810 likes | 1.62k Vues
Microbiology of dental plaque - differences between immature and mature plaque. Microbial metabolism and plaque biofilm pathogenic potential. Dental plaque (bacteria biofilm ) - g enesis and structure . Prof. d-r Kabaktchieva - 2014y.
E N D
Microbiology of dental plaque - differences between immature and mature plaque.Microbial metabolism and plaque biofilm pathogenic potential. Dental plaque (bacteria biofilm) - genesis and structure. Prof. d-r Kabaktchieva - 2014y.
Thedental professional comesintocontactwithtwoofthemostwidespreadofallhumandiseases - dentalcariesandperiodontaldiseases
gingivitis caries caries Unliketypicalinfectiousdiseases, dentalcariesandperiodontaldiseasesarenotcausedby a singlepathogenicmicroorganism.
DentalcariesandperiodontaldiseasesresultfromtheaccumulationofmanydifferentspeciesofbacteriathatformDentalcariesandperiodontaldiseasesresultfromtheaccumulationofmanydifferentspeciesofbacteriathatform • dentalplaque a naturallyacquiredbacterialbiofilmthatdevelopsontheteeth
Dentalplaqueis a multi-speciesbiofilm, Somebacterialspeciesmaybeofgreaterrelevanceinthedevelopmentofcariesandperiodontaldiseases. Dental plaque
Tounderstandtheroleofdentalplaqueincaries • mustfirstknowhowdentalplaqueforms ? • howchangesintheproportionsofdifferentplaquebacteria cancontributetothedevelopmentof this oraldisease?
DentalPlaque: A MicrobialBiofilm • Mostnaturalsurfaceshavetheirowncoatingofmicroorganisms, orbiofilm, adaptedtotheirindividualhabitats.
Bacterialadhesiontosurfacesprimarilyinvolvestwotypesofreactions: physicochemicalandbiochemical. Thesesameinteractionsoccurintheformationofplaqueandcalculusonoralstructures.
Alllivingcellsinnature, includingbacterialplaquecells, have a net-negativesurfacecharge. • Thecellscan, therefore, beattractedtooppositelychargedsurfacesasskin. inthecaseofbacterialplaque, have attracting between thesurfacesofcells ,teeth, andsofttissuesoftheoralcavity.
Themicroorganismswithinbacterialplaquecanproduce : • extracellularcoatings, suchas slimelayerswhich prolongtheexistenceof biofilms ; • a varietyofsurfacefibrils, orappendages, thatextendfromtheircellwalls. • Thesemechanismsmediateattachmentofbacteriato a substratebyprovidingadditionalattachmentstructuresbetweenthetoothsurfaceandtheplaque, thusallowingtheformationofadherentmatrices.
BacterialColonizationoftheMouth • Microorganismsfoundintheoralcavityarenaturallyacquiredfromtheenvironment. • Bacteriaareacquiredfromtheatmosphere, food, humancontact. • Bacteriaformcoloniesbetweensalivaandhardtissuessuchaseruptedteeth, andexposedrootcementumanddentin.
Priortoeruption, theexternalsurfaceof toothenamelislinedbyremnantsofthe enamel-formingorgan. • Thesetissueremnantsare: - thereducedenamelepitheliumand - thebasallamina
Thebasallaminaconnectstheepitheliumtotheenamelsurface. • Thebasallaminaisalsocontinuouswithorganicmaterialthatfillsthemicroscopicvoidsinthesuperficialenamel. • Thissubsurfaceorganicmaterialappearsas a fringe-likestructureattachedtothebasallaminaandiscomposedofresidualenamelmatrixproteins. Thismaterialisreferredtoas a subsurfacepellicle. Thepellicleoriginatesfromlocalcellsduringtoothformation; therefore, itisconsideredtobeofendogenousorigin.
SSP B AP ES • The transmissionelectronmicrographdemonstrates: • remnantsofthesubsurfacepellicle (SSP) • theacquiredpellicle (AP) • They are betweentheenamelsurface (ES) and • thebacterialcells (B) ofthedentalplaque.
RA HD EM ES BL Figure .Junctionofreducedenamelepitheliumandenamel. Thereducedameloblasts (RA) areattachedtotheenamelbyhemidesmosomes (HD) and a basallamina (BL). EM, enamelmatrixremnantsform a subsurfacepellicle; ES, enamelspace.
