Impact of Dental Plaque Biofilms in Periodontal Disease: Management and Future Therapy

Abstract

Oral cavity represents an ideal environment for the microbial cell growth, persistence, and dental plaque establishment. The presence of different microniches leads to the occurrence of different biofilm communities, formed on teeth surface, above gingival crevice or at subgingival level, on tongue, mucosa and dental prosthetics too. The healthy state is regulated by host immune system and interactions between microbial community members, maintaining the predominance of "good" microorganisms. When the complexity and volume of biofilms from the gingival crevice increase, chronic pathological conditions such as gingivitis and periodontitis can occur, predisposing to a wide range of complications. Bacteria growing in biofilms exhibit a different behavior compared with their counterpart, respectively planktonic or free cells. There have been described numerous mechanisms of differences in antibiotic susceptibility of biofilm embedded cells. Resistance to antibiotics, mediated by genetic factors or, phenotypical, due to biofilm formation, called also tolerance, is the most important cause of therapy failure of biofilm-associated infections, including periodontitis; the mechanisms of tolerance are different, the metabolic low rate and cell's dormancy being the major ones. The recent progress in science and technology has made possible a wide range of novel approaches and advanced therapies, aiming the efficient management of periodontal disease.

The biofilm‐associated bacterial infections unrelated to indwelling devices

“…They do not cause any disease, but instead, they impede pathogenic species from adhering to mucosal surfaces. Dental plaque biofilms represent a multibacterial community, consisting of Fusobacterium, Streptococcus, Veillonella, Actinomyces, Prevotella, Porphyromonas, Neisseria, Eubacteria, Treponema, Lactobacterium, Haemophilus, Eikenella, Capnocytophaga, Peptostreptococcus, Leptotrichia, Propionibacterium, and Staphylococcus …”

“…Later, bacterial cells bind the pellicle, leading to the interplay between particular adhesins and compositions (fimbriae, glycocalyx, and capsule) as well as the complementary receptors. Gram‐positive cocci are the primary colonizers ( Streptococcus mutans , Streptococcus mitis , Streptococcus sanguis , Streptococcus oralis , Rothia dentocariosa , and Staphylococcus epidermidis ), followed by Gram‐positive rods, actinobacteria ( Actinomyces israelii and Actinomyces viscosus ), and several Gram‐negative cocci . The adhered bacteria form various exopolymers such as glucan that are involved in the expansion of the biofilm matrix and facilitate the aggregation of other bacterial species.…”

“…The presence of various bacterial cells in the human oral cavity leads to different biofilm types, such as the supra‐gingival plaque, the sub‐gingival plaque, plaque on the tongue and the mucosal surfaces, and biofilms developed on dental prosthetics and implants. Some bacterial species strongly adapt to certain conditions; for instance, based on oxygen requirements, bacteria can be categorized as obligate anaerobes (Fusobacterium and Veillonella), obligate aerobes, facultative anaerobes (Actinomyces and Streptococci), microaerophiles preferring low O2 levels (from 2 to 10%), and capnophiles (bacteria such as Neisseria that grow better in the presence of CO 2 concentrations, ranging from 5 to 10%) …”

“…Spirochetal bacteria are more commonly found in patients suffering from periodontal disorders compared to healthy individuals. Two significant spirochetes, Treponema denticola and Treponema vincentii , are also associated with periodontal disorders that have the ability to produce proinflammatory lipopolysaccharides and uncommon metabolic products, such as hydrogen sulfide, ammonia, and indole which are toxic to the human cells . Besides bacterial components, genetic, behavioral, and physiological determinants also contribute to the immunopathogenesis of periodontal disorders.…”

Health Literacy Associations with Periodontal Disease among Slovak Adults

“…Periodontitis is a microbial infection that is manifested by inflammation of the gingival tissue. Bacteria, especially gram-negative species, damage the pendulum apparatus of the teeth, forming a subgingival biofilm [7]. Our immune system reacts to its presence and pro-inflammatory molecules are released.…”