Ta syndrome and its counterpart anhidrotic (hypohidrotic) ectodermal dysplasia (EDA) in human are characterized by absence or hypoplasia of sweat glands, hair and teeth. DESIGN: Analysis of tooth morphogenesis using serial histological sections and 3D computer aided reconstructions of the dental epithelium in the cheek region of the mandible. SETTING AND SAMPLE POPULATION: Institute of Experimental Medicine, Academy of Sciences, Prague. Heads of 75 Ta homozygous and hemizygous mice and 40 wild type (WT) control mice aged from embryonic day (ED) 14.0-20.5 (newborns), harvested during 1995-2001. OUTCOME MEASURE: Prenatal identification of five distinct morphotypes of Ta dentition on the basis of differences in tooth number, size, shape, position and developmental stage and of the morphology of the enamel knot in the most mesial tooth primordium. RESULTS: The mesio-distal length of the dental epithelium was similar in the lower cheek region in Ta and WT mice. In Ta embryos, there was altered the mesio-distal segmentation of the dental epithelium giving rise to the individual tooth primordia. Prenatally, two basic morphotypes I and II and their particular subtypes (Ia, Ib, Ic, and IIa, IIb, respectively) of the developing dentition were identified from day 15.5. The incidence of the distinct morphotypes in the present sample did not differ from postnatal data. The proportion of the morphotype I and II was dependent on mother genotype. CONCLUSION: The different dentition morphotypes in Ta mice originate from a defect in the mesio-distal segmentation of the dental epithelium in mouse embryos. This defect presumably leads to variable positions of tooth boundaries that do not correspond to those of the WT molars. One tooth primordium of Ta mice might be derived from adjacent parts of two molar primordia in WT mice.

Embryotoxicity of cisplatin and a cisplatin-procaine complex (DPR) studied in chick embryo.

Cisplatin is widely used as an antitumor drug. To reduce its toxic side effects in patients, cisplatin has been bound with procaine in a cisplatin-procaine complex (DPR). The lethal and teratogenic effects of cisplatin alone and of complexed cisplatin were determined in the chick embryo in ovo in order to compare their influence on rapidly proliferating embryonic tissues. The embryotoxic (lethal + teratogenic) effect was examined after a single intra-amniotic injection of one of six different doses, ranging from 0.03 to 30.0 microg, on embryonic days (ED) 3, 4 or 5. The minimal embryotoxic dose was lower for cisplatin alone (0.03-0.3 microg) than for cisplatin in the DPR complex (0.3-3.0 microg), suggesting that cisplatin alone is more embryotoxic than complexed cisplatin. Both substances caused malformations in the surviving embryos evaluated on ED 9. These malformations included microphthalmia, microcephaly, hypoplasia of the upper and lower jaw, cleft beak, and haemocephaly. Moreover, heart septum defects and limb reduction deformities were found after exposure to the DPR complex. The embryotoxicity of complexed cisplatin exhibited a stage-response effect. It was highest on day 3 and gradually decreased until ED 5. Such an apparent stage-response effect was not observed for cisplatin alone. The embryotoxicity of procaine hydrochloride - a component of the complex - was also tested. Procaine hydrochloride alone did not produce any embryotoxic effect, not even after a single injection of the maximal tested dose (100.0 microg per embryo). We also examined the protective effect of procaine hydrochloride, whose separate administration at ED 4 was followed by the injection of 0.3 microg cisplatin. We did not observe any protective effect of procaine hydrochloride if injected separately.

Significant differences in the incidence of orofacial clefts in fifty-two Czech districts between 1983 and 1997.

Between 1983 and 1997 a total of 2029 children with CL/P (cleft lip, cleft lip and palate or cleft palate), who were born in the Bohemian districts of the Czech Republic and who underwent surgery and treatment at the Clinic of Plastic Surgery in Prague, were analysed. One possibility for decreasing the risk of delivery of a child with CL/P is to decrease or eliminate its prenatal exposure to embryotoxic factors. Detection of the embryotoxic factors acting at the individual level (e.g. elevated temperature, drug consumption, x-ray examination or infection) is easier than the detection of embryotoxic factors operating at the population level (e.g. water contamination, air pollution). When searching for the latter factors, we first have to reveal regional differences in CL/P incidence. The aim of the present paper was to determine significant differences in the mean incidence of newborns with CL/P in Bohemian districts during a 15 year period. The correlation between the incidence of CL/P and the birth rate in the different districts was also examined. The mean incidence of CL/P in all Bohemian districts was 1.86 per 1000 newborns (1.86/1000). Districts were divided into three groups, according to significant differences in the incidence of CL/P using a confidence interval. The lowest mean incidence of CL/P was detected in the Svitavy district (0.72/1000) and Louny (1.05/1000). The highest mean incidence was found in the Beroun district (2.86/1000). Besides Beroun, a high mean incidence of CL/P (more than 1.96/1000) was also found in Klatovy, Melník, Tábor, Kolín, Semily, Ceská Lípa, Pardubice, Teplice, Ceský Krumlov, Sokolov, Chomutov, Praha-západ, Jicín, Rakovník, Kladno, Prachatice, Rokycany, Tachov, Liberec, Pelhrimov. Paradoxically, the districts with a higher or lower birth rate exhibited a lower (1.62/1000) or higher (1.92/1000) incidence of CL/P, respectively. Future studies should elucidate whether the significant regional differences in the incidence of CL/P can be related to differing exposure of pregnant women to harmful environmental embryotoxic factors.

