biofilm dan plak

8/19/2019 Biofilm Dan Plak

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Plak (Plaque)

drg. Puspito Ratih H Sp Perio


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Tujuan pembelajaran

• Menjelaskan respon imun terhadapplak

•

Menjelaskan plak (sifat sismikroorganisme)


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• !bnu Sina "#$i%enna The &anon ofMedi%ine sekresi tubuh organismeinang terkontaminasi %emaran

organisme asing 'ang tidak dilihatmata telanjang sehingga terjadiinfeksi

•

illoughb' Miller (*+,,an) important %ausal role of oral ba%teriain the etiolog' of dental %aries


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• *-,an peran plak sbg etiologiperiodontitis /H jelek akumulasiplak 00 pen'akit periodontal


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• Human fetus inside uterus is sterile it passes through the birth %anal a%quires $aginal and fe%al

mi%roorganism

• ithin 1 2eeks mature mi%robiotain the gut of ne2born bab'

• &oloni3ation of oral %a$it' also starts%lose to the time of birth


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ental plaque is a host4asso%iated biolm. The biolm %ommunit' is initiall' formedthrough ba%terial intera%tions 2ith thetooth and then through ph'si%al andph'siologi% intera%tions among di5erent

spe%ies 2ithin the mi%robial mass.


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Dental plaque can be defned as the sot depositsthat form the biolm adhering to the tooth surfa%e or

otherhard surfa%es in the oral %a$it' in%luding remo$ableand6ed restorations.

Plaque is di5erentiated from other deposits that ma'be found on the tooth surfa%e su%h as materia albaand %al%ulus.

Materia alba soft a%%umulations of ba%teria and

tissue %ells that la%k the organi3ed stru%ture ofdental plaque and are easil' displa%ed 2ith a 2aterspra'.

Calculus is a hard deposit that forms b'minerali3ation of dental plaque and is generall'


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7omposisi plak

• Mikroorganisme *gr plak tdd 0 8,, sp%

• M'%oplasma 'eastsproto3oa $irus

• Matriks interseluler(1,49,: massa plak)

• /rganik dan anorganik

dari sali$a ;&


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ental plaque ma' be readil' $isuali3ed on teeth after *to 1 da's 2ith no oral h'giene measures. Plaque is 2hitegra'ish or 'ello2 and has a globular appearan%e.

Plaque is t'pi%all' obser$ed on the gingi$al third of thetooth surfa%e 2here it a%%umulates 2ithout disruption b'the mo$ement of food and tissues o$er the tooth surfa%e

during masti%ation.

Plaque deposits also form preferentiall' in %ra%ks pitsand ssures in the tooth stru%ture> under o$erhanging

restorations>and around malaligned teeth.

The lo%ation and rate of plaque formation $ar' amongindi$iduals determining fa%tors in%lude oral h'giene as

2ell as host


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Tahapan pembentukan plak


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Pembentukan pelikel


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The me%hanisms in$ol$ed in enamel pelli%le formationin%lude ele%trostati% $an der aals and h'drophobi%for%es.

The h'dro6'apatite surfa%e has a predominan%e ofnegati$el' %harged phosphate groups that intera%tdire%tl' or indire%tl' 2ith positi$el' %harged%omponents of sali$ar' and %re$i%ular ?uid

ma%romole%ules.

Pelli%les fun%tion as a prote%ti$e barrier pro$idinglubri%ationfor the surfa%es and pre$enting tissue desi%%ation

pro$ide a substrate to 2hi%h ba%teria in theen$ironment atta%h.

The epithelial tissue %ells are %ontinuall' sloughed theba%terialpopulation on the tissue surfa%es is %ontinuall'disrupted.


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!nitial adhesi bakteri

ithin a fe2 hours ba%teria are found onthe dental pelli%le.

The initial ba%teria %oloni3ing the pelli%le4

%oated toothsurfa%e are predominantl' gram4positi$efa%ultati$e mi%roorganisms su%h as

Actinomyces viscosus and Streptococcus

sanguis.

These initial colonizers adhere to the pelli%le1*1@A9 through spe%i% mole%ules termed

adhesins on the ba%terial surfa%e that


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&ells of A. !iscosus possess brous proteinstru%tures %alled fmbriae that e"tend from theba%terial %ell surfa%e. Protein adhesins on thesembriae spe%i%all' bind to proline4ri%h proteinsthat are found in dental pelli%leA9 resulting in theatta%hment of the ba%terial %ell to the pelli%le4%oated toothsurfa%e.

