Chapter 2 Dental Plaque. Introduction. Dental caries and periodontal diseases are two of the most widespread of all human maladies, resulting from the accumulation of many different species of bacteria Dental plaque is a naturally acquired, multi-species biofilm. FIGURE 2–1 - PowerPoint PPT Presentation
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Primary Preventive Dentistry, Seventh EditionNorman O. Harris, Franklin García-Godoy, and Christine N. Nathe
Introduction
•Dental caries and periodontal diseases are two of the most widespread of all human maladies, resulting from the accumulation of many different species of bacteria
•Dental plaque is a naturally acquired, multi-species biofilm
Primary Preventive Dentistry, Seventh EditionNorman O. Harris, Franklin García-Godoy, and Christine N. Nathe
FIGURE 2–1
A 13-year-old female with dental caries on the facial surface of the incisors in the maxilla and swollen, discolored gingival tissues around the mandibular incisors, which is
characteristic of chronic gingivitis. (Courtesy of Dr. W. K. Grigsby, University of Iowa College of Dentistry, Iowa City.)
Primary Preventive Dentistry, Seventh EditionNorman O. Harris, Franklin García-Godoy, and Christine N. Nathe
FIGURE 2–2
The dental plaque on these teeth has been stained with a discoloring solution and rinsed. Note the presence of plaque interproximally and adjacent to the gingiva, but relatively absent closer to the incis. (Courtesy of Dr. W. K. Grigsby, University of Iowa College
Primary Preventive Dentistry, Seventh EditionNorman O. Harris, Franklin García-Godoy, and Christine N. Nathe
Historical Aspect
•One of the first known examples of life is mineralized bacteria or algae attached to rocks from the Precambrian Era (approximately 3800 million years ago)
•Calculus is a hard calcified deposit of plaque that has become mineralized
Primary Preventive Dentistry, Seventh EditionNorman O. Harris, Franklin García-Godoy, and Christine N. Nathe
FIGURE 2–3
This transmission electron micrograph demonstrates remnants of the subsurface pellicle (SSP) and the acquired pellicle (AP) between the enamel (ES) surface and the bacterial
cells (B) of the dental plaque. (Courtesy of Dr. M. A. Listgarten, University of Pennsylvania School of Dental Medicine, Philadelphia.)
Primary Preventive Dentistry, Seventh EditionNorman O. Harris, Franklin García-Godoy, and Christine N. Nathe
FIGURE 2–4
Junction of reduced enamel epithelium and enamel. The reduced ameloblasts (RA) are attached to the enamel by hemidesmosomes (HD) and a basal lamina (BL). EM, enamel matrix remnants form a subsurface pellicle; ES, enamel space. Original
magnification × 45,000. (Courtesy of Dr. M. A Listgarten, University of Pennsylvania School of Dental Medicine, Philadelphia.)
Primary Preventive Dentistry, Seventh EditionNorman O. Harris, Franklin García-Godoy, and Christine N. Nathe
The Acquired Pellicle
•Acellular
•Consists primarily of glycoproteins derived from saliva
•Occupies million of microscopic voids in the erupted tooth caused by chemical and mechanical interactions of the tooth surface with the oral environment
•If the pellicle is displaced by a prophylaxis it begins to reform immediately
Primary Preventive Dentistry, Seventh EditionNorman O. Harris, Franklin García-Godoy, and Christine N. Nathe
The Acquired Pellicle (Continued)
•Also forms on dental restorations
•Interestingly, there is competition for binding sites on the pellicles, not only by receptors on bacteria but also from host proteins, including immunoglobulins
Primary Preventive Dentistry, Seventh EditionNorman O. Harris, Franklin García-Godoy, and Christine N. Nathe
Molecular Mechanisms of Bacterial Adhesion
•The initial bacterial attachment to the acquired pellicile is thought to involve physicochemical interactions between molecules or portions of molecules
•Bacteria have external cell-surface proteins termed adhesions
Primary Preventive Dentistry, Seventh EditionNorman O. Harris, Franklin García-Godoy, and Christine N. Nathe
FIGURE 2–6
This diagram illustrates some of the possible molecular mechanisms that mediate attachment of bacteria to teeth during dental plaque formation. A. A side chain of a phenylalanine component of a bacterial protein interacts via hydrophobic bonding with a side chain of a leucine component of a salivary glycoprotein in
the acquired pellicle. B. The negatively charged carboxyl group of a bacterial protein is attracted to a positively charged calcium ion (i.e., electrostatic attraction), which in turn is attracted to a negatively charged phosphate group of a salivary phosphoprotein in the acquired pellicle. C. The host’s dietary
sucrose is converted by the bacterial enzyme, glucosyltransferase, to the extracellular polysaccharide, glucan, which has many hydrophobic groups and can interact with amino acid side-chain groups, such as serine, tyrosine, and threonine. D. The fimbrial surface appendage extends from the bacterial cell to
permit the terminal adhesin portion to bind to a sugar component of a salivary glycoprotein in the acquired pellicle.
