The role of ascorbic acid on the structural integrity of developing tooth germs.

Tooth germs grown in ascorbate deficient medium for up to 20 days underwent progressive and widespread changes. Proliferation and differentiation of preameloblasts and preodontoblasts progressed normally. Newly differentiated odontoblasts, however, became vacuolated when they began secreting: this suggested a metabolic disturbance. Failure to maintain differentiated odontoblasts, ameloblasts and pulpal cells resulted in aberrant dentin matrix, cessation of dentin production, and finally overall structural collapse with loss of normal morphology. Biochemical studies then were undertaken to define the lesion involved. The relative rate of collagen synthesis in ascorbate deficient cultures was comparable to that of ascorbate supplemented cultures, but the collagen was found to be underhydroxylated. In this state it would be unstable at 37 degrees and subject to preferential degradation. This correlates with the observation that a major fraction of the hydroxyproline in the scorbutic cultures was found in the medium as small molecular weight peptides. The overall effect of ascorbate deficiency was to deprive the tooth germ of the normal quality and quantity of collagen resulting in the characteristic histological and structural abnormalities observed. Flattening and deterioration due to structural failure most likely resulted from abnormal extracellular matrix synthesis in the supportive pulp and dentin due to the aberrant collagen.