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Objective: In this study, we applied a spring-loaded impactor to deliver traumatic forces to articular cartilage in vivo. Based on our recent finding that a 0.28-J impact induces maximal catabolic response in adult bovine articular cartilage in vitro using this device, we hypothesize that this impact will induce the formation of a focal osteoarthritic defect in vivo., Design: The femoral condyle of New Zealand White rabbits was exposed and one of the following procedures performed: 0.28 J impact, anterior cruciate ligament transection, articular surface grooving, or no joint or cartilage destruction (control). After 24 hours, 4 weeks, or 12 weeks (n = 3 for each time point), wounds were localized with India ink, and tissue samples were collected and characterized histomorphometrically with Safranin O/Fast green staining and Hoechst 33342 nuclear staining for cell vitality., Results: The spring-loaded device delivered reproducible impacts with the following characteristics: impact area of 1.39 ± 0.11 mm(2), calculated load of 326 ± 47.3 MPa, time-to-peak of 0.32 ± 0.03 ms, and an estimated maximal displacement of 25.1% ± 4.5% at the tip apex. The impact resulted in immediate cartilage fissuring and cell loss in the surface and intermediate zones, and it induced the formation of a focal lesion at 12 weeks. The degeneration was defined and appeared more slowly than after anterior cruciate ligament transection, and more pronounced and characteristic than after grooving., Conclusion: A single traumatic 0.28 J impact delivered with this spring-loaded impactor induces focal cartilage degeneration characteristic of osteoarthritis.

Recent studies have demonstrated that several species of oral streptococci, such as Streptococcus gordonii, bind soluble salivary alpha-amylase. The goal of the present study was to determine if amylase immobilized onto a surface such as hydroxyapatite can serve as an adhesion receptor for S. gordonii. Initially, human parotid saliva was fractionated on Bio-Gel P60, and fractions were screened for their ability to promote adhesion of S. gordonii to hydroxyapatite. Fractions containing alpha-amylase and proline-rich proteins promoted the adhesion of [3H]-labeled S. gordonii to hydroxyapatite. Similar findings were obtained with purified amylase and acidic proline-rich protein 1 (PRP1). Incubation of S. gordonii G9B in the presence of starch and maltotriose increased the binding of this strain to amylase-coated hydroxyapatite, while the adhesion of S. sanguis 10556 to amylase-coated hydroxyapatite was not affected by these saccharides. These results suggest that amylase may serve as a hydroxyapatite pellicle receptor for amylase-binding streptococci. Furthermore, starch and starch metabolites may enhance the adhesion of amylase-binding streptococci to amylase in dental pellicles to augment the formation of dental plaque.

The binding of the chemotactic complement fragment, C5a, to peripheral blood neutrophils of Localized Juvenile Periodontitis (LJP) patients and normal controls was quantitated using iodinated human C5a and a rapid centrifugation assay. There was a significant reduction in the number of binding sites per cell on neutrophils from the patient group, whereas the binding affinity remained the same as control values.

Members of a family of acidic proteins taken from human submandibular-sublingual saliva were designated cysteine-containing phosphoproteins, since they could be distinguished from other salivary phosphoproteins by the presence of half-cystine. These molecules consisted of a single peptide chain of approximately 14,000 daltons. Their isoelectric points ranged from 4.3 to 5.9. Two groups (C2 and C3) were O-phosphorylated. Their charge heterogeneity was apparently due to variations in content of phosphate and acidic and basic amino acids.

Selected reference and freshly isolated strains of Streptococcus mitis (mitior) and Streptococcus sanguis were assayed for cell-associated neuraminidase activity by their ability to hydrolyze [3H-] sialyllactitol. A cell-associated neuraminidase was detected with S. mitis and S. sanguis serotype II (reclassified as S. mitis) but not with S. sanguis serotypes I and III. Neuraminidase activity of S. mitis correlated with this organism's inability to hydrolyze arginine, aesculin, and few, if any, sugars. The findings indicate that the presence of cell-associated neuraminidase activity is useful for the taxonomic classification of S. mitis.

