A comparative investigation in dogs: 2-year morphometric results of the dental implant--bone interface.

One hundred twenty titanium and ceramic root-form and titanium blade implants were placed into 30 dog mandibles. Twenty-four implants in six control dogs (in situ for 5 months) did not receive prostheses. Ninety-six implants in 24 dogs supported prostheses for 6, 12, 18, or 24 months. Computerized morphometry data presented the percent of the implant surface apposed directly by bone. A three-way factorial analysis of variance was used to assess significance. Individual implant means ranged from 0% (mobile implant) to 71% bone adaptation. From these data, two-stage titanium root-form implants were shown to be apposed by more bone than the other five systems, and overall, titanium implant systems were apposed by more bone than ceramic systems. Between 41% and 50% of the surface of integrated ceramic implants were apposed by bone, whereas between 50% and 65% of the surfaces of titanium implants were apposed by bone. Also, two-stage surgery for blade implants appears important for implant success. Furthermore, the use of Nomarski differential illumination appears to be useful for examining the quality of interfacial bone to correlate with the amount of bone quantified by morphometric protocols.

A microbiological study of recurrent dentinal caries.

A cross-sectional microbiological study of recurrent (secondary) dentinal caries was conducted. Freshly extracted human teeth containing amalgam restorations judged to be clinically intact were scrubbed with chlorhexidine soap and soaked in povidone-iodine solution. The teeth were then split to remove the fillings and examined for dentinal caries. Of 54 teeth examined, 22 (40%) were free of dentinal caries in the restored site. The remainder were assigned to arbitrary groups of questionable (15), initial (8) and active caries (9), based on the amount of dentinal decay observed. Comparison of pre-extraction bite-wing radiographs with the in situ findings revealed the sensitivity for secondary caries detection to be only about 50%. In contrast, the specificity for absence of caries was 73%. There was considerable variation in the numbers and types of micro-organisms found in dentine samples from lesions of comparable severity. Facultatively, anaerobic streptococci were the most numerous and most prevalent micro-organisms in the affected dentine, but no single species was significantly associated with recurrent caries. Mutans streptococci were found in 40% of sites with any degree of caries and in only 3 of the 9 sites with the most caries. Homofermentative lactobacilli were present in 18 of the 54 dentine samples, including 4 from caries-free sites. While the prevalence and numbers of lactobacilli increased with the degree of caries, they occurred in less than half of the affected dentine samples. Actinomyces occurred in 15 of 32 affected sites but only in 2 of the 9 most active sites. Their numbers never exceeded 3 x 10(3) CFU/mg.(ABSTRACT TRUNCATED AT 250 WORDS)

Biochemical properties of Streptococcus sobrinus reisolates from the gastrointestinal tract of a gnotobiotic rat.

Streptococcus sobrinus strain 6715-13-201 was inoculated into the oral cavity of a gnotobiotic rat and then reisolated from different portions of the gastrointestinal tract. Fourteen isolates, selected on the basis of their colonial morphology, were then screened for their ability to adhere to saliva-coated hydroxyapatite (SHA) in vitro, and their ability to produce extracellular polysaccharide from sucrose, and low pH in glucose broth. Certain isolates were also tested for their cariogenic potential as monoinfectants in gnotobiotic rats. All isolates differed in their abilities to adhere to SHA, with most showing an increased level of adhesion in the presence of sucrose, but this did not correlate with their ability to be aggregated by dextran. Most isolates were capable of producing glucosyltransferases (with only one exception) and dextranases (also one exception). There was more variability in the production of dextranase inhibitor. No isolate was capable of producing dextranase inhibitor in the absence of dextranase production. There were no correlations between the ability of isolates to adhere in vitro or produce/utilize polysaccharides and their ability to produce caries in vivo. Due to the differences between strains in their abilities to adhere, produce polysaccharides, utilize polysaccharides or produce a low pH and the lack of correlation between any of these parameters and cariogenicity, the results suggest that the ability of strains to colonize and produce caries depends on a number of different characteristics, no one of which is essential.