Whenthetoothemergesintotheoralcavity, theremnantsofthereducedenamelepitheliumare: - wornoff - digestedbysalivaryandbacterialenzymes
Aneruptedtoothimmediatelybecomescoveredby a thin, microscopiccoatingofsalivamaterials. • Thesalivarycomponentsbecomeadsorbedtothesurfaceoftheenamelwithinseconds. Thiscoatingisalsoreferredtoas a pellicle.
Becausethepellicleisacquiredaftereruptionofteeth, itissaidtohaveanexogenousorigin thepelliclewasformedby a substancefromoutsidethetooth, ratherthanduringthedevelopmentofteeth.
TheAcquiredPellicle Thecoatingofsalivaryoriginthatformsonexposedtoothsurfacesiscalledtheacquiredpellicle. Itisacellularandconsistsprimarilyofglycoproteinsderivedfromsaliva B АР ЕS
A glycoproteinis a proteinmoleculethatincludesanattachedcarbohydratecomponent.
Oralfluidsandsmallmoleculescanslowlydiffusethroughtheacquiredpellicleintothesuperficialenamel;Oralfluidsandsmallmoleculescanslowlydiffusethroughtheacquiredpellicleintothesuperficialenamel; • Ifthepellicleisdisplaced, (by a prophylaxis), thepelliclebeginstoreformimmediately; • Ittakesabout a weekforthepellicletodevelopitscondensed, maturestructure, whichmayalsoincorporatebacterialproducts.
Colonizationoftheacquiredpelliclecanbebeneficialforthebacteria, becausethepelliclecomponentscanserveasnutrients. • Forexample: proline-richsalivaryproteinsmaybedegradedbybacterialcollagenases. Thisactionreleases peptides, freeaminoacids, + salivarymucinsmayenhancethegrowthofdentalplaqueorganisms, suchasactinomycetesandspirochetes.
Thecarbohydratecomponentsofcertainpellicleglycoproteinsmayserveasreceptorsforproteinsthatbindbacteriatosurfaces - e.g., adhesins, Тherebythe adhesinscontributingtobacterialadhesiontothetooth.
Thebindingsitesonthepellicle, are alsohostproteins, including: • immunoglobulins (i.e., antibodies), • theenzymelysozyme, and • proteinsofthecomplementsystem. Thesehostproteinsoriginatefromsalivaandgingivalsulcusfluid.
АnantagonisticrelationshipoftenexistsbetweendifferenttypesofbacteriaАnantagonisticrelationshipoftenexistsbetweendifferenttypesofbacteria competingforthebindingsites. • Forexample: ithasbeenshownthatsomestreptococcisynthesizeandreleaseproteinscalledbacteriocins, whichcaninhibitsomestrainsofActinomycesandActinobacillusspecies.
DentalPlaqueFormation • Allbacteriathatinitiateplaqueformation comeincontactwiththeorganicallycoatedtoothsurfacebychance. • Forcesexistthattendeithertoallowbacteriatoaccumulateonteethortoremovethem. • Shiftsintheseforcesdeterminewhethermoreorlessplaqueaccumulatesat a givensiteon a tooth.
Bacteriatendtoberemovedfromtheteethduringmasticationoffoods, bythetongue, andbytoothbrushingandotheroralhygieneactivities. • Forthisreason, bacteriatendtoaccumulateonteethinsheltered, undisturbedenvironments, whichbasicallyaresitesatrisk. • Thesesitesincludetheocclusalfissures, thesurfacesapicaltothecontactbetweenadjacentteeth, andinthegingivalsulcus.
Therefore, itisnocoincidencethatthemajorplaque-baseddiseases - cariesandinflammatoryperiodontaldiseasesariseatthesesiteswhereplaqueismostabundantandstagnant.
Initialplaqueformationmaytakeaslongas 2 hours. • Colonizationbeginsas a seriesofisolatedcolonies, oftenconfinedtomicroscopictoothsurfaceirregularities.
Withtheaidofnutrientsfromsalivaandhostfood, thecolonizingbacteriabegintomultiply. • About 2 daysarerequiredfortheplaquetodoubleinmass, • Duringwhichtimethebacterialcolonieshavebeengrowingtogether.
Themostdramaticchangeinbacterialnumbersoccursduringthefirst 4 or 5 daysofplaqueformation. • Afterapproximately 21 days, bacterialreplicationslows, andplaqueaccumulationbecomesrelativelystable.
Theincreasingthicknessoftheplaquelimitsthediffusionofoxygentotheentrappedoriginal, oxygen-tolerantpopulationsofbacteria. • As a result, theorganismsthatsurviveinthedeeperaspectsofthedevelopingplaqueareeitherfacultativeorobligateanaerobes.
