In this review, the regulatory mechanisms of autophagy were described, and its interaction with apoptosis was identified. The role of autophagy in embryogenesis, tooth development, and cell differentiation were also investigated. Autophagy is regulated by various autophagy-related genes and those related to stress response. Highly active autophagy occurrences have been reported during cell differentiation before implantation after fertilization. Autophagy is involved in energy generation and supplies nutrients during early birth, essential to compensate for their deficient supply from the placenta. The contribution of autophagy during tooth development, such as the shape of the crown and root formation, ivory, and homeostasis in cells, was also observed. Genes control autophagy, and studying the role of autophagy in cell differentiation and development was useful for understanding human aging, illness, and health. In the future, the role of specific mechanisms in the development and differentiation of autophagy may increase the understanding of the pathological mechanisms of disease and development processes and is expected to reduce the treatment of various diseases by modulating the autophagic phenomenon.

In addition to its effectiveness in resolving apical periodontitis, regenerative endodontic treatment (RET) has advantages of inducing root maturation and restoring innate immunity or sensory function through revascularization. However, its adoption in mature teeth in adults has been scarce due to limited stem cell sources and constricted apical size. In recent years, there have been instances of studies performing RET in mature permanent teeth. The present case report describes the treatment of apical periodontitis in a previously treated mature permanent tooth using RET with a 3-year follow up. In the present case, a 34-year-old female patient presented with previously treated maxillary lateral incisor with a large radiolucency. After removal of previous gutta percha within the root canal, bleeding was induced by passing hand file beyond root apex and calcium hydroxide was applied over the blood clot. During the 9-month follow-up, a reduction in periapical radiolucency was observed. Subsequently, after removing calcium hydroxide, apical bleeding was induced again and mineral trioxide silicate was placed up to 3mm beneath cemento-enamel junction, above the blood clot. The tooth was later restored with glass-ionomer cement and composite resin. After 3 years, the tooth was asymptomatic and radiographic evaluations showed complete resolution of periapical radiolucency with presence of normal lamina dura and periodontal ligament space. In conclusion, modified RET with long-term calcium hydroxide application is a potentially viable treatment option for previously treated mature permanent teeth with apical periodontitis. However, further clinical studies with larger number of cases are recommended to verify its effect.

In the realm of dental prosthesis fabrication, obtaining accurate impressions has historically been a challenging and inefficient process, often hindered by hygiene concerns and patient discomfort. Addressing these limitations, Company D recently introduced a cutting-edge solution by harnessing the potential of intraoral scan images to create 3D dental models. However, the complexity of these scan images, encompassing not only teeth and gums but also the palate, tongue, and other structures, posed a new set of challenges. In response, we propose a sophisticated real-time image segmentation algorithm that selectively extracts pertinent data, specifically focusing on teeth and gums, from oral scan images obtained through Company D's oral scanner for 3D model generation. A key challenge we tackled was the detection of the intricate molar regions, common in dental imaging, which we effectively addressed through intelligent data augmentation for enhanced training. By placing significant emphasis on both accuracy and speed, critical factors for real-time intraoral scanning, our proposed algorithm demonstrated exceptional performance, boasting an impressive accuracy rate of 0.91 and an unrivaled FPS of 92.4. Compared to existing algorithms, our solution exhibited superior outcomes when integrated into Company D's oral scanner. This algorithm is scheduled for deployment and commercialization within Company D's intraoral scanner.

In case of gingival recession and alveolar bone defects due to tooth loss for a long period of time in a single tooth in the maxillary anterior region, it is not easy to obtain aesthetic results with a single implant prosthesis. For aesthetic restoration, it is important to preserve hard and soft tissues through alveolar bone augmentation as well as restore harmony with adjacent teeth and soft tissues by placing the implant in an ideal location. In this case, an implant was placed using guided bone regeneration and a connective tissue graft simultaneously with immediate implantation after extraction from the maxillary anterior region where only residual root was left for a long period of time.

This study summarizes the recent cutting-edge approaches for dentin regeneration that still do not offer adequate solutions. Tertiary dentin is formed when odontoblasts are directly affected by various stimuli. Recent preclinical studies have reported that stimulation of the Wnt/β-catenin signaling pathway could facilitate the formation of reparative dentin and thereby aid in the structural and functional development of the tertiary dentin. A range of signaling pathways, including the Wnt/β-catenin pathway, is activated when dental tissues are damaged and the pulp is exposed. The application of small molecules for dentin regeneration has been suggested as a drug repositioning approach. This study reviews the role of Wnt signaling in tooth formation, particularly dentin formation and dentin regeneration. In addition, the application of the drug repositioning strategy to facilitate the development of new drugs for dentin regeneration has been discussed in this study.

