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Sex Chromosomes in Human Tooth Root Growth. Radiographic Studies On D855etukansi.fm Page 1 Thursday, September 7, 2006 9:03 AM D 885 OULU 2006 D 885 UNIVERSITY OF OULU P.O. Box 7500 FI-90014 UNIVERSITY OF OULU FINLAND ACTA UNIVERSITATIS OULUENSIS ACTA UNIVERSITATIS OULUENSIS ACTA D SERIES EDITORS Raija Lähdesmäki MEDICA RaijaLähdesmäki ASCIENTIAE RERUM NATURALIUM Professor Mikko Siponen SEX CHROMOSOMES BHUMANIORA IN HUMAN TOOTH ROOT Professor Harri Mantila GROWTH CTECHNICA Professor Juha Kostamovaara RADIOGRAPHIC STUDIES ON 47,XYY MALES, DMEDICA 46,XY FEMALES, 47,XXY MALES AND Professor Olli Vuolteenaho 45,X/46,XX FEMALES ESCIENTIAE RERUM SOCIALIUM Senior Assistant Timo Latomaa FSCRIPTA ACADEMICA Communications Officer Elna Stjerna GOECONOMICA Senior Lecturer Seppo Eriksson EDITOR IN CHIEF Professor Olli Vuolteenaho EDITORIAL SECRETARY Publication Editor Kirsti Nurkkala FACULTY OF MEDICINE, INSTITUTE OF DENTISTRY, DEPARTMENT OF ORAL DEVELOPMENT AND ORTHODONTICS, ISBN 951-42-8169-1 (Paperback) UNIVERSITY OF OULU ISBN 951-42-8170-5 (PDF) ISSN 0355-3221 (Print) ISSN 1796-2234 (Online) ACTA UNIVERSITATIS OULUENSIS D Medica 885 RAIJA LÄHDESMÄKI SEX CHROMOSOMES IN HUMAN TOOTH ROOT GROWTH Radiographic studies on 47,XYY males, 46,XY females, 47,XXY males and 45,X/46,XX females Academic Dissertation to be presented with the assent of the Faculty of Medicine, University of Oulu, for public discussion in Auditorium 1 of the Institute of Dentistry, on September 16th, 2006, at 12 noon OULUN YLIOPISTO, OULU 2006 Copyright © 2006 Acta Univ. Oul. D 885, 2006 Supervised by Professor Lassi Alvesalo Reviewed by Professor Timo Peltomäki Professor Janna Waltimo-Sirén ISBN 951-42-8169-1 (Paperback) ISBN 951-42-8170-5 (PDF) http://herkules.oulu.fi/isbn9514281705/ ISSN 0355-3221 (Printed ) ISSN 1796-2234 (Online) http://herkules.oulu.fi/issn03553221/ Cover design Raimo Ahonen OULU UNIVERSITY PRESS OULU 2006 Lähdesmäki, Raija, Sex chromosomes in human tooth root growth. Radiographic studies on 47,XYY males, 46,XY females, 47,XXY males and 45,X/46,XX females Faculty of Medicine, University of Oulu, P.O.Box 5000, FI-90014 University of Oulu, Finland, Institute of Dentistry, Department of Oral Development and Orthodontics, University of Oulu, P.O.Box 5281, FI-90014 University of Oulu, Finland Acta Univ. Oul. D 885, 2006 Oulu, Finland Abstract Studies on families and individuals with sex chromosome abnormalities and 46,XY females, together with molecular research, have provided proof that both X and Y chromosome genes are expressed in human tooth crown growth. The Y chromosome promotes the formation of both permanent tooth crown enamel and dentin, whereas the effect of the X chromosome is seen mainly in enamel formation. In particular, the effect of the Y chromosome on dentin formation explains the expression of sexual dimorphism in crown size. When crown growth is complete, root dentin is formed and requires proliferation of epithelial cells in Hertwig's epithelial root sheath to initiate the differentiation of root odontoblasts. These epithelial cells determine the size, shape and number of the roots. There is a clear sex difference in tooth crown sizes, men have larger teeth than women. The aim of this research was to study completed permanent tooth root lengths in individuals with sex chromosome abnormalities and 46,XY females, an approach which might also provide some clues for a further insight into the development of sexual dimorphism in human growth. The underlying hypothesis was that the effect of the X and Y chromosomes on crown growth is also expressed in root growth. The subjects were participants of L. Alvesalo's research project, Kvantti, and comprised 45,X/ 46,XX females, 47,XYY and 47,XXY males and female sex reversals with insensitivity to androgens (46,XY females). The root lengths were measured from dental panoramic radiographs with a sliding digital calliper. All available teeth (except third molars) with complete root formation on both sides of the jaws were measured. The results showed longer final permanent tooth root lengths in 47,XYY and 47,XXY males, while the roots in 45,X/46,XX females were shorter compared with the values of normal men and women, respectively. The root lengths of 46,XY females were longer compared to normal women and placed on a level with normal men. The root morphology did not reveal any major deviations from normal variation. In terms of population dental developmental standards it is conceivable that changes in these study groups in final size of their permanent tooth roots become evident during a period beginning eight years after birth and continuing up to the age of 14 years, at least. It became clear that the effect of the Y chromosome on tooth root growth is greater than that of the X chromosome, and this may cause the