Dental enamel is the hardest and most mineralized tissue in extinct and extant vertebrate species and provides maximum durability that allows teeth to function as weapons and/or tools as well as for food processing. Enamel development and mineralization is an intricate process tightly regulated by cells of the enamel organ called ameloblasts. These heavily polarized cells form a monolayer around the developing enamel tissue and move as a single forming front in specified directions as they lay down a proteinaceous matrix that serves as a template for crystal growth. Ameloblasts maintain intercellular connections creating a semi-permeable barrier that at one end (basal/proximal) receives nutrients and ions from blood vessels, and at the opposite end (secretory/apical/distal) forms extracellular crystals within specified pH conditions. In this unique environment, ameloblasts orchestrate crystal growth via multiple cellular activities including modulating the transport of minerals and ions, pH regulation, proteolysis, and endocytosis. In many vertebrates, the bulk of the enamel tissue volume is first formed and subsequently mineralized by these same cells as they retransform their morphology and function. Cell death by apoptosis and regression are the fates of many ameloblasts following enamel maturation, and what cells remain of the enamel organ are shed during tooth eruption, or are incorporated into the tooth's epithelial attachment to the oral gingiva. In this review, we examine key aspects of dental enamel formation, from its developmental genesis to the ever-increasing wealth of data on the mechanisms mediating ionic transport, as well as the clinical outcomes resulting from abnormal ameloblast function.

中文翻译：

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牙釉质的形成及其对口腔健康和疾病的影响。

牙釉质是已灭绝和现存脊椎动物物种中最坚硬，矿化度最高的组织，并具有最大的耐用性，可使牙齿充当武器和/或工具以及用于食品加工。牙釉质的发育和矿化是一个复杂的过程，被称为成釉细胞的牙釉质器官的细胞严格调控。这些高度极化的细胞在发育中的牙釉质组织周围形成单层，并在形成蛋白质生长基质的蛋白质基质时，以特定的方向在指定方向上移动。成釉细胞维持细胞间的连接，从而形成一种半渗透性屏障，其一端（基础/近端）从血管接收营养和离子，而另一端（分泌/顶端/远端）则在指定的pH条件下形成细胞外晶体。在这种独特的环境中，成釉细胞通过多种细胞活动（包括调节矿物质和离子的运输，pH调节，蛋白水解和胞吞作用）来协调晶体的生长。在许多脊椎动物中，大部分釉质组织体积首先形成，然后在这些相同的细胞重新改变其形态和功能时被矿化。牙釉质成熟后，通过凋亡和退化引起的细胞死亡是许多成釉细胞的命运，牙釉质在牙齿萌发过程中脱落了牙釉质器官中剩余的细胞，或者被整合到牙齿上皮与口腔牙龈的结合中。在这篇综述中，我们研究了牙釉质形成的关键方面，从牙釉质的发展成因到有关离子迁移机理的数据不断增加，