Abstract

Background: Developmental dental defects (DDD = D3) of enamel are highly prevalent worldwide and their treatment can be clinically challenging. Robust responses to the D3 challenge require amalgamation of diverse interests and talents to develop broad-based initiatives for improving diagnosis, prevention and treatment. Seeking such holistic solutions, The D3 Group (D3G) is a world-first translational research initiative comprising clini- cians, scientists, educators, students, professional societies, indus- try and D3-affected families (www. thed3group.org). This presentation exemplifies how a D3G team of clinicians and scien- tists is exposing the molecular details of Molar Hypomineralisa- tion (MH). It is hypothesised that better understanding of the variable hardness of MH-opacities may open new avenues for improved diagnosis and treatment. Aim: To seek a molecular explanation for variable softness within demarcated enamel opacities. Design: Using MH-affected adult-first-molars sourced from D3G practitioners, demarcated opacities (intact surface; D3G criteria) were sub-sampled (clinical hardness, lesion topography) and sub- jected to biochemical analysis (protein profiling by SDS-PAGE and immunoblotting). Results: Immunoblots revealed a positive correlation between enamel softness/chalkiness and abundance of albumin. Albumin concentrations typically varied 10-fold within individual lesions (soft centre vs hard border), suggesting that clinical properties might be dictated largely by the content of this extrinsic protein. Conclusion: These findings implicate albumin in the biophysical properties and pathogenesis of MH enamel. Correlating albumin abundance with enamel chalkiness might have clinical utility (e.g. predicting caries risk, locating lesion borders before placing resto- ration). The D3G translational approach appears to be a useful model for improving healthcare of D3-affected children.