Cariogenicity of a lactate dehydrogenase-deficient mutant of Streptococcus mutans serotype c in gnotobiotic rats.

A lactate dehydrogenase-deficient (Ldh-) mutant of a human isolate of Streptococcus mutans serotype c was tested in a gnotobiotic rat caries model. Compared with the wild-type Ldh-positive (Ldh+) strains, it was significantly (alpha less than or equal to 0.005) less cariogenic in experiments with two different sublines of Sprague-Dawley rats. The Ldh- mutant strain 044 colonized the oral cavity of the test animals to the same extent as its parent strain 041, although its initial implantation was slightly but not significantly (P greater than or equal to 0.2) less. Multiple oral or fecal samples plated on 2,3,5-triphenyltetrazolium indicator medium revealed no evidence of back mutation from Ldh- to Ldh+ in vivo. Both Ldh+ strain 041 and Ldh- strain 044 demonstrated bacteriocinlike activity in vitro against a number of human strains of mutans streptococci representing serotype a (S. cricetus) and serotypes c and e (S. mutans). Serotypes b (S. rattus) and f (S. mutans) and strains of S. mitior, S. sanguis, and S. salivarius were not inhibited. Thus, Ldh mutant strain 044 possesses a number of desirable traits that suggest it should be investigated further as a possible effector strain for replacement therapy of dental caries. These traits include its stability and low cariogenicity in the sensitive gnotobiotic rat caries model, its bacteriocinlike activity against certain other cariogenic S. mutans (but not against more inocuous indigenous oral streptococci), and the fact that it is a member of the most prevalent human serotype of cariogenic streptococci.

Inhibition of caries in hamsters treated with staphylococcin 1580.

Littermate hamsters were infected orally with cariogenic Streptococcus mutans NS-50S and maintained on a high-sucrose diet to induce dental caries. Individual groups of animals were treated by single daily instillation of staphylococcin 1580 (100 micrograms) in the cheek pouches. Other groups were treated similarly with bacitracin (60 or 120 U) or saline. After 35 days on the caries test regimen, animals treated with staphylococcin 1580 had 49 or 60% less caries than the saline controls in two separate trials. Hamsters treated with 60 U of bacitracin had 40% less caries, while animals receiving 120 U of bacitracin had 58% less caries. Significant reductions in the oral and fecal levels of S. mutans NS-50S were also observed in the treated animals. In contrast to earlier, inconclusive experiments in which these agents were placed directly into the oral cavity, the inhibition of caries in this study is attributed to prolongation of the oral retention of these agents, with increased opportunity to interact with cariogenic microorganisms.

Effects of chlorhexidine gluconate in drinking water on dental caries and oral microorganisms in the Syrian hamster.

Hamsters infected with Streptococcus sobrinus (formerly Streptococcus mutans) strain 6715-1119 were given high-sucrose diet 2000. After 5 days, they were presented with 0.05 or 0.1 per cent w/v chlorhexidine gluconate (CHX) continuously in their drinking water, which was well-tolerated. Compared to infected but untreated controls, their caries scores were less by 84 and 97 per cent respectively after 42 days. Coronal dental plaque deposits were reduced in a dose-related fashion. Culture plates of oral swabs showed reductions in Strep. sobrinus and total streptococci after 10 and 35 days of CHX. Hamster oral streptococci were more sensitive to CHX than were lactobacilli but neither was completely eliminated. The incidence of stained tooth deposits after 0.1 per cent CHX was slightly but not significantly greater than in controls.

Prevalence, distribution of serotypes, and cariogenic potential in hamsters of mutans streptococci from elderly individuals.

