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Microhardness is performed to evaluate mechanical properties of hard tissues like tooth and bone. To date, divergent microhardness measurement methods have been reported. Most of the measurement information, especially sample preparations and the indentation sites are likely to be insufficient. This study focused on the microhardness protocol for enamel and alveolar bone in dental fluorosis and periodontal diseases models. To obtain consistent and accurate results, the critical steps in this protocol are orientation of the specimen in resin embedding, keeping the evaluation surface parallel to the ground, serial polishing of evaluation surface to obtain mirror finish, and indentation regions and sites set by reference point. During the resin embedding and polishing procedures, it is important to check that the evaluation surface is consistently parallel to the ground and the surface is intact by eye or under a microscope. Although it is optional, μCT analysis is encouraged to determine indentation sites.
In the dental fluorosis model, NaF (125 ppm) treatment made it difficult to identify enamel structure from the cervical to middle regions by μCT. Only the tip region enamel could be distinguished from dentin (Figure 1 and Supplementary Figure 1). Therefore, to evaluate enamel microhardness in the dental fluorosis model, the tip region indentation is appropriate. In accordance, previous studies evaluated the tip region of incisor enamel in dental fluorosis models6,7. In the periodontal disease model, 3D observation by μCT helps identify the bone resorption on both buccal and palatal sides (Figure 5). This is critical for understanding the amount of bone loss and the anatomical position of the alveolar bone to determine consistent indentation sites for microhardness.
A previous study demonstrated a positive correlation between microhardness and mineral density17. Our results of EMD by μCT and enamel microhardness (HV; Figure 1 and Figure 4) are concordant with the study. These results suggest that the approximate tendency of microhardness can be anticipated by μCT non-destructively. However, the gradient microhardness differences among the enamel three layers (Figure 4B,C,F) are difficult to identify as EMD gradients by μCT analysis. In this regard, microhardness testing could be considered higher resolution than μCT to clarify pathological conditions. Also, this protocol can be applied to other dental hard tissues, including dentin. Using the same specimen, multifaceted evaluation (SEM, SEM-EDX, micro-XRF and Raman spectroscopy) can be incorporated into the experimental flow prior to microhardness indentations18. Since indentations damage samples, start with a non-destructive test.
One of the critical limitations of microhardness testing is that the value tends to be affected by several factors during sample preparation and indentation. To minimize subjective factors, it is necessary to optimize indentation sites and to standardize measurement protocols that are appropriate for each pathological condition or disease model. In this study, we demonstrated an enamel microhardness protocol for a dental fluorosis model. However, modification and/or optimization of the protocol may be necessary for other enamel hypoplasia, e.g., amelogenesis imperfecta (AI) model because pathology differs in each disease model. In the periodontal disease model, alveolar bone is the main target tissue. L-PBR models are highly applicable in terms of the application of genetic modification techniques in mice. To date, many studies on L-PBR models have been published19,20 . However, to the best of our knowledge, none of the studies has ever addressed microhardness of alveolar bone in mouse periodontal disease models. This can be attributed to several factors. The relationship between alveolar bone microhardness and periodontal disease is not yet clear. The microhardness test is technically difficult to perform in the mouse alveolar bone, especially in bone resorption lesions (because of difficulties to set indentation sites due to bone destruction). It is reasonable to assume that the latter is the factor why microhardness has not been evaluated in periodontal disease models, despite microhardness value is validated as a mechanical parameter in femur and other bones21. This standardized protocol can evaluate the mechanical properties of alveolar bone affected by periodontal disease and/or disease recovery model.
In this report, we demonstrate the standardized protocol to evaluate enamel and alveolar bone microhardness in a mouse oral disease model. This opens the door for future evaluation of enamel and periodontal bone loss/regeneration to develop novel preventive and therapeutic strategies for enamel malformation and periodontal disease.