Studies were begun to compare the oligosaccharide structures of the low-molecular-weight mucin purified from the submandibular-sublingual saliva of a normal individual with that from one with cystic fibrosis. Following alkaline/borotritide cleavage, neutral and sialic acid-containing chains were purified by a combination of gel filtration, paper chromatography, and high-voltage paper electrophoresis. Oligosaccharides ranged in size from a disaccharide to a heptasaccharide. Approximately 80% of the oligosaccharides were GalB1, 3GalNAc; Fuc alpha 1,2GalB1,3GalNAc; and NeuAc alpha 2,3GalB1, 3GalNAc. The other structures were Fuc alpha 1,2GalB1,4(Fuc alpha 1,3)GlcNAcB1,6(GalB1,3)GalNAc or GalB1,4(Fuc alpha 1,3)GlcNAcB1,6(Fuc alpha 1,2GalB1,3)GAlNAc; GalB1,4(Fuc alpha 1,3)GlcNAcB1,6(NeuAc alpha 2,3GalB1,3)GalNAc; and Fuc alpha 1,2GalB1,4(Fuc alpha 1,3)GlcNAcB1,6 (NeuAc alpha 2,3GalB1,3)GalNAc. There were no apparent qualitative differences in the neutral and sialic acid-containing units recovered from the normal and cystic fibrosis samples.

This study demonstrated that human submandibular-sublingual saliva (HSMSL) provided a better substrate than did whole saliva or parotid saliva for the binding of Streptococcus sanguis in a glass adherence assay. Additional evidence indicated that the lower molecular weight salivary mucin in HSMSL was involved in these interactions. Mucin's sialic acid residues were found to play a major role in mediating the binding of certain strains of Streptococcus sanguis.

The submandibular saliva of patients with cystic fibrosis was found to contain about 66% more lipids/100 ml of saliva than that of normal individuals and exhibited elevated levels of neutral lipids, phospholipids, and glycolipids. No significant differences were noted in the proportions of individual neutral lipid and phospholipid components present in both types of samples. The glycolipids of normal saliva consisted entirely of glyceroglucolipids, whereas those of cystic fibrosis saliva, in addition to glyceroglucolipids, also contained small amounts of glycosphingolipids. These quantitative and qualitative differences may affect the physicochemical properties of the secretion.

Modern technology has allowed us to understand better the functions of saliva and now provides a rationale for developing: (1) diagnostic reagents for monitoring oral and systemic health status and (2) replacement therapies for individuals with salivary dysfunctions. Several areas of dental research are directed at augmenting or enhancing both the quality and quantity of saliva for individuals with dry mouth. An "intrinsic" approach is being explored which utilizes medications such as pilocarpine and bromhexine to stimulate the salivary glands to produce more saliva. An "extrinsic" approach proposes to use topically applied artificial saliva. Studies in our laboratory have been directed toward developing artificial salivas which incorporate many of the protective features of "native" saliva. An ideal artificial saliva should be "long-lasting", provide lubrication, inhibit colonization of microflora responsible for dental caries and gingivitis, and coat the oral soft tissues for protection against environmental insult and desiccation. Studies are currently under way to determine the structural requirements of salivary molecules responsible for these protective functions. Composite salivary molecules consisting of multiple biologically active or "functional domains" could then be designed and synthesized based upon primary sequence and conformational analyses, computer-assisted structural predictions, and in vitro testing. These supersalivary substances could then be used as saliva substitutes for targeting to selected oral surfaces to promote mineralization, hydration, and/or regulate microbial-mediated disease.