Primary Preventive Dentistry, Seventh EditionNorman O. Harris, Franklin García-Godoy, and Christine N. Nathe
FIGURE 2–7
An electron micrograph showing palisades (P) of bacteria perpendicular to the enamel surface (ES), bacterial cells that are probably secondary colonizers (SC), the
intercellular plaque matrix (IPM), and the acquired pellicle (AP). (Courtesy of Dr. M. A Listgarten, University of Pennsylvania School of Dental Medicine, Philadelphia.)
Primary Preventive Dentistry, Seventh EditionNorman O. Harris, Franklin García-Godoy, and Christine N. Nathe
FIGURE 2–8
A. Cross section of “corn cob” from 2-month-old plaque. A coarse fibrillar material attaches the cocci (C) to the central filament (CF). Original magnification × 22,500. (From
Listgarten, M. A., Mayo, H. E., & Tremblay, R. (1975). J Periodontol, 46:10–26.)
B. Coarse “test-tube brush” formations consisting of central filament (CF) surrounded by large, filamentous bacteria with flagella uniformly distributed over its body (LF).
Background consists of a spirochete-rich microbiota (S). Original magnification × 4,300. (From Listgarten, M. A. (1976). J Periodontol, 47: 1–18.)
Primary Preventive Dentistry, Seventh EditionNorman O. Harris, Franklin García-Godoy, and Christine N. Nathe
FIGURE 2–9
Radiograph demonstrating a “spur”- shaped deposit of calculus (C) on the distal side of the left first molar in the maxilla. The calculus is apical to the overhanging metallic
restoration (R). The arrow (G) marks the coronal level of the gingival tissues, which indicates that this is a subgingival deposit of calculus. (Courtesy of Dr. W. K. Grigsby,
University of Iowa College of Dentistry, Iowa City.)
Primary Preventive Dentistry, Seventh EditionNorman O. Harris, Franklin García-Godoy, and Christine N. Nathe
FIGURE 2–10
Deposits of supragingival calculus on the lingual surface of incisors and canines that could not be removed by brushing. (Courtesy of Dr. W. K. Grigsby, University of Iowa
Primary Preventive Dentistry, Seventh EditionNorman O. Harris, Franklin García-Godoy, and Christine N. Nathe
FIGURE 2–11
Typical pattern of dental plaque mineralization in which the initial mineralization occurs in the inter-bacterial plaque matrix (M), with bacterial cells (B) becoming mineralized
secondarily. Original magnification × 40,000. (Courtesy of Dr. M. A. Listgarten, University of Pennsylvania School of Dental Medicine, Philadelphia.)
Primary Preventive Dentistry, Seventh EditionNorman O. Harris, Franklin García-Godoy, and Christine N. Nathe
FIGURE 2–12
Atypical pattern of dental plaque mineralization in which bacterial cells (B) act as foci of initial mineralization, with the matrix (NM), becoming mineralized secondarily. Original magnification × 25,000. (Courtesy of Dr. M. A. Listgarten, University of Pennsylvania