The effect of fluoride on enamel and dentin formation in the uremic rat incisor
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ORIGINAL ARTICLE
The effect of fluoride on enamel and dentin formation in the uremic rat incisor Donacian M. Lyaruu & Antonius L. J. J. Bronckers & Fernando Santos & Robert Mathias & Pamela DenBesten
Received: 28 August 2007 / Revised: 28 March 2008 / Accepted: 4 May 2008 / Published online: 19 June 2008 # The Author(s) 2008
Abstract Renal impairment in children is associated with tooth defects that include enamel pitting and hypoplasia. However, the specific effects of uremia on tooth formation are not known. In this study, we used rat mandibular incisors, which continuously erupt and contain all stages of tooth formation, to characterize the effects of uremia on tooth formation. We also tested the hypothesis that uremia aggravates the fluoride (F)-induced changes in developing teeth. Rats were subjected to a two-stage 5/6 nephrectomy or sham operation and then exposed to 0 (control) or 50 ppm NaF in drinking water for 14 days. The effects of these treatments on food intake, body growth rate, and biochemical serum parameters for renal function and calcium metabolism were monitored. Nephrectomy reduced food intake and weight gain. Intake of F by nephrectomized rats increased plasma F levels twofold and further decreased food intake and body weight gain. Uremia affected formation of D. M. Lyaruu (*) : A. L. J. J. Bronckers Department of Oral Cell Biology, Academic Centre for Dentistry Amsterdam (ACTA), Room D246, v.d. Boechorststraat 7, 1081 BT Amsterdam, The Netherlands e-mail: [email protected] F. Santos Department of Pediatrics and Anatomy, Instituto Universitario de Oncologia del Principado de Asturias, University of Oviedo and Hospital Central de Asturias, Oviedo, Spain R. Mathias Nemours Children’s Clinic, Orlando, FL, USA P. DenBesten Department of Growth and Development, UCSF Dental School, San Francisco, CA, USA
dentin and enamel and was more extensive than the effect of F alone. Uremia also significantly increased predentin width and induced deposition of large amounts of osteodentin-like matrix-containing cells in the pulp chamber. In enamel formation, the cells most sensitive to uremia were the transitional-stage ameloblasts. These data demonstrate that intake of F by rats with reduced renal function impairs F clearance from the plasma and aggravates the already negative effects of uremia on incisor tooth development. Keywords Fluoride . Uremia . Fluorosis . Incisor . Rat
Introduction Fluoride (F) ingestion is associated with hypoplastic enamel (in healthy patients) and in severe cases can present itself as a pitted enamel surface [1, 2]. During tooth formation, renal insufficiency is also associated with defective tooth structure, and in particular, enamel hypoplasia [3–5]. In patients with renal insufficiency, the decreased ability to excrete F leads to increased retention of this anion. Indeed, the serum levels of F are elevated in children [6] and adults [7] with impaired renal function. The similarities between the appearance of fluorosed enamel [1, 2] and the hypoplastic enamel defects of uremia
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