Molecular Regulacin of Tooth Development

Teeth are present only in vertebrales and parallel the evolutionary appearance
of the neural crest. Tooth development represents a classic example of an
epithelial-mesenchymal interaction, in this case between the overlying
epithelium and underlying neural crest-derived mesenchyme. Regulation of
tooth patterning from incisors to molars is generated by a combinatorial
expres- sion of HOX genes expressed in the mesen- chyme. With respect to
each tooths individual development, the epithelium governs differenti- ation
to the bud stage, at which time this regula- tory function is transferred to the
mesenchyme. Signis for development involve growth factors including
WNTs, BMPs, and FGFs; the secreted factor SHH; and transcription factors,
such as MSXl and MSX2, that interact in a complex pathway to produce cell
diFerentiation and pat- terning for each tooth. Teeth also appear to have a
signaling center that represents the organizer for tooth development much
like the activity of the node during gastrulation (see Chapter 5). This
organizer regin is called the enamel knot, and it appears in a circumscribed
regin of the dental epithelium at the tips of the tooth buds. It then enlarges at
the cap stage into a tightly packed group of cells but undergoes apoptosis
(cell death) and disappears by the end of this stage (Fig. 17.32B). While it is
present, it ex- presses FGF4, SHH, and BMP2 and 4. FGF4 may reglate
outgrowth of cusps much as it partici- pates in limb outgrowth produced by
the apical