Alterations in the incisor development in the Tabby mouse.

The X-linked tabby (Ta) syndrome in the mouse is homologous to the hypohidrotic ectodermal dysplasia (HED) in humans. As in humans with HED, Ta mice exhibit hypohidrosis, characteristic defects of hairs and tooth abnormalities. To analyze the effects of Ta mutation on lower incisor development, histology, morphometry and computer-aided 3D reconstructions were combined. We observed that Ta mutation had major consequences for incisor development leading to abnormal tooth size and shape, change in the balance between prospective crown- and root-analog tissues and retarded cytodifferentiations. The decrease in size of Ta incisor was observed at ED13.5 and mainly involved the width of the tooth bud. At ED14.5-15.5, the incisor appeared shorter and narrower in the Ta than in the wild type (WT). Growth alterations affected the diameter to a greater extent than the length of the Ta incisor. From ED14.5, changes in the shape interfered with the medio-lateral asymmetry and alterations in the posterior growth of the cervical loop led to a loss of the labio-lingual asymmetry until ED17.0. Although the enamel organ in Ta incisors was smaller than in the WT, a larger proportion of the dental papilla was covered by preameloblasts-ameloblasts. These changes apparently resulted from reduced development of the lingual part of the enamel organ and might be correlated with a possible heterogeneity in the development of the enamel organ, as demonstrated for upper incisors. Our observations suggest independent development of the labial and lingual parts of the cervical loop. Furthermore, it appeared that the consequences of Ta mutation could not be interpreted only as a delay in tooth development.

Early stages of tooth morphogenesis in mouse analyzed by 3D reconstructions.

Computer-aided 3D reconstructions were used to investigate early odontogenesis in the ICR mouse, from the dental lamina to the cap stage. The diastemal region of the maxilla was not an empty zone: five transient epithelial rudiments (D1-D5) were found between ED 12.5-13.5. Two further rudiments (R1 and R2) were observed between D5 and the maxillary first molar primordium, whose bud emerged at ED 13.5. These rudiments might be related to vestiges of ancestral teeth. During this period, only an epithelial lamina was observed in front of the bud-shaped molar epithelium in the cheek region of the mandible. Apoptosis plays an important role in the reduction of antemolar rudiments in the maxilla and in the remodeling of the epithelium anterior to the M1 bud and cap in both jaws: two successive waves of apoptosis were detected in the mandible and in the maxilla. Computer-aided 3D reconstructions clearly demonstrated that morphologically different developmental stages coexist along the anteroposterior axis of M1 in both jaws.

Cleft beak induced by hydrocortisone in the chick is prevented by increased cell division after experimental reduction of amniotic fluid.

Hypoplasia of the medial nasal process has been reported in chick embryos on embryonic day (ED) 5, 24 h after their exposure to hydrocortisone (HC). As a result, the cleft beak occurs in 80-100% of specimens on ED 9. In order to analyze its influence on cell proliferation, HC was injected intra-amniotically into embryos on ED 4, and the mitotic index and number of BrdU-positive cells were evaluated 24 h later, both in the epithelium and mesenchyme of the medial nasal processes, on serial frontal histological sections. Two hours after BrdU administration, there were 50% of labeled mesenchymal cells in the embryos exposed to HC and only 23% in the control group. The mitotic index of mesenchymal cells was significantly lower in the HC group than in the controls. The epithelium showed no significant difference. HC seemed to prevent the mesenchymal cells from entering mitosis. The cleft beak in the embryos exposed to HC on ED 4 was totally eliminated by tearing open the amnion (amniotomia) and allowing fluid to leak out on ED 5. In some of specimens exposed to HC, the mitotic index was investigated at six time intervals from 15 to 120 min after amniotomia. A significant increase in the mitotic index was detected in the mesenchymal cells of the medial nasal processes during the first hour after amniotomia. Such a prompt increase of the mitotic activity may be hypothetically explained by release of the HC from its receptor binding as a consequence of outflow of the amniotic fluid together with the HC pool, and freeing of the mesenchymal cells, blocked in the G2 phase, to enter mitosis. As a result, the hypoplasia of the medial nasal process might be compensated and the development of the cleft beak prevented.

