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(1) Tooth surface, (2) Filling materials, (3) Crowns, (4) Orthodontic appliance, (5)
Denture
plaque formation
(1) Absence of food intakes
(2) Consistency of food: hard, friction, fibrous
(3) composition
(1) Microorganism, (2) Epithelial cell, (3) Leukocyte, (4) Macrophage, (5) matrix
Plaque matrix
- plaque volume 25%
-
a. Altered glycoprotein from saliva and crevicular fluid
b. Bacterial destransm levans and other sugar polymers
c. Bacterial metabolites and extracellular enzymes
d. Bacterial cell wall, cytoplasmic constituents
-
a. Organic CHO(30%), protein(30%), lipid
b. Inorganic Ca, Mg, phosphorus
Supragingival plaque
Subgingival plaque
biofil
m
Acquired pellicle
Attached to gingival epithelial and
tooth surfaces (adhesion on pellicle
mass growth and maturation )
2-4 hours. Irreversible bactieral
colonization
Gram(+) facultative cocci
* subgingival plaque
Attached zone
G(+)
No extend junctional epithelium
Associated root caries, calculus, root
resorption
Food debris
Acquired
pellicle
Cuticle
Calculus
soft accumulation of bacteria and tissue cell that lack of organized structure of
dental plaque
Yellow, grayish white soft sticky deposit
Microorganism, desquamated epithelial cell, leukocyte, salivary of PT, lipids
Less adherent can be flushed away by water spray
(1) Dental plaque is not a derivative of food debris
(2) Not an important cause of gingivitis
an acellular, bacteria free, granular and heterogenous material coating of
variable thickness
derived from saliva and crevicular fluid, also from bacterial and host tissue cell
products
selective adsorption of environmental macromolecules electrostatic, van der
Waals force
Organic component
(1) PT-polysaccharide complex
(2) Desquamated epithelial cell
(3) Leukocytes
(4) microorganism
Prevelance:
(1) supragingival calculus reaching a maximum at 25-30 y/o
(2) subgingivally no teeth without calculus by age 30
(3) increase with age
(4) Norway: molar and lingual of lower anterior teeth with 80% at teenage, no
increase with age
Mineral
source
Supragingival calculus
White, whitish yellow
Hard, clay like
Easy detach
Saliva
Subgingival calculus
Dark brown, greenish black
Hard, flint like
Firm attach
Gingival fluid
eruption
Preschool
child
4. Microorganism in saliva
(1) 750 million per mm
(2) G(+) facultative cocci (streptococci 45%), fungi, virus, mycoplasma
5. Flora (healthy gingiva v.s. gingivitis)
Normal flora (healthy gingivae)
Streptococci, Actinomyces (85%)
Non-motile : motile = 40 : 1
G(-) P. intermedius, P. gingivalis
Flora in gingivitis
(initial) Streptococci to Actinomyces
(gingivitis with bleeding) A. viscosus,
bacteroids
GI: 3
P. gingivalis 31.8%
6. Pregnant gingivitis:
P. intermedia, associated with estrogen, progesterone
7. Acute Necrotizing Ulcerative Gingivitis (ANUG)
Treponema 32%,P. melaminogenicus 26%, Selenomonas 6%, Fusobacterium 3%
8. Periodontitis
(1) G(-) anaerobes, motile
(2) Non-motile : motile = 1 : 1
(3) P. gingivalis 40%, Spirochetes 30%
(4) Attachment loss associate spirochetes
9. Flora associated early-onset form periodontitis
(1) Juvenile periodontitis:
Actinobacillus actinomycetemcomitans, Haemophilusm, P. gingivalis, Fusobacterium
nucleatum, Eikenella corrodens
(2) Child periodontitis:
Fusobacterium, Selenomonas Wolinella, Capnocytophaga
10. Rapidly progressive periodontitis
P. gingivalis, P. melaninogenius, Wolinella Haemophilus, Spirochetes