Disrupted Iron Storage in Dental Fluorosis.

Enamel formation and quality are dependent on environmental conditions, including exposure to fluoride, which is a widespread natural element. Fluoride is routinely used to prevent caries. However, when absorbed in excess, fluoride may also lead to altered enamel structural properties associated with enamel gene expression modulations. As iron plays a determinant role in enamel quality, the aim of our study was to evaluate the iron metabolism in dental epithelial cells and forming enamel of mice exposed to fluoride, as well as its putative relation with enamel mechanical properties. Iron storage was investigated in dental epithelial cells with Perl's blue staining and secondary ion mass spectrometry imaging. Iron was mainly stored by maturation-stage ameloblasts involved in terminal enamel mineralization. Iron storage was drastically reduced by fluoride. Among the proteins involved in iron metabolism, ferritin heavy chain (Fth), in charge of iron storage, appeared as the preferential target of fluoride according to quantitative real-time polymerase chain reaction, Western blotting, and immunohistochemistry analyses. Fluorotic enamel presented a decreased quantity of iron oxides attested by electron spin resonance technique, altered mechanical properties measured by nanoindentation, and ultrastructural defects analyzed by scanning electron microscopy and energy dispersive x-ray spectroscopy. The in vivo functional role of Fth was illustrated with Fth+/- mice, which incorporated less iron into their dental epithelium and exhibited poor enamel quality. These data demonstrate that exposure to excessive fluoride decreases ameloblast iron storage, which contributes to the defective structural and mechanical properties in rodent fluorotic enamel. They raise the question of fluoride's effects on iron storage in other cells and organs that may contribute to its effects on population health.

A natural biomimetic porous medium mimicking hypomineralized enamel.

OBJECTIVES: In order to evaluate the clinical impact of low viscosity resin infiltration in hypomineralized enamel, it is necessary to obtain a biomimetic porous substrate capable of mimicking enamel. The specifications for the biomimetic porous medium are defined using the literature data on hypomineralized enamel. Based on these specifications, we propose to use deproteinized dentin, the latter being deproteinized by heat treatment. METHODS AND RESULTS: Thermogravimetry analysis (TGA), field emission scanning electron microscopy (FESEM) observations, mercury intrusion porosimetry (MIP) tests and nanoindentation are performed on the deproteinized dentin tissue. Heat treatment is shown to be an effective and reproducible method for removing organic fluids and protein residues in dentin. Deproteinizing dentin also enables forming nanovoids by eliminating its organic matrix. The interconnected open nanoporosities (porosities of less than 100 nm) created at 600°C are distributed between 14 nm and 32 nm and the total porosity is 39% (including 36% due to nanoporosities). At 800°C, they are distributed between 60 nm and 100 nm and total porosity is 37% (including 33% arising from the nanoporosities). The hydroxyapatite crystal structure is transformed less at 600°C, so this temperature should be preferred. SIGNIFICANCE: Besides providing new understanding of the dentin tissue itself, this study led to characterizing a porous medium made of natural apatite, and proposing and validating its use as a porous medium mimicking hypomineralized enamel. The next logical step of this study is the characterization of resin infiltration in this medium and its mechanical reinforcement.

Three-dimensional pore-scale modelling of dentinal infiltration.

Dentine is the fundamental substrate of restorative dentistry, and its properties and characteristics are the key determinants of restorative processes. In contemporary restorative techniques, bonding to Dentine is created by the impregnation of the demineralised dentine by blends of resin monomers. In this paper, a numerical model of dentinal infiltration is proposed. The aim is to follow the resin front and to point out the optimal parameter set. The main tool is a level set technique to follow the evolving interface. It is coupled with the Navier-Stokes equation where capillary effect gives rise to the appearance of a new term in the variational approach than discretised by finite elements. Using an appropriate geometry representing demineralised dentine, the moving front is observed. First, a simulation of porosimetry test is achieved in order to validate the model. The two expected pore sizes are detected and the simulation also points out limitations of mercury intrusion porosimetry test in an educational way. Then a wetting fluid (representing the dental resin) is numerically infiltrated. In the dentinal porous network, capillarity is taken into account in our model by including a capillary term. A crucial conclusion is drawn from this study: resin application time by practitioners is sufficient if, in the infiltration process, the wetting phase is the resin.