The plaque mass then matures through the gro2thof atta%hed spe%ies as 2ell as the %oloni3ation andgro2thof additional spe%ies. #n this ecologic succession othe

bioflm there is a transition rom the early aerobic


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7olonisasi

Se%ondar' %oloni3ers are the mi%roorganisms that do notinitiall' %oloni3e %lean tooth surfa%es in%luding &revotellaintermedia &revotella loescheii Capnocytophagaspp. 'usobacterium nucleatum and &orphyromonasgingivalis.

These mi%roorganisms adhere to %ells of ba%teria alread'in the plaque mass.

B6tensi$e laborator' studiesha$e do%umented the abilit'of di5erent spe%ies andgenera of plaque mi%roorganisms

to adhere to one anothera pro%ess kno2n ascoaggregation.

This process occursprimaril' through the highl' spe%i%stereo%hemi%alintera%tion of protein and %arboh'dratemole%ules lo%atedon the ba%terial %ell surfa%esC C in


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The signi%an%e of %oaggregation in oral %oloni3ation has

been do%umented in studies of biolm formation in $itroDas 2ell as in animal model studies se%ondar' %oloni3ers2ith earl' %oloni3ers in%lude the %oaggregation of '.(ucleatum 2ith S. sanguis) * &. loescheii %ith A.!iscosus and Capnocytophaga ochracea %ith A.

viscosus.

Most studies of %oaggregation ha$e fo%used onintera%tions among di5erent gram4positi$e spe%ies andbet2een gram4positi$e

and gram4negati$e spe%ies.!n the latter stages of plaque formation %oaggregationbet2een di5erent gram4negati$e spe%ies is likel' topredominate. B6amples of these t'pes of intera%tions arethe %oaggregation of '. nucleatum2ith P. +ingivalis or Treponema denticola


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Long-standing supragingival plaque near thegingivalmargin demonstrates "corncob"arrangement. A central gramnegative

flamentous core supports the outer coccalcells, which arefrmly attached by


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S%anning ele%tron photomi%rograph of %ross se%tion of%ementum

(& 2ith atta%hed subgingi$al plaque (#P). #rea sho2n is2ithin a periodontal po%ket. (&ourtes' r. E. Sottosanti Fa Eolla &alif.)


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Bio flm constitutes

# bioflm an aggregate ofmi%roorganisms in 2hi%h %ells are stu%kto ea%h other and"or to a surfa%e.

These adherent %ells are frequentl'embedded 2ithin a self4produ%edmatri6 of e6tra%ellular pol'meri%substan%e (BPS).

Giolm BPS 2hi%h is also referred to asCslimeC is a pol'meri% jumble of =#proteins and pol'sa%%harides.


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Bioflm is a complexsubstance.

# biolm is a %omple6aggregation of

mi%roorganismsgro2ing on a solid

substrate. Giolms are%hara%teri3ed b'

stru%tural

heterogeneit'

geneti% di$ersit'

%omple6 %ommunit'intera%tions and ane6tra%ellular matri6 of

pol'meri% substan%es.


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Giolms found in =ature e$er'2here2here is there is moisture

• More properly ,no%n as bioflm slimecities thrive-lie %herever there is %ater$ in the ,itchen on contact lenses in

the gut linings o animals. hen theurban spra%l is e"tensive bio flms canbe seen %ith the na,ed eye coating theinside o %ater pipes or dangling

slippery and green licin menggntg rom plumbing.C !oghlan ##$%


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Bioflm supports theBacterial growth

• Giolm are a %ommon mode of ba%terialgro2th in nature and their presen%e has anenormous impa%t on man' aspe%ts of ourli$es su%h as se2age treatment %orrosion of

materials food %ontamination duringpro%essing pipe %ollapse plant4mi%roorganisms intera%tion in the biospherethe formation of dental plaque the

de$elopment of %hroni% infe%tions in li$etissue (mastitis /titis pneumonia urinar'infe%tions osteom'elitis) or problems relatedto medi%al implants.


