Preventive Dentistry: Lecture 1

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49 Terms

1
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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.

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how long does it take for the acquired pellicle to form

30-90 mins after brushing

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what is the function of the pellicle

mineral homeostasis, host defense, and lubrication

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what is mineral homeostasis

protecting against demineralization and serving as a scaffold for remineralization

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what are the host defenses of the acquired pellicle

antimicrobial proteins that control bacterial colonization

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biofilm

dental plaque - structured community of over 700 distinct microorganisms encapsulated in a self produced extracellular polymeric substance (EPS) matrix

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what does biofilm attach to

teeth, calculus, and prosthesis

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how is biofilm removed

typically with a toohbrush

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materia alba

loosley adherent, unstructured, white or grayish mass of oral debris and bacteria that lies over the dental biofilm

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what does materia alba look like

cottage cheese

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what is materia alba composed of

living and dead bacteria, desquamated epithelial cells, disintegrating leukocytes, salivary proteins, and food debris

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how is materia alba removed

basic mechanical self oral care

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food debris

unstructured, loosley attached particulate matter remaining after eating

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where does food debris typically accumulate

the cervical third of the tooth and proximal embrasures and can be vertically impacted into contacts

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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

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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

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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

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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

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what is quorum sensing

cell to cell communication

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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

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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

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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

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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

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supragingival calculus

calculus that forms coronal to the gingival margin on clinical crowns w

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where are minerals derived from in supragingival calc

saliva

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common sited for supragingival calc

lingual surfaces of mandibular anterior teeth and facial surfaces of maxillsuary molars

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subgingival calc

calc that forms apical to the gingival margin, extending toward the clinical attachment

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where are minerals derived from in subgingival calc

gingival cervicular fluid

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what does subgingival calc look like

dark brown, green, or black due to blood products and blood breakdown products

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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

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what is the average time for calculus formation

about 12 days for the primary deposit to occur

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when does initial mineralization of calc occur

can begin in first 2 days with inadequate oral care

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calculus is a secondary _____ factor because it serves as a resivoir for bacteria and endotoxins that contribute to dental caries and periodontal disease

etiologic

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is supragingival or subgingival calc harder

subgingival

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how is calc detected

through visual examination, compressed air, and with probe and explorers

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significance of stain

dental stains are primarily significant for their appearance and cosmetic effect. Usually related and associated to calculus

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extrinsic stain

occur on the external surfaces of the tooth and are removable by brushing, scaling, or polishing

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instrinsic stain

occur within the tooth structure, representing changes in structural composition or thickness. They cannot be removed by scaling or polishing

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internalized stain

extrinsic stains that become incorporated into defects in the tooths structure

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exogenous stain

develop from sources outside the tooth

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endogenous stain

develop from within the tooth and are always intrinsic

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yellow stain

yellowish discoloration of biofilm, often generalized, more common in older adults, associated with dietary sources, tobacco use, inadequate oral care

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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

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tobacco stain

incorporation in calc deposits. can penetrate irregularities in the enamel. Primary on lingual surfaces, but quantity isnt proportional to tobacco use

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metallic stain

result from industrial metal containing dust

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orange and red stain

rare, appear in the anterior teeth, possibly due to chromogenic bacteria and poor oral hygiene

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____ 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

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subgingival biofilm is predominantly composed of gram _____, ____ organisms

negative'

anaerobic

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_____ 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