Several factors, including genetic and environmental insults, impede protein folding and secretion in the endoplasmic reticulum (ER). Accumulation of unfolded or mis-folded protein in the ER manifests as ER stress. To cope with this morbid condition of the ER, recent data has suggested that the intracellular event of an unfolded protein response plays a critical role in managing the secretory load and maintaining proteostasis in the ER. Tauroursodeoxycholic acid (TUDCA) is a chemical chaperone and hydrophilic bile acid that is known to inhibit apoptosis by attenuating ER stress. Numerous studies have revealed that TUDCA affects hepatic diseases, obesity, and inflammatory illnesses. Recently, molecular regulation of ER stress in tooth development, especially during the secretory stage, has been studied. Therefore, in this study, we examined the developmental role of ER stress regulation in tooth morphogenesis using in vitro organ cultivation methods with a chemical chaperone treatment, TUDCA. Altered cellular events including proliferation, apoptosis, and dentinogenesis were examined using immunostaining and terminal deoxynucleotidyl transferase dUTP nick end labeling assay. In addition, altered localization patterns of the formation of hard tissue matrices related to molecules, including amelogenin and nestin, were examined to assess their morphological changes. Based on our findings, modulating the role of the chemical chaperone TUDCA in tooth morphogenesis, especially through the modulation of cellular proliferation and apoptosis, could be applied as a supporting data for tooth regeneration for future studies.

A 20-year-old woman who had a main symptom of intermittent pain in both mandibular third molar visited our hospital. In CBCT findings, the #38, 48 teeth were located on the lingual side of the inferior alveolar nerve. In addition, a large stone about 12mm in length was observed in the right Wharton's duct in CBCT findings. Neck CT scan was performed and a large stone about 12mm in length was observed, and the accumulation of saliva in the rear of the stone was observed. The patient underwent sialolithotomy and #38, 48 tooth extraction through intraoral approach under general anesthesia. The removed stone was similar in shape and color to a tooth. The removed stone was markedly fragmented and composed of dentin and enamel-like tissue which showed lamellate arrangement in microscopic examination. Patient was presently symptom free after 10-months postoperatively.

Enamel knot (EK)—a signaling center—refers to a transient morphological structure comprising epithelial tissue. EK is believed to regulate tooth development in early organogenesis without its own cellular alterations, including proliferation and differentiation. EKs show a very simple but conserved structure and share functions with teeth of recently evolved vertebrates, suggesting conserved signaling in certain organs, such as functional teeth, through the course of evolution. In this study, we examined the expression patterns of key EK-specific genes including Dusp26 , Fat4, Meis2, Sln , and Zpld1 during mice embryogenesis. Expression patterns of these genes may reveal putative differentiation mechanisms underlying tooth morphogenesis.

Presence of a palato-nasally impacted supernumerary tooth with nasopalatine canal involvement is a unique finding that demands careful attention during surgical extraction due to its distinctive anatomy. In this case report of a 7-year-old child, an impacted supernumerary tooth had a developmental anomaly that required both palatal and nasal approaches to successfully remove the tooth.

Teeth and bones are highly mineralized tissues containing inorganic minerals such as calcium phosphate, and a growing number of evidences show that their mineral content is associated with many diseases. Although the quantification of mineral contents by micro-computed tomography(micro- CT) has been used in diagnosis and evaluation for treating bone diseases, its application for teeth diseases has not been well established. In this study, we attempted to estimate a usefulness of a high-resolution micro-CT in analysis of human teeth. The teeth were scanned by using the Skyscan 1172 micro-CT. In order to measure tooth mineral content, beam hardening effect of the machine was corrected with a radiopaque iodinecontaining substance, iodoacetamide. Under the maximum resolution of 6.6 μm, X-ray densities in teeth and hydroxyapatite standards were obtained with Hounsfield unit (HU), and they were then converted to an absolute mineral concentration by a CT Analyzer software. In enamel layer of cusp area, the mean mineral concentration was about 2.14 mg/mm3 and there was a constant mineral concentration gradient from the enamel surface to the dentinoenamel junction. In the dentin of middle 1/3 of tooth, the mean mineral concentration was approximately 1.27 mg/mm3 and there was a constant mineral concentration gradient from the outer of root to the pulp side, ranging from 1.3 to 1.06 mg/mm3. In decay region of dentin, the mineral content was gradually decreased from the intact inner side to the decayed surface. These results suggest that high-resolution micro-CT can be as a useful tool for non-invasive measurement of mineral concentration in teeth.

