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Dental Plaque Biofilms Page 1 of 6 Dental Plaque Biofilms By Jill S. Nield-Gehrig, RDH, MA* Bacteria are the primary etiologic agents in periodontal disease. More than 500 bacterial strains may be found in dental plaque.1 These bacteria have evolved to survive in the environment of the tooth surface, gingival epithelium, and oral cavity. Recent technical advances have led to the recognition that dental plaque is a biofilm. Changes in thinking about the structure of dental plaque have improved our understanding of why peri- odontitis is so difficult to treat and will affect the strategies used to prevent and control periodontitis in the future. Bacterial Lifestyles Bacteria may be free-floating or attached to a surface. Recent advances in research technology have allowed researchers to study bacteria in their natural environment. These studies have revealed that most bacteria live in complex communities called biofilms. A biofilm is a well-organized community of bacteria that adheres to surfaces and is embedded in an extracellular slime layer. Once a bacterium attaches to a surface, it activates a whole different set of genes that gives the bacterium different characteristics from those that it had as a free-floating organism. It has been estimated that more than 99% of all bacteria on the earth live as attached bacteria.2 Biofilms can be found on medical and dental implants living in intravenous and urinary catheters, contact lenses, and prosthetic devices, such as heart valves, biliary stents, pacemakers, and artificial joints (Figure 1). Bacteria can also be life- threatening; Legionnaire's disease, which killed 29 people in 1976, was the result of a bacterial biofilm in the hotel's air conditioning system. The Structure of Biofilm Communities A biofilm community comprises bacterial microcolonies, an extracellular slime layer, fluid channels, and a primitive communication system. The basic properties of the biofilm structure are summarized in the Table. As the bacteria attach to a surface and to each Dental Plaque Biofilms Page 2 of 6 other, they cluster together to form sessile, mushroom-shaped microcolonies that are attached to the surface at a narrow base (Figure 2). Each microcolony is a tiny, independent community containing thousands of compatible bacteria. Different microcolonies may contain different combinations of bacterial species. Bacteria in the center of a microcolony may live in a strict anaerobic environment, while other bacteria at the edges of the fluid channels may live in an aerobic environment (Figure 3). Thus, the biofilm structure provides a range of customized living envi- ronments (with differing pHs, nutrient availability, and oxygen c o n c e ntrations) within which bacteria with different physiological needs can survive. The extracellular slime layer is a protective barrier that surrounds the mushroom- shaped bacterial microcolo.
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Dental plaque
1.
Dental plaque
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31.
3. Formation of
mature subgingival plaque biofilm
32.
33.
34.
Microbial interactions
35.
36.
Neutrophil
37.
38.
Lymphocyte
39.
40.
Phagocytosis
41.
Sequence of events
in host response
42.
43.
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48.
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52.
CONCLUSION PLAQUE +
TIME = GINGIVITIS GINGIVITIS +TIME = PERIODONTITIS PERIODONTITIS + TIME = TOOTH LOSS
53.