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&ormation o' Bioflms

• Giolms ma' formon li$ing or non4li$ing surfa%es

and represent apre$alent mode ofmi%robial life innatural industrialand hospitalsettings


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Giolms in%reases #ntibioti%resitan%e

ithmi%roorganisms

are highl'resistant toantimi%robialtreatment and are

tena%iousl' bound"kuat to thesurfa%e


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Me%hanisims of Giolmformation

• &ormation o' a bioflmbegins with theattachment o' 'ree-(oating microorganismsto a sur'ace. )hese frstcolonists adhere to thesur'ace initially throughwea*, reversible van der+aals 'orces. ' thecolonists are notimmediatelyseparated 'rom thesur'ace, they can

anchor themselvesmore permanentlyusing cell adhesionstructures such as pili


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teps in Bioflmevelopment

• Giolm de$elopment %anbe di$ided into se$eralke' steps in%ludingatta%hment mi%ro%olon' formation biolmmaturation anddispersion> and in ea%hstep ba%teria ma' re%ruitdi5erent %omponents

and mole%ules in%luding?agella t'pe ! pili =#and e6o pol'sa%%harides.


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tages o' bioflmdevelopment.


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Bacteria associated withBioflms di/er

• Ga%teria li$ing in a biolm %an ha$esigni%antl' di5erent properties fromfree4?oating ba%teria as the dense andprote%ted en$ironment of the lm allo2sthem to %ooperate and intera%t in $arious2a's. /ne benet of this en$ironment isin%reased resistan%e to detergents andantibioti%s as the dense e6tra%ellularmatri6 and the outer la'er of %ells prote%tthe interior of the %ommunit'.


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Giolms major %ause of=oso%omial infe%tions

• Mi%robial biolms2hi%h often areformed b'

antimi%robial4resistantorganisms areresponsible for

A8: of infe%tionstreated in thede$eloped 2orld.

Gi l ; h


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Giolms a ;reat threat to!mplants

• # signi%ant number of people area5e%ted b' biolm infe%tions 2hi%hde$elop on medi%al de$i%es implanted in

the bod' su%h as %atheters (tubes usedto %ondu%t ?uids in or out of the bod')arti%ial joints and me%hani%al heart$al$es. hen implanted material

be%omes %oloni3ed b' mi%roorganisms aslo2 de$eloping but persistent infe%tionresults.


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Giolms a ;ro2ing %on%ern inModern Medi%ine

• Prostheti% de$i%e infe%tions su%h asthose in$ol$ing arti%ial heart $al$esintra$as%ular %atheters or prostheti%

joints are prime e6amples of biolm4asso%iated infe%tions. ith thein%reasing use of su%h de$i%es in the

modern pra%ti%e of medi%ine thepre$alen%e of these infe%tions ise6pe%ted to in%rease.


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ental plaques

• The formation ofdental plaque biolms in%ludes aseries of steps thatbegins 2ith theinitial %oloni3ationof the pelli%le andends 2ith the%omple6 formationof a mature bio lm.


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&ormation o' ental Bioflms

• #dditionall' throughthe gro2th pro%ess ofthe plaque bio lm themi%robial %omposition

%hanges from one thatis primaril' gram4positi$e andstrepto%o%%us4ri%h to astru%ture lled 2ith

gram4negati$eanaerobes in its moremature state.

&ell %ell signaling (e6 quorum sensing)


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&ell4%ell signaling (e6. quorum sensing)and %ommuni%ation 2ith di5erent ba%teria

enhan%e Giolm formation


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Bioflms everywhere

• The'Dre e$er'2hereIon 'our sho2er%urtain on medi%alde$i%es implanted in

patients on ro%ks inri$ers and streamsand in 'our nose.hile the sheer

number of di5erentorganisms a biolmma' %ontain makes ita %hallenge to stud'


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Giolm and #ntibioti%


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Giolm and #ntibioti%resistan%e

• # ke' propert' of biolms is that indi$idualmi%roorganisms arebound together b' a

pol'meri% substan%ee6%reted b' themi%roorganisms.. Thisprote%ti$e

en%apsulation isbelie$ed to pla' a rolein some antibioti%4resistant infe%tion.

Ga%terial resitan%e and


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Ga%terial resitan%e andGiolms

• #nother area of great importan%e from apubli% health perspe%ti$e is the role ofbiolms in antimi%robial4drug resistan%e.Ga%teria 2ithin biolms are intrinsi%all'more resistant to antimi%robial agentsthan plank toni% %ells be%ause of thediminished rates of mass transport ofantimi%robial mole%ules to the biolmasso%iated %ells or be%ause biolm %ellsdi5er ph'siologi%all' from plank toni%%ells


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biofilm dan plak

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