Major advances in our understanding of the role of the neutrophil in host defense against periodontal organisms have been made through studies of localized juvenile periodontitis (LJP). Several lines of evidence suggest that LJP is an infectious process closely associated with Actinobacillus (Haemophilus) actinomycetemomitans as a causative agent, although other organisms may also participate. The immunologic profile of LJP patients suggests that a cell-associated neutrophil locomotory dysfunction is a key underlying immunodeficiency resulting in increased susceptibility to periodontal infection. In addition, LJP patients often exhibit cervical lymphadenopathy and IgG-hypergammaglobulinemia, and a markedly elevated antibody response to the infecting organism, A. actinomycetemcomitans, is found in the serum and crevicular fluid of most patients. Evaluation of the locomotory properties of LJP neutrophils shows that random migration and chemokinesis are normal; however, about 70% of the LJP patients suffer from a defect in chemotaxis, with their neutrophils responding poorly to bacterial chemotactic factors, synthetic chemotactic peptides, and complement fragments (C5a). Depressed chemotaxis of LJP neutrophils is paralleled by their reduced capacity to bind the synthetic chemotactic peptide N-formylmethionylleucylphenylalanine (FMLP), as well as C5a. Furthermore, there is a reduction in the amount of glycoprotein 110, a neutrophil membrane matrix component and differentiation antigen which is associated with FMLP- and possibly also C5a-mediated chemotaxis. Reduction of C5a and of FMLP ligand binding, decreased expression of GP-110, and reduced neutrophil chemotaxis are consistent with a stem cell maturation error in LJP patients. This is further supported by studies demonstrating increased expression of CR2, the C3d/EBV receptor, on peripheral blood neutrophils of LJP patients. CR2 receptors are normally present on immature human neutrophils but are lost during the maturation process. These alterations in neutrophil surface components and their reduced chemotaxis may result from a genetically determined abnormality. Studies demonstrating the familial nature of both the neutrophil chemotactic disorder and the clinical entity represented by localized juvenile periodontitis point to a strong role for genetic determinants in the disease which affect neutrophil surface receptors.

Medicine, particularly with respect to diagnostic decision-making, has seen remarkable advances in the last ten years. The art of diagnosis has become much more of a science. Basic science advances have moved from the laboratory into the hospital and radically changed the way a medical diagnosis is arrived at or confirmed. Dentistry, especially oral diagnosis, as yet has not been a significant part of this general medical advance. However, several examples demonstrate that this situation is starting to change. Oral conditions are beginning to be evaluated with greater precision and sophistication. This report reviews some recent advances in oral diagnostic research and suggests where they will carry dentistry over the next 25 years.

The protective functions of saliva are attributed, in part, to its serous and mucous glycoproteins. We have studied, as representative molecules, the proline-rich glycoprotein (PRG) from human parotid saliva and the high (MG1) and low (MG2) molecular weight mucins from submandibular-sublingual saliva. PRG (38.9 kDa) contains 40% carbohydrate consisting of 6 triantennary N-linked units and a single peptide chain of 231 amino acids, 75% of which = PRO + GLY + GLN. PRG's secondary structure is comprised of 70% random coil (naked regions) and 30% beta-turns (glycosylated domains). MG1 (greater than 10(3) kDa) contains 15% protein (several disulfide linked subunits), 78% carbohydrate (290 units of 4-16 residues), 7% sulfate, and small amounts of covalently linked fatty acids. MG2 (200-250 kDa) contains 30% protein (single peptide chain), 68% carbohydrate (170 units of 2-7 residues), and 2% sulfate. The major carbohydrate units of MG2 are: NeuAc alpha 2,3Gal beta 1,3GalNAc,Gal beta 1,3GalNAc, and Fuc alpha 1,2Gal beta 1,3GalNAc. MG1 contains hydrophobic domains, as evidenced by its ability to bind fluorescent hydrophobic probes; MG2 does not. Collectively, the biochemical and biophysical comparisons between MG1 and MG2 indicate that these two mucins are structurally different. Several functional properties of MG1, MG2, and PRG have been examined, including their presence in two-hour in vivo enamel pellicle, binding to synthetic hydroxyapatite, lubricating properties, and interactions with oral streptococci. The data presented suggest that these glycoproteins may have multiple functions which are predicated, in part on their carbohydrate units. The potential significance of the structure-function relationships of these glycoproteins to the oral ecology is discussed.