Biofilms and Periodontal Disease

Biofilms and Periodontal Disease is organized by Homestead Schools, Inc.

Learning Objectives
After completing the course, you'll be able to:
• Define the term biofilm.
• Explain the difference between planktonic organisms and biofilm organisms.
• Describe how bacteria adhere to a surface.
• Discuss how biofilm bacteria communicate with each other.
• Explain the difference between primary and secondary colonizers.
• Explain the term ‘bridging’ between early and late colonizers.
• Discuss the goals of periodontal therapy.
• Discuss biofilm resistance to antimicrobial agents and the host immune system.
• Discuss the significance of Aggregatibacter actinomycetemcomitans (formerly Actinobacillus actinomycetemcomitans), Porphyromonas gingivalis, and Fusobacterium nucleatum as periodontal pathogens.
• Describe the effect of periodontal therapy on subgingival microbiota.
• Discuss the diversity of antimicrobials used to treat periodontal disease.
• Describe the bacterial recolonization of periodontal pockets.
• Explain the ramifications of total eradication v. reduction of levels and proportions of periodontal pathogens.
• Discuss the future trends in periodontal therapy.

Course Contents:
1. The Biofilm Community
    • Biofilm City of Microbes
    • Social Lives of Pathogens and Virulence
2. Adherence of Oral Bacteria
    • Introduction
    • Habitat
    • Adhesins and Receptors
    • Evolution
    • Conclusions
3. Survival Mechanisms of Microbes in Biofilms
    • Introduction
    • Biofilms Defined
    • How Microorganisms form Biofilms
    • Biofilm Examination and Measurement
    • Biofilm Ultrastructure
    • Resistance to Antimicrobial Agents
       • Delayed Penetration of the Antimicrobial Agent
       • Altered Growth Rate of Biofilm Organisms
       • Other Physiological Changes Due to Biofilm Mode of Growth
    • Human Infections Involving Biofilms<
       • Periodontitis
    • Biofilms on Medical Devices
       • Dental Unit Water Lines
    • Relationship Between Biofilm Formation and Disease
       • Detachment of Cells or Cell Aggregates
       • Production of Endotoxins
       • Bacterial Biofilm Resistance to the Host Immune System
       • Provision of a Niche for the Generation of Resistant Organisms
    • Intervention Strategies
       • Dental Unit Water Lines
         • Specific Treatments Proposed for Dental Unit Water Lines
         • Novel and Unproven Strategies
    • Conclusions
4. Microbial Aspects of Periodontal Biofilm Communities, Development and Treatment
    • Molecular Genetics Analyses of Dental Biofilm Formation
    • Genetic Basis of Horizontal Gene Transfer Among Oral Bacteria
    • Bacterial Interactions and Successions During Plaque Development
    • The Breadth of Bacterial Diversity in the Oral Cavity
    • The Role of Tannerella Forsythia in the Etiology of Periodontitis
    • Current Understanding of the Role of Actinobacillus Actinomycetemcomitans in Aggressive Forms of Periodontitis
    • Effect of Periodontal Treatment on the Subgingival Microbiota
    • Comment
5. Molecular Genetics Analyses of Biofilm Formation in Oral Isolates
    • Introduction
    • Background
    • Streptococci
    • Actinobacillus Actinomycetemcomitans
    • Porphyromonas Gingivalis
    • Intra-and Inter-Species Interactions
    • Conclusions
6. Microbiological Goals of Periodontal Therapy
    • Introduction
    • The Target Species for Periodontal Therapy
    • Heterogeneity in the Subgingival Microbiota
    • Measurement of the Effect of Therapy on the Subgingival Microbiota
    • Sampling Strategy
    • The Preparation and Processing of the Sample
    • Microbiological Technique
    • Expression of Data
    • Presence or Absence of Species Above Selected Thresholds
    • Why Quantify Species in Subgingival Biofilm Samples?
       • Methods to Quantