Colonization of the cementum surface of teeth by oral Gram-negative bacteria

Therapeutic ratio quantifies laser antisepsis: Ablation ofPorphyromonas gingivalis with dental lasers

BACKGROUND AND OBJECTIVES

It is established that both pulsed Nd:YAG (1,064 nm) and continuous diode (810 nm) dental lasers kill pathogenic bacteria (laser antisepsis), but a quantitative method for determining clinical dosimetry does not exist. The purpose of this study was to develop a method to quantify the efficacy of ablation of Porphyromonas gingivalis (Pg) in vitro for two different lasers.

STUDY DESIGN/MATERIALS AND METHODS

The ablation thresholds for the two lasers were compared in the following manner. The energy density was measured as a function of distance from the output of the fiber-optic delivery system. Pg cultures were grown on blood agar plates under standard anaerobic conditions. Blood agar provides an approximation of gingival tissue for the wavelengths tested in having hemoglobin as a primary absorber. Single pulses of laser energy were delivered to Pg colonies and the energy density was increased until the appearance of a small plume was observed coincident with a laser pulse. The energy density at this point defines the ablation threshold. Ablation thresholds to a single pulse were determined for both Pg and for blood agar alone.

RESULTS

The large difference in ablation thresholds between the pigmented pathogen and the host matrix for pulsed-Nd:YAG represented a significant therapeutic ratio and Pg was ablated without visible effect on the blood agar. Near threshold the 810-nm diode laser destroyed both the pathogen and the gel.

CONCLUSIONS

Clinically, the pulsed Nd:YAG may selectively destroy pigmented pathogens leaving the surrounding tissue intact. The 810-nm diode laser may not demonstrate this selectivity due to its greater absorption by hemoglobin and/or longer pulse duration.

Colonization and persistence of rough and smooth colony variants of Actinobacillus actinomycetemcomitans in the mouths of rats

Fresh isolates of Actinobacillus actinomycetemcomitans (Aa) bind avidly to surfaces in vitro, but existing in vivo studies of the adherence of Aa are limited. This study had two goals: (1) to compare the oral colonization of two isogenic strains of Aa-CU1010, a clinical isolate that expresses the adherent phenotype, and CU1012, a minimally adherent laboratory variant-and (2) to check for phenotypic reversion of these strains in a clinical setting. Rifampicin-resistant strains, developed for tracking in Sprague-Dawley rats, were tested in vitro to determine their stability and binding. In study 1, after antibiotic suppression, six rats (group I) received CU1010 in their feed. The eight rats in group II received CU1012 in their feed and four were supplemented by oral swabbing and four by gastric gavage. Group III consisted of three sham-inoculated controls. All rats were inoculated for 4 days. Microbiological data were collected at 1, 4 and 8 weeks after inoculation. Supporting data were supplied by antibody titres and clinical measures of alveolar bone loss. Study 2 consisted of six rats in each of three groups as above, but tagged strains of Aa were delivered by food alone. At all time-points in both studies, Aa was absent before inoculation and controls had no Aa or antibody to Aa. In study 1, all six rats in group I yielded positive cultures for Aa at 8 weeks. In group II, five of eight had positive cultures for Aa at 1 week, two of eight at 4 weeks and none had Aa at 8 weeks (P < or =0.001). All six rats in group I had serum anti-Aa titres compared to group II, where titres were seen in four of eight rats (P < or =0.015). In vitro data paralleled those found in vivo. No phenotypic reversion of either strain was seen in vivo. In study 2, four of six rats in group I showed Aa and had titres to Aa, while no other animals showed Aa at any time. The model provides convincing evidence that, unlike laboratory variants, clinical isolates colonize, persist and integrate into an already established, albeit reduced, econiche.

In vitro colonisation of acrylic resin denture base materials by Streptococcus oralis and Actinomyces viscosus

AIM

The aim of the study was to compare the attachment of two typical strains of oral bacteria to four denture base materials.

DESIGN

In vitro study.

METHOD

Discs of acrylic resin denture base materials (Paladon 65, polished and unpolished; Palapress; Microbase, polished and unpolished, and Triad VLC) were placed into Petri dishes with Schaedler's medium, inoculated with Streptococcus oralis 34 or Actinomyces viscosus T14V.

MAIN OUTCOME MEASURES

After 24 h or 48 h the numbers of adhering bacteria were measured.

RESULTS

The bacteria adhered to all discs in similar numbers: 3-9 x 10(6)/ml (viable cell count) and 9-22 x 10(8)/ml (total cell count) for T14V, and 2-6 x 10(6)/ml (viable cell count) and 1.5-3 x 10(8)/ml (total cell count) for 34.

CONCLUSIONS

Polishing had little effect on adherence. Denture base materials are not resistant against adherence and possible surface damage by oral bacteria. Therefore, thorough oral hygiene is important for denture wearers.

Tenacious adhesion of Actinobacillus actinomycetemcomitans strain CU1000 to salivary-coated hydroxyapatite

Adherence of Actinobacillus actinomycetemcomitans to hard-tissue surfaces was evaluated by comparing a phenotypically stable, well-maintained clinical isolate (strain CU1000) to Streptococcus gordonii G9B, an extensively studied oral-colonizing bacterium. Standard innocula of radiolabelled bacteria were added to saliva-coated hydroxyapatite (SHA) and the ratio of bound to unbound cells counted. Several other clinical isolates as well as laboratory strain Y4 were studied. In other experiments, cell detachment from SHA was compared in static and shaking vessels to calculate controlled desorption of cells over time. A sonic-displacement assay was used to measure avidity of binding to HA and SHA. To better define the attachment properties of CU1000, bacteria were treated with a variety of agents including detergents, salts and enzymes before or after incubation with SHA. Results indicated that CU1000 bound better than G9B (a minimum of 10-fold greater; p < or = 0.05) and did not desorb from SHA, while G9B desorbed to equilibrium in 4 h. Furthermore, Langmuir isotherm calculations indicated that, unlike G9B, CU1000 did not follow second-order adsorption kinetics and thus did not achieve saturation. In addition, of the agents tested only periodate reduced attachment and resulted in detachment of CU1000 from surfaces. These experiments suggest that clinical isolates of A. actinomycetemcomitans possess unique binding properties that promote adsorption to and impede desorption from SHA. The characteristics described for the actinobacillus in this study have been previously underestimated, appear to be mediated by glycoconjugates, and may resemble attachment described for several biofilm-forming, non-oral pathogens.

The influence of oral bacteria on the surfaces of resin-based dental restorative materials--an in vitro study

Three tooth-coloured, resin-based restorative materials (Charisma, Dyract, and Pertac) were exposed to typical oral bacteria (S. mutans, S. oralis and A. naeslundii) over a period of up to 35 days. The three strains of bacteria all colonised the resin-based materials within a few hours and formed thick bacterial films. Determination of the bacterial glucose consumption and lactate production during the incubation period showed no difference from the controls which contained no resin samples. Following the experimental exposure, the materials were examined by scanning electron microscopy (SEM) for possible surface damage and roughness was measured in a perthometer. Little damage to the resin-based composite material surfaces (Charisma, Pertac) could be observed, whereas the polyacid-modified composite material (Dyract) showed greater damage. There was a significant difference in the resin surface roughness after exposure to S. mutans and to A. naeslundii. The study clearly showed that the bacteria used strongly adhered to the resin-based restorative materials. As a consequence of bacterial colonisation and/or poor oral hygiene, damage to the restorative materials might develop. This suggests the need for dentists to evaluate personal oral hygiene, along with general indications and economic factors, in selecting materials for restorations, since the known anti-bacterial properties of amalgam are considerable.

Microbial attachment and growth in fixed-film reactors: Process startup considerations

Optimal steady-state performance of any biofilm reactor requires a fully developed and mature biofilm. During fixed-film reactor startup phase, biofilm is in process of development and accordingly, process performance is difficult to quantify. Environmental, cellular and surface factors greatly influence the process of biofilm formation during reactor startup. Improved knowledge of nutritional, toxicological and environmental requirements of wastewater degrading microorganisms has helped define optimal microbial growth conditions. In case of anaerobic fixed film reactors the startup is hindered by low microbial growth rates, strict environmental requirements and limited ability of methanogens to adhere and form fixed biofilms. These obstacles could be overcome by proper support media selection and formulation of appropriate inoculation procedures and startup strategies.

In vitro attachment of bacteria to extracts of cementum

Cementum is a specialized mineralized tissue providing for the attachment of periodontal fibers to the root surface of a tooth. In periodontal disease this connective tissue attachment to the cemental surface is lost. The ability of bacteria to adhere to the root surface, an initial event in the disease process, may be influenced by the organic matrix of cementum. Therefore, an in vitro assay of cell attachment was modified to study bacterial adherence to protein extracts of cementum. Petri dishes coated with the extracts were pre-incubated in culture media and then bacteria were added. Using this assay, Capnocytophaga-like species, a gram negative bacterium implicated in periodontal disease, attached preferentially to dishes coated with cemental extracts when compared with Type I collagen or uncoated dishes. This assay system should prove beneficial for studying the attachment of various microorganisms to protein extracts of both normal and diseased cementum, as well as providing insight into the unique attachment properties of cementum.

Actinobacillus actinomycetemcomitans strains Y4 and N27 adhere to hydroxyapatite by distinctive mechanisms

Actinobacillus actinomycetemcomitans strains Y4 and N27 absorb to spheroidal hydroxyapatite in roughly the same numbers per milligram of substrate and with the same tenacity as two previously tested Cytophaga species. Although the two strains of A. actinomycetemcomitans exhibited similar affinities and number of binding sites for SHA, their response to enzyme treatment and heating were very different. The capacity of strain Y4 to attach to spheroidal hydroxyapatite was diminished by treatment with proteases and phospholipases and was unaffected by neuraminidase, while strain N27 was unaffected by proteases and phospholipases and lost its binding capabilities when treated with neuraminidase.

In vitro sorption of albumin, immunoglobulin G, and lysozyme to enamel and cementum from human teeth

Sorption of three 125I-labeled human proteins (albumin, immunoglobulin G, and lysozyme) to enamel and cementum was investigated. All three proteins sorped most when suspended in 0.0005 M solution of phosphate or calcium chloride where the least competition between solute ions and label occurred. The addition of human serum to labeled proteins caused a decrease in their sorption which could be partially reversed by increasing the concentration of label. Kinetic experiments demonstrated that sorption was dependent on protein concentration and incubation time and that most of the sorption occurred within the first minute of the reaction. In conclusion, the binding of the three labeled proteins was affected by the charge of the solute ions and was dependent on ion concentration and reaction time. Sorption correlated for the most part with the pK values of the proteins and thus lysozyme, the most basic protein, sorped more than immunoglobulin G, which sorped more than albumin. In all cases, cementum bound more basic protein than did enamel. Increased levels of albumin sorption to enamel occurred when the protein was suspended in the CaCl2 solution rather than in phosphate. In addition, based on Scatchard analysis, approximately twice as many potential protein binding sites were found for cementum versus enamel.

Optimization of an hydroxyapatite adhesion assay for Streptococcus sanguis

Previous studies have compared the adhesion of [3H]thymidine-labeled Streptococcus sanguis to saliva-coated hydroxyapatite (SHA) and buffer-coated hydroxyapatite (HA) beads. Although the hypotonic buffer used in these assays was adjusted to simulate saliva, it does not necessarily provide the optimal parameters for the quantitative estimate of adhesion under in vitro conditions. Optimization is necessary to provide the maximum sensitivity of the assay for detecting the effects of various salivas as well as for quantitating the effect of environmental growth conditions on the adhesion of S. sanguis to SHA and HA. A major distinction between the adhesion of S. sanguis to SHA and HA was observed when the bacterial concentration was varied. At high cell concentrations, the number of cells adhering to SHA was twice the number adhering to HA. Such differences were not detected at low cell concentrations. The optimal pH for the adsorption to both SHA and HA was 6. Changes in the ionic strength or addition of mono- or divalent cations found in saliva had little effect on adhesion to HA. In contrast, high concentrations of monovalent cations inhibited adhesion to SHA. Anions such as carbonate, chloride, and sulfate did not have specific effects on adhesion, whereas acetate inhibited adhesion to both SHA and HA. Fluoride inhibited adhesion to both SHA and HA, suggesting an interaction between fluoride and hydroxyapatite. These results indicated that 2 mM phosphate buffer at a pH of 6 containing 5 mM KCl and 1 mM CaCl2 was the optimal buffer for studying the in vitro adhesion of S. sanguis to SHA.

A rationale for management of periodontal diseases: rapid identification of microbial 'therapeutic targets' with phase-contrast microscopy

Monitoring the composition of subgingival flora can provide clinicians with a supplement to periodontal diagnosis and therapy. Conventional bacteriologic culturing may be clinically impractical, but direct microscopy may not.