Theformingbacterialcoloniesarerapidlycoveredbysaliva. • Whenseenwiththescanningelectronmicroscope, growingcoloniesprotrudefromthesurfaceoftheplaqueasdomes.
“Domes” have appearanceof a clusterofigloosbeneathnewlyfallensnow Scanningelectronmicrograph ofdomeformationintheplaque. .
Inindividualswithpoororalhygiene, superficialdentalplaquemayincorporate : - fooddebris , - humancellssuchasepithelialcells (desquamatedcells) - leukocytes. • Thisdebrisiscalledmateriaalba, whichliterallymeans "whitematter.“ • Unlikeplaque, itisusuallyremovedeasilybyrinsingwithwater. cloud
Attimes, theplaquedemonstratesstaining, whichiscausedbychromogenicbacteria, whichproduce a brownpigment.
MolecularMechanismsofBacterialAdhesion • Theinitialbacterialattachmenttotheacquiredpellicle ( A)isthoughttoinvolvephysicochemicalinteractions (e.g., electrostaticforcesandhydrophobicbonding) betweenmoleculesoftheaminoacidsphenylalanineandleucine.
detailsA. A sidechainof a phenylalaninecomponentof a bacterialproteininteractsviahydrophobicbondingwith a sidechainof a leucinecomponentof a salivaryglycoproteinintheacquiredpellicle.
Thehydrophobicityofsomestreptococci, iscausedbycellwall-associatedmoleculesincludingglucosyltransferase, anenzymethatconvertstheglucoseportionofthesugar, sucrose, intoextracellularpolysaccharide. • Someglucosyltransferaseshavebeendesignatedashydrophobins. • Thesepolysaccharidesinclude "sticky" glucansthat, throughhydrogenbonding, arethoughttocontributetothemediationofbacterialadhesion (Fig. C). • Oncethebacteriaadhere, theyareoften "entombed" asadditionalglucanisproduced.
C.Thehost'sdietarysucroseisconvertedbythebacterialenzyme, glucosyltransferase, totheextracellularpolysaccharide, glucan, whichhasmanyhydrophobicgroupsandcaninteractwithaminoacidside-chaingroups, suchasserine, tyrosine, andthreonine. intheacquiredpellicle.
B.Thenegativelychargedcarboxylgroupof a bacterialproteinisattractedto a positivelychargedcalciumion (i.e., electrostaticattraction), whichinturnisattractedto a negativelychargedphosphategroupof a salivaryphosphoproteinintheacquiredpellicle.
Bacteriaalsohaveexternalcell-surfaceproteinstermedadhesins, whichhavelectin-likeactivity, becausetheycanbindtocarbohydratecomponentsofglycoproteins. • Тheadhesinsmaybelocatedonbacterialsurfaceappendages, suchasfimbriae (FigureD). • Fimbria-associatedadhesinsprobablymediatebacterialadhesionviaionicorhydrogen-bondinginteractions.
D.Thefimbrialsurfaceappendageextendsfromthebacterialcelltopermitthe terminal adhesinportiontobindto a sugarcomponentof a salivaryglycoprotein
Facultativeanaerobescanexistinanenvironmentwithorwithoutoxygen; • obligateanaerobescannotexistinanenvironmentwithoxygen. • Lectinsareplantproteinswithreceptorsitesthatbindspecificsugars.
Anothermolecularmechanismofbacterialadhesioniscalciumbridging. (Figure B). • Inthisprocesspositivelycharged, divalentcalciumionsinthesalivahelptolinkthenegativelychargedcellsurfacesofbacteriatothenegativelychargedacquiredpellicle
BacteriaintheDentalPlaque • Thebacteriacolonizetheteethin a reasonablypredictablesequence. • Thefirsttoadhereareprimarycolonizers, sometimesreferredtoas "pioneerspecies”. • Thesearemicroorganismsthatareabletostickdirectlytotheacquiredpellicle.
Thosethatarrivelateraresecondarycolonizers. • Theymaybeabletocolonizeanexistingbacteriallayer, buttheyareunabletoactasprimarycolonizers. • Generallyspeaking, theprimarycolonizersarenotpathogenic.
Iftheplaqueisallowedtoremainundisturbed, iteventuallybecomespopulatedwithsecondarycolonizersthatarethelikelyetiologicagentsofdentalcariesandperiodontaldiseases. • Theearliestcolonizersarecocci (sphericalbacteria), especiallystreptococci, whichconstitute 47% to 85% ofthecellsfoundduringthefirst 4 hoursafter professional toothcleaning. • Theseorganismstendtobefollowedby shortrodsandfilamentousbacteria.