The prevalence of mutans streptococci (Streptococcus mutans, Streptococcus cricetus, Streptococcus sobrinus, and Streptococcus rattus) was determined in the salivas of 169 elderly individuals ranging in age from 60 to 87 years. Approximately 40% of these individuals were edentulous and wore full upper and lower dentures. With the exception of a higher proportion of saliva counts below 1,000 CFU/ml in the full-denture wearers, the prevalence and the serotype and species distributions of the mutans streptococci were similar in the denture wearers and individuals with natural teeth only. The species and serotype distributions of mutans streptococci in this elderly population were also consistent with reported observations of other workers on younger, more caries-prone populations. A total of 87 representative isolates of the mutans streptococci were tested for cariogenic potential in a hamster model system. A considerable degree of variation in virulence between different strains was observed. However, these differences were not relatable to individual species or serotypes or to whether the organisms were isolated from denture wearers or naturally dentate subjects. The results of our studies indicate that elderly individuals with either natural or artificial dentitions may be a hitherto unrecognized reservoir of mutans streptococci having varying degrees of potential cariogenicity. Hence, in close family situations they could serve, along with parents and siblings, as vectors in the initial transmission of cariogenic microorganisms to young children.

Cariogenicity of human plaque lactobacilli in gnotobiotic rats.

Thirty-two strains of Lactobacilli, comprising eight species and obtained from human dental plaque or other sources, were tested for cariogenic potential in gnotobiotic Sprague-Dawley rats receiving modified cariogenic Diet 2000. Seventeen of these strains were moderately to highly cariogenic, and only one, a strain of Lactobacillus lactis, was scored as non-cariogenic. The molar fissures were the predominant site of caries attack. Primary lesions of the smooth surfaces were infrequently seen, although these surfaces were often secondarily involved by the extension of fissure lesions. . The preferential location of caries in the sheltered fissure sites was attributed to their inability to form adherent plaque deposits on the smooth surfaces of the teeth. Caries production by a strain of L. salivarius was equally severe on sucrose- or glucose-containing versions of Diet 2000, but glucose was less supportive of caries development than sucrose for a strain of L. fermentum. It is concluded that a wide variety of lactobacilli may be cariogenic under favorable environmental conditions.

Cariogenicity of human oral lactobacilli in hamsters.

Of 50 strains of lactobacilli isolated from dental plaque of school children, two strains, provisionally identified as Lactobacillus salivarius, and one strain, provisionally identified as Lactobacillus fermentum, induced significant caries activity in conventional hamsters. Sucrose was a required dietary cariogenic substrate and could not be replaced with glucose or starch. In contrast to cariogenic strains of Streptococcus mutans the active lactobacilli did not form adherent sucrose-mediated plaques in vitro, did not form intracellular iodophilic polysaccharides and did not form detectable insoluble extracellular polyglucans.

Amino acid requirements and proteolytic activity of Streptococcus sanguis.

The growth response of Streptococcus sanguis groups 1:A and 1:B in a complete chemically defined medium was not influenced by the oxygen concentration of the growth atmosphere. All of the cultures required cysteine and arginine; tyrosine and branched-chain amino acids were frequently required. Proteolysis of casein, mucin, and the anionic proteins of germfree rat saliva by S. sanguis was demonstrated. Hydrolytic activity toward casein was found in the soluble contents of the cells and in the cellular debris after disruption of the cells, with the soluble fractions exhibiting greater proteolytic activity toward casein. The soluble fractions from S. sanguis did not hydrolyze mucin, but this substrate was hydrolyzed by the cell debris fraction. When the amino acid requirements and proteolytic activity of S. sanguis and S. mutans were compared, these two oral streptococcal species exhibited distinct and characteristic differences.

Increased selectivity of Mitis-Salivarius agar containing polymyxin.

Incorporation of the antibiotic polymixin B sulfate in plates of Mitis-Salivarius medium at a level of 100 U per ml effectively suppressed the growth of gram-negative spreading organisms which occasionally overgrow Mitis-Salivarius plates of oral samples and make them unsuitable for enumeration and differentiation of streptococci. At the indicated level the antibiotic did not affect the growth or typical colonial characteristics of the oral streptococci.