observed sexual dimorphism, males having longer roots than females. It is suggested that root growth may be affected by the same genes on the X and Y chromosomes which promote crown growth. Keywords: aneuploidy, chromosomes human X, chromosomes human Y, growth and development, humans, sex characteristics, tooth root Just keep on trusting that everything is much more wonderful than we can understand, it is the truth. Vincent van Gogh To my children Perttu, Mauri, Esko, and Seppo Acknowledgements This study was carried out at the Department of Oral Development and Orthodontics, Institute of Dentistry, University of Oulu, first during postgraduate studies and later as a part-time job in addition to work as a clinical orthodontist in the Kuopio and Iisalmi district health care centres. The theoretical studies and writing of the summary to the thesis were carried out in the last year as a part of full-time work at Oulu University. This study is a part of a larger research series belonging to Lassi Alvesalo’s research project, Kvantti, on individuals with sex chromosome abnormalities. The clinical examinations of the patients and relatives, and the documentation were performed by Professor Lassi Alvesalo and his research team, mainly at the Institute of Dentistry, University of Turku, during the 1970s and 1980s. I am most grateful to Professor Lassi Alvesalo, D.Odont., head of the Orthodontic Department, for the opportunity to take part in his research project. My first interest was to find out factors affecting growth in humans, and as an interesting response to this I was asked to study human tooth root growth, which was suggested by Professor Lassi Alvesalo. I want to thank him for the immensely valuable work he has done in conducting me into the world of science in an extremely forbearing and sensible manner. Special thanks go to Professor Erkki Tammisalo, D.Odont. for his great contribution to the accomplishment of radiographic examinations. This work was based entirely on that radiographic method as carried out by him at the Institute of Dentistry, University of Turku. The statistical calculations were performed by Ahti Niinimaa, Ph.D., who also kindly advised me on related problems whenever needed. Malcolm Hicks, M.A. (Cantab.) revised the English language of the reports during all stages of this thesis. He has been of great help in finding good and simple phrases to express the complex notions we have sometimes been dealing with. Sincere thanks to the official reviewers of the thesis, Professor Janna Waltimo-Sirén, D.Odont. Institute of Dentistry, University of Helsinki, and Professor Timo Peltomäki D.Odont., Clinic for Orthodontics and Pediatric Dentistry, Center for Dental and Oral Medicine and Cranio-Maxillofacial Surgery, University of Zürich, Switzerland, for the thorough and constructive comments on the main details and concepts in this thesis. They both get my special thanks for the opportunity to have profound discussions in this subject and tools to clarify the message. I also want to thank in advance my opponent Professor Grant Townsend, D.Odont., Associate Dean (Academic), Dental School, University of Adelaide, Australia. I received irreplaceable help from Ms Sirpa Väätäjä on many occasions during these years, while statistician Päivi Laukkanen, M.Sc. helped me to create the computer databases and secretary Ms Eija Tuomi helped me in transferring some of the data to the computer program. The staff at the Institute of Dentistry has provided good discussions and support during these years, which has greatly encouraged me to continue with the work. The head of the orthodontic department today, Professor Pertti Pirttiniemi, D.Odont., has adopted a very stimulating attitude towards my studies and the personnel of the department have given me most valuable help and support, which has made this all possible. Also I want to thank the Deans of the Institute of Dentistry Professors Aune Raustia, D.Odont. Kyösti Oikarinen, D.Odont. and Hannu Hausen, D.Odont. for providing the facilities to carry out the research. The Kvantti research project was supported during the earlier years by the Emil Aaltonen Foundation, the University of Turku Foundation and the Academy of Finland. In addition, this study has been supported by the University of Oulu, the Finnish Dental Society, Apollonia and the Orthodontic Section of the Finnish Dental Society, Apollonia. My parents have been most helpful and supportive to me in my career in so many ways during all these years. They have always had faith in my visions, and I am most grateful for that. Last but not least, I wish to thank my boys, Perttu, Mauri, Esko and Seppo, for their patience and great understanding during these years when I have been working on this thesis away from home. I hope they feel that it
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