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acquired pellicle
thin, acellular film composed of proteins, carbohydrates, and lipids. It forms over exposed tooth surfaces, mucosa, and restorative materials within 30-90 mins after cleaning.
how long does it take for the acquired pellicle to form
30-90 mins after brushing
what is the function of the pellicle
mineral homeostasis, host defense, and lubrication
what is mineral homeostasis
protecting against demineralization and serving as a scaffold for remineralization
what are the host defenses of the acquired pellicle
antimicrobial proteins that control bacterial colonization
biofilm
dental plaque - structured community of over 700 distinct microorganisms encapsulated in a self produced extracellular polymeric substance (EPS) matrix
what does biofilm attach to
teeth, calculus, and prosthesis
how is biofilm removed
typically with a toohbrush
materia alba
loosley adherent, unstructured, white or grayish mass of oral debris and bacteria that lies over the dental biofilm
what does materia alba look like
cottage cheese
what is materia alba composed of
living and dead bacteria, desquamated epithelial cells, disintegrating leukocytes, salivary proteins, and food debris
how is materia alba removed
basic mechanical self oral care
food debris
unstructured, loosley attached particulate matter remaining after eating
where does food debris typically accumulate
the cervical third of the tooth and proximal embrasures and can be vertically impacted into contacts
what are the stages of biofilm formation and maturation
pellicle formation
initial adhesion: planktonic cells attach to pellicle
maturation - later colonizers attach to early colonizers
detachment and dispersion
what happens in step 1 - pellicle formation on the staged of biofilm formation
the acquired pellicle forms first, providing glycoproteins that serve as the foundation for bacterial attachment
what happens in step 2 - initial adhesion of the formation of the biofilm
planktonic bacterial cells attach to the pellicle primarily through fimbriae and pili via electrostatic interactions. The initial attachment is reversible and can be dislodged with self oral care. Early colonizers then secrete EPS and cocci adhere to filamentous bacteria
what happens in step 3 - maturation of the formation of the biofilm
Around 72 hours later, later colonizers attach to early colonizers, leading to the formation of microcolonies. This stage includes the development of quorum sensing and the creation of food chains within the biofilm
what is quorum sensing
cell to cell communication
what occurs in the 4th step- detachment and dispersion in the formation of the biofilm
As bacterial colonies mature, they release planktonic cells. Bacteria convert to motile forms to disperse and colonize other areas in the oral cavitye
what is the clinical significance of the biofilm formation and maturation
highlights why thourough, frequent biofilm disruption is essential. Undisrupted biofilm for 7 days leads to an increase in gram positive anaerobic bacteria which heightens the risk of caries and gingivitis
initially, biofilm is dominated with gram _____ cocci (days 1-2), evolving to _____ ___ and ___ (days 2-10), with gingivitis clinically evident by days ___ to ___
positive
filamentous forms and rods
10 to 21
what is the composition of calculus
essentially calcified dental biofilm mineralized by calcium phosphate crystals. It is always covered with a layer of nonmineralized dental biofilm containing live bacteria
supragingival calculus
calculus that forms coronal to the gingival margin on clinical crowns w
where are minerals derived from in supragingival calc
saliva
common sited for supragingival calc
lingual surfaces of mandibular anterior teeth and facial surfaces of maxillsuary molars
subgingival calc
calc that forms apical to the gingival margin, extending toward the clinical attachment
where are minerals derived from in subgingival calc
gingival cervicular fluid
what does subgingival calc look like
dark brown, green, or black due to blood products and blood breakdown products
mechanism of calc mineralization
the process begins with the supersaturation of saliva or gingival crevicular fluid which drives mineralization. Degraded microorganisms provide a matrix, and initial crystals form by binding with bacterial wall phospholipids, crystal maturation, then the final stable phase occurs around 8 months
what is the average time for calculus formation
about 12 days for the primary deposit to occur
when does initial mineralization of calc occur
can begin in first 2 days with inadequate oral care
calculus is a secondary _____ factor because it serves as a resivoir for bacteria and endotoxins that contribute to dental caries and periodontal disease
etiologic
is supragingival or subgingival calc harder
subgingival
how is calc detected
through visual examination, compressed air, and with probe and explorers
significance of stain
dental stains are primarily significant for their appearance and cosmetic effect. Usually related and associated to calculus
extrinsic stain
occur on the external surfaces of the tooth and are removable by brushing, scaling, or polishing
instrinsic stain
occur within the tooth structure, representing changes in structural composition or thickness. They cannot be removed by scaling or polishing
internalized stain
extrinsic stains that become incorporated into defects in the tooths structure
exogenous stain
develop from sources outside the tooth
endogenous stain
develop from within the tooth and are always intrinsic
yellow stain
yellowish discoloration of biofilm, often generalized, more common in older adults, associated with dietary sources, tobacco use, inadequate oral care
green stain
primarily on the facial gingival third or maxillary anteriors. Composed of chromogenic bacteria and decomposed hemoglobin. Occurs mostly in childhood due to poor oral hygiene, biofilm retention, and gingival hemmorage
tobacco stain
incorporation in calc deposits. can penetrate irregularities in the enamel. Primary on lingual surfaces, but quantity isnt proportional to tobacco use
metallic stain
result from industrial metal containing dust
orange and red stain
rare, appear in the anterior teeth, possibly due to chromogenic bacteria and poor oral hygiene
____ is the primary etiologic factor for periodontal disease.
biofilm
if left undisturbed for appx 12 days, the growth of gram negative anaerobic bacteria increases, raising the risk of gingivitis
subgingival biofilm is predominantly composed of gram _____, ____ organisms
negative'
anaerobic
_____ serves as a resevoir for bacteria and endotoxins, thus acting as a secondary factor in the initiation and progression of periodontal disease
calculus
The nonmineralized layer of biofilm covering calculus contains live bacteria that elicit an inflammatory response