To enhance the physiological activity of the Rhynchosia volubilis (RV), R. volubilis (RVHE-A) and R. volubilis-added herbal powder (RVHE-B) were fermented with a solid state culture of Hericium erinaceum mycelia (HE). The total isoflavone contents of the non-fermented RV-A (489.9 μg/g) and RV-B (571.1 μg/g) were remarkably increased in fermented RVHE-A (1,836.4 μg/g) and RVHE-B (1,276.7 μg/g). In particular, aglycone isoflavones such as daidzein and genistein were significantly higher in the RVHE-A than any other sample. When hot-water (HW) and EtOH extracts (E) were fractionated from the RV and RVHE, both extracts from the RVHE-A were higher than those from the RV-A in total polyphenol and flavonoid contents. However, the RVHE-B-HW showed a lower polyphenol and flavonoid content level than did RV-B-HW. RVHE-A-HW and -E also had more potent ABTS radical scavenging activity than any extract from the non-fermented RV and other ferments (RVHE-B). In the meanwhile, RVHE-A-HW potently stimulated the production of macrophage activation-related cytokines such as TNF-α, IL-6 and IL-12 (841.7±71.3 pg/mL, 3.9±0.1 ng/mL, 179.3±30.2 pg/mL) from peritoneal macrophage more than RV-A-HW (92.5±1.5 pg/mL, 0.1±0.0 ng/mL, 37.4±5.4 pg/mL) as well as RVHE-B-HW (557.0±21.3 pg/mL, 1.8±0.0 ng/mL, 90.0±10.0 pg/mL). However, all the EtOH extracts did not show significant activity. In addition, the RVHE-A-HW showed a significantly higher intestinal immune system modulating activity through Peyer’s patch and GM-CSF production than did any other extract from RV and RVHE-B. In conclusion, these results suggest that the fermented R. volubilis with H. erinaceum mycelia possesses a possible use as an industrial application as functional food or material.

Tooth autotransplantation is the placement of an impacted or erupted tooth into an extraction site or surgically prepared dental socket within the same individual. This procedure may become a new treatment alternative, because of its osteogenetic potential and its ability to promote regeneration of alveolar processes. The present study reports the case of a 10-year-old girl whose maxillary central incisor was ankylosed as the result of an injury, and who underwent tooth autotransplantation and orthodontic treatment for the functional and aesthetic recovery of the maxillary central incisor. The transplanted tooth showed satisfactory alveolar bone recovery, and orthodontic tooth movement. No complications occurred. We chose to report this case because it illustrates the autotransplantation of a premolar in a child scheduled for orthodontic treatment, including tooth extraction. The procedure showed good prognosis in terms of the recovery of an anterior tooth affected by an injury.

This study was undertaken to achieve a high bleaching efficacy with plasma, through longer application and reparative bleaching processes, by different shade evaluation methods. Extracted human teeth were divided into 6 groups (n=10). All teeth were treated in pairs. Low concentration of 15% carbamide peroxide (CP) was applied, with and without plasma, for 10, 20, and 30-min tooth bleaching, respectively. The bleaching procedure was repeated once daily for four days. The teeth were maintained in a moist environment provided by artificial saliva. The Vitapan Classical shade guide and Commission Internationale de L’Eclairage (CIELAB) color system were collectively used to measure the bleaching efficacy. Color evaluation was statistically analyzed using Student t-test and one-way analysis of variance (ANOVA) complemented by Tukey’s test. Combining the plasma with 15% CP showed significantly greater color changes compared to bleaching without plasma (p<0.05). A high bleaching efficacy with plasma is proportional to the repetitive application and the treatment time. A 30-min application with plasma provided the best bleaching. Repetitive bleaching showed lower probability of color relapse of the bleached tooth. The color change by shade guide correlated with the changes in CIELAB color system. A value of 1 color change units (CCU) conversion factor for overall color change (ΔE) values comparisons was 3.724 values. The two measuring methods provide a more accurate correspondence of color change. The repetitive and longer application for tooth bleaching, combined with plasma, has a strong bleaching effect and produces whiter teeth.