Timing of exchange of the maxillary deciduous and permanent teeth in boys with three types of orofacial clefts.

Timing of exchange of the deciduous and permanent maxillary teeth was investigated using dental plaster casts of 163 boys with total unilateral cleft (UCLP), 82 boys with bilateral cleft (BCLP), and 97 boys with isolated cleft palate (CP). All patients were treated at the Prague Plastic Surgery Clinic. The results were compared with a control group of 294 schoolboys. To evaluate the course of eruption, the proportion of each erupted teeth in each year of age was employed. In boys with UCLP, eruption of the permanent maxillary lateral incisors and the permanent maxillary second molar was retarded on the cleft side. On the non-affected side, no delay of eruption was observed, but earlier eruption was found in the permanent maxillary canine and in the permanent maxillary first and second premolars. In boys with BCLP, the highest retardation of eruption was found in the permanent maxillary lateral incisor and in the permanent maxillary first molar. The permanent maxillary canine and both permanent maxillary premolars erupted earlier than in the control group. In boys with CP, only the permanent maxillary central incisors erupted earlier. The maxillary deciduous canines and the second molars were both lost early. We conclude that the developmental disturbances of the maxillary jaw and teeth in patients with orofacial clefts are also associated with alteration of timing of dental exchange.

Apoptosis is involved in the disappearance of the diastemal dental primordia in mouse embryo.

Three transient dental primordia (D1, D2 and D3) exist in the upper diastema in mouse embryos and their regression is associated with the presence of cell death. In order to specify the type of cell death and its temporo-spatial distribution, staining with hematoxylin, supravital staining with Nile Blue, TUNEL method, electron microscopic analysis and computer assisted 3-D reconstructions were performed. These data demonstrated that apoptosis is involved in the disappearance of the diastemal dental rudiments. Apoptosis occurred first with prevalence in the buccal part of the epithelium of the diastemal dental primordia and extended later to the whole epithelium of the dental rudiments and the dental lamina interconnecting them with the incisor and molar epithelia. Cell death occurred only sporadically in the adjacent mesenchyme. The prospective upper diastema in mouse embryos may provide a model for studies of developmental determination of toothless areas in the jaw as well as a tool for analyses of regulatory mechanisms of programmed cell death in morphogenesis.

Sex differences in the incidence of orofacial clefts and the question of primary prevention in families with genetic risk.

Systematic registration of all children with orofacial clefts in Bohemia (Czech Republic) started at the Clinic of Plastic Surgery, Prague in 1964. A sample of 181 affected children with positive family histories (i.e. one of the parents had some type of orofacial cleft) was selected for the present study. The aim of this study was to follow the relation not only between the type of cleft in the child and in its parent, but also between the sex of the child and of the affected parent. Among children of mothers with cleft lip 68% were boys and only 32% were girls with cleft lip or cleft lip and palate. If the mother had cleft lip and palate, the same cleft type was found in 64% of boys and only 15% of girls. If the mother had cleft palate, the same cleft type was found in 37% of boys and 51% of girls. Very similar results were found for affected fathers and their children, with only one exception: among children of fathers with cleft lip and palate, the percentage of boys and girls with CLP was 43% and 40%, respectively. We can conclude that the cleft type in a child depends not only upon the cleft type present in the mother or father, but also upon the sex of the child. There was higher risk to have the orofacial cleft in sons of mothers with CL or CLP or fathers with CL and daughters of mothers or fathers with CP. The combination of the preconception choice of the sex of the baby with the ultrasonography method for the prenatal screening of malformations could decrease the risk delivering a child with an orofacial cleft in families with a genetic predisposition.

Comparison of expression of the msx-1, msx-2, BMP-2 and BMP-4 genes in the mouse upper diastemal and molar tooth primordia.

The existence of transient putative tooth anlagen in the prospective mouse upper diastema region has been documented previously in morphological studies. By in situ hybridization we investigated the expression patterns of the msx-1, msx-2, BMP-2 and BMP-4 genes, supposed to regulate early tooth development, in day 10-14 mouse embryonic upper diastema and molar regions, using 49 series of frontal sections. On the basis of comparison of the temporo-spatial expression patterns in both diastemal and molar tooth primordia we conclude that each of the four genes was expressed at least for some period simultaneously and at a comparable developmental stage in the transient and persisting dental primordia. BMP-2 and BMP-4 expression was downregulated in the diastemal dental primordia during their regression starting at day 13. The temporo-spatial pattern of BMPs expression may be associated with the disappearance of diastemal rudiments. Contrary to the molar anlage, we did not detect msx-2 gene expression in the diastemal dental rudiments after the stage of epithelial thickening. The deficiency of the msx-2 gene products may play a role in the growth retardation of diastemal dental primordia resulting in their subsequent involution.