Coaggregation of human oral Cytophaga species and Actinomyces israelii

A total of 19 strains of oral Cytophaga sp. obtained from subgingival plaque deposits were tested for their ability to coaggregate with strains of Actinomyces israelii, A. viscosus, A. naeslundii, Streptococcus sanguis, S. mutans, S. salivarius, and S. mitis. Coaggregation was observed only with A. israelii. Based on their coaggregation patterns with eight A. israelii strains, the Cytophaga strains were distributed among three distinct groups: those that coaggregated with A. israelii PK16 but not with A. israelii W1011 (ATCC 29322), those that coaggregated with A. israelii ATCC 29322 but not with A. israelii PK16, and those that coaggregated with none of the eight A. israelii strains. In each of the coaggregations, prior heat treatment (85 degrees C, 30 min) of the Cytophaga cells prevented coaggregation, whereas identical treatment of the A. israelii cells had no effect. The ability of A. israelii PK16 to form adherent plaque on a tooth surface previously coated with Cytophaga plaque was tested with one of the coaggregating Cytophaga strains. White patches of A. israelii plaque were found covering both the amber-colored Cytophaga plaque on the cementum surface as well as the enamel surface to which Cytophaga strains do not adhere. Electron micrographs of thin-sectioned mixed-plaque material revealed both cell types in close proximity. In addition, electron micrographs of negatively stained coaggregated cells showed interbacterial adherence between surface fimbrae on A. israelii and outer membrane blebs on the gram-negative Cytophaga sp. The kinetics of binding of A. israelii to spheroidal hydroxyapatite and to root powder were indicative of a high-affinity binding system with comparatively large numbers of available binding sites on both substrata. These results indicate the highly specific nature of Cytophaga sp.--A. israelii recognition. The contribution of such recognition toward the mechanisms that are responsible for the indigenous nature of these oral bacteria is discussed.

Suppression of murine lymphocyte mitogen responses by exopolysaccharide from Capnocytophaga ochracea

An extracellular polysaccharide was purified from culture supernatants of Capnocytophaga ochracea 25, a gram-negative bacillus associated with human periodontal disease. The extracellular polysaccharide suppressed in vitro mitogenic responses of murine splenic lymphocytes to concanavalin A and lipopolysaccharide. This suppression wad dose dependent, persisted up to 120 h, and was not caused by direct toxicity of the extracellular polysaccharide.

Endotoxin penetration into root cementum of periodontally healthy and diseased human teeth

This study was undertaken to determine the extent of in vitro penetration of E. coli endotoxin into the root cementum of periodontally healthy and diseased teeth. Freshly extracted teeth were washed in distilled water, scaled and divided into two groups of 16 teeth each. Nine diseased and five healthy teeth in the first group were immersed in various concentrations of E. coli endotoxin for 2 to 12 weeks. They were then prepared for indirect immunofluorescence examination after treatment with anti-endotoxin antibody and rhodamine conjugated secondary antibody. Teeth in the second group were prepared for autoradiographic examination by immersing nine diseased and five healthy teeth in tritium labelled E. coli endotoxin for 2 to 12 weeks. The latter technique also allowed for semi-quantitative study of the depth of endotoxin penetration by creating facets on the root at various depths after endotoxin exposure. This technique was also used to investigate the strength of endotoxin binding to the tooth surface by brushing for 1 minute and re-examining the tooth for the presence of endotoxin. Controls included periodontally diseased and healthy teeth. Results of the study showed that (1) endotoxin adheres to the tooth surface without penetration into the root cementum of either periodontally healthy or diseased teeth, and (2) the binding of the endotoxin to the root surface appears to be weak.

Attachment of oral Cytophaga species to hydroxyapatite-containing surfaces

Model systems simulating the cementum portion of teeth were used to characterize the attachment process by which certain species of oral Cytophaga initiate the colonization of the tooth root surface in vitro. The adsorption of these bacteria to spheroidal hydroxyapatite beads and mechanically powdered root material followed Langmuir isotherm kinetics. From such data, the number of binding sites per 20 mg of substrate and the affinity constants were evaluated for two strains of Cytophaga sp. Resting cells of the two strains tested adhered relatively tenaciously to hydroxyapatite beads in numbers similar to those observed with cells of Streptococcus sanguis. Attachment of bacteria to the substrates was partially inhibited by (i) coating the substrates with human serum or saliva, (ii) pretreating cell suspensions with proteinase K or phospholipase C or D, or (iii) exposing the cells to temperatures greater than 60 degrees C for 15 min. Treating resting cell suspensions with pronase, neuraminidase, phospholipase A2, or 0.1 M ethylenediaminetetraacetic acid had no effect on the attachment process.

Attachment of bacteria to mammalian surfaces

Much attention has been devoted to the study of bacterial adherence to mammalian surfaces in vitro during the past several years. Some in vivo evidence also suggests that this process may indeed be an integral part of the pathogenesis of colonization and certain infections. The biochemical basis of attachment and definition of the actual receptor sites involved are just starting to become known and seem to be different amongst individual bacteria genera. However, pili may mediate attachment of a variety of gram-negative organisms to receptor cells, and streptococcal lipoteichoic acids probably serve a similar function. Some recent study methods and results in this field are reviewed.