The ultrastructural parameters related to synaptic release of endings which are presynaptic to tooth pulp afferent terminals (p-endings) were analyzed to understand the underlying mechanism for presynaptic modulation of tooth pulp afferents. Tooth pulp afferents were labelled by applying wheat-germ agglutinin conjugated horseradish peroxidase to the rat right lower incisor, whereafter electron microscopic morphometric analysis with serial section and reconstruction of p-endings in the trigeminal oral nucleus was performed. The results obtained from 15 p-endings presynaptic to 11 labeled tooth pulp afferent terminals were as follows. P-endings contained pleomorphic vesicles and made symmetrical synaptic contacts with labeled terminals. The p-endings showed small synaptic release-related ultrastructural parameters: volume, 0.82 ± 0.45 μm3 (mean ± SD); surface area, 4.50 ± 1.76 μm2; mitochondrial volume, 0.15 ± 0.07 μm3; total apposed surface area, 0.69 ± 0.24 μm2; active zone area, 0.10 ± 0.04 μm2; total vesicle number, 1045 ± 668.86; and vesicle density, 1677 ± 684/μm2. The volume of the p-endings showed strong positive correlation with the following parameters: surface area (r=0.97, P<0.01), mitochondrial volume (r=0.56, P<0.05), and total vesicle number (r=0.73, P<0.05). However, the volume of p-endings did not positively correlate or was very weakly correlated with the apposed surface area (r=-0.12, P=0.675) and active zone area (r=0.46, P=0.084). These results show that some synaptic release-related ultrastructural parameters of p-endings on the tooth pulp afferent terminals follow the “size principle” of Pierce and Mendell (1993) in the trigeminal nucleus oralis, but other parameters do not. Our findings may demonstrate a characteristic feature of synaptic release associated with p-endings.

Composite resins are developed as restorative materials to improve esthetics and mechanical properties. To improve the physical properties of resin material, resin filler have to be added. However, no imaging method is adopted for resin filler distribution. Optical coherence tomography (OCT) is a optical imaging technique to delineate microscopic structures within biological tissue. The OCT application to dental composites resin and its filler is not described yet. So, this new and advanced optical method is needed for clinical application for evaluation of dental composite resin. To analyze the spatial distribution of dental composite resin and to evaluate the resin restoration in cavity, frequency domain optical coherence tomography (FD-OCT) was used for their analysis. Resin restored tooth was prepared. For morphological observation, serially sectioned teeth, conventional X-ray taking and micro computed-tomography (CT) images were compared with OCT images. The experiment has done to evaluate the success of the resin restoration using 3 dimensional structure OCT image. In this research, OCT is evaluated as a new technique to image resin restoration. The evaluation of resin restored tooth was performed by OCT. Inappropriate restoration such as marginal adaptation, large porosities, internal integrity and poor contour could be detected. Resin filler also could be checked by OCT. The distribution, number, regularity and size of resin filler can be differentiated from several commercial products. Considering the characteristics of the OCT, it can be used to evaluate the defects of resin restoration, resin filler distribution, and internal integrity between resin material and tooth structure. The OCT can be considered to be a new and advanced method for the evaluation of resin restorations.

Tooth development shows dynamic morphological changes from the stages of cap to hard tissue formation and is strictly regulated during development. In the present study, we compared expression and localization of 3 major enamel matrix proteins in rats: amelogenin, enamel and ameloblastin. DD-PCR and RT-PCR revealed differential expression of the major proteins from the cap stage to root stage. Immunofluorescence staining results indicated that amelogenin was not detected in either inner enamel epithelium or reduced enamel epithelium, but highly immunoreactive in preameloblasts and ameloblasts; in addition, it was sporadically expressed in preodontoblasts abutting preameloblasts. Ameloblastin expression was also observed in not only differentiated ameloblasts but also osteoblasts. Immunoreactivity to ameloblastin in ameloblasts was strong in Tomes' processes. Enamelin was exclusively localized along the entire newly formed and maturing enamel. Enamelin was largely localized in near Tomes' processes and enamel rods in maturing enamel. Alendronate treatment resulted in down-regulation of amelogenin and ameloblastin at both transcription and translation levels; whereas, enamelin expression was unchanged in response to the treatment. These results suggested that amelogenin, ameloblastin and enamelin might be implicated in cell differentiation, adhesion of ameloblasts to enamel and enamel crystallization during enamel matrix formation, respectively.

The aim of this study was to investigate the effect of n-3 polyunsaturated fatty acids (PUFAs) on eruptive movement during tooth development. Sprague-Dawley (SD) rat pups were randomly divided into two groups; control group and experimental group. The experimental group was administered daily with n-3 PUFA by intraperitoneal (IP) injection. After 10 days postpartum, rat pups were sacrificed to evaluate the effect of n-3 PUFA on eruptive tooth movement. Histological analyses were by hematoxylin-eosin (H&E) staining. Tartrate-resistant acid phosphatase (TRAP) assay was performed to compare the osteoclast distribution in the bone matrix above the developing molar teeth. Incisor teeth eruptions were noticeably observed in IP group, as compared to control group. Rat pups in IP group showed faster tooth eruption on day 8 after birth. Through histological analyses, IP group showed thinner bone matrix and more osteoclasts above the 1st molar teeth, as compared to control group. TRAP assay showed significantly stronger stained pattern that the osteoclast above the 1st molar teeth in IP group, as compared to control group. The results suggested that n-3 PUFA could affect osteoclastic activity involved in bony remodeling during eruptive tooth movement.

Odontogenic cells express many genes spatiotemporally through complex and intricate processes during tooth formation. Therefore, investigating them during the tooth development has been an important subject for the better understanding of tooth morphogenesis. The present study was performed to identify the genetic profiles which are involved in the morphological changes during the different stages of rat tooth development using the Agilent Rat Oligonucleotide Microarrays. Morphologically, the maxillary 3rd molar germ at 10 days post-partum (dpp) was at the cap/bell stage. In contrast, the maxillary 2nd molar germ showed the root development stage. After microarray analysis, there were a considerable number of up- or down-regulated genes in the 3rd and the 2nd molar germ cells during tooth morphogenesis. Several differentially expressed genes for nerve supply were further studied. Among them, neuroligin 1 (Nlgn 1) was gradually downregulated during tooth development both at the transcription and the translation level. Also, Nlgn 1 was mostly localized in the dental sac, which is an important component yielding the nerve supply. This genetic profiling study proposed that many genes may be implicated in the biological processes for the dental hard tissue formation and, furthermore, may allow the identification of the key genes involved in the nerve supply to the dental sac.

Osteocalcin (OC) is the most abundant noncollagenous protein of extracellular matrix in the bone. In an OC deficient mouse, bone formation rates are increased in cancellous and cortical bones. OC is known as a negative regulator of mineral apposition. OC is also expressed in the tooth of the rat, bovine, and human. However, little is known about OC during tooth development in Xenopus. The purpose of this study is to compare the expression of OC with mineralization in the developing tooth of Xenopus, by using von Kossa staining and in situ hybridization. At stage 56, the developmental stage of tooth germ corresponds to the cap stage, and an acellular zone was apparent between the dental papilla and the enamel organ. From stage 57, calcium deposition was revealed by von Kossa staining prior to OC expression, and the differentiated odontoblasts forming predentin were located at adjoining predentin. At stage 58, OC transcripts were detected in the differentiated odontoblasts. At stage 66, OC mRNA was expressed in the odontoblasts, which was aligned in a single layer at the periphery of the pulp. These findings suggest that OC may play a role in mineralization and odontogenesis of tooth development in Xenopus.

Nonthermal atmospheric pressure plasma has attracted great interest for biomedical applications. The plasma consists of charged particles, radicals, and a strong electric field as the fourth state of matter. This study evaluated the change in the surface roughness after tooth bleaching by plasma in combination with a low concentration (15%) of carbamide peroxide, specifically whether the application of plasma produced detriments, such as demineralization and structural change, with the goal of efficient and safe tooth bleaching. After being combined with plasma and 15% carbamide peroxide, the hydroxyapatite surface was significantly smoother with a low roughness average value. Tooth bleaching with 15% carbamide peroxide alone produced an irregular surface and increased the surface roughness with high roughness average value. Tooth bleaching with plasma resulted in no significant variations in hydroxyapatite in terms of change in surface roughness and surface topography. The application of tooth bleaching with plasma is not deleterious to dental hard tissue, implicating it as a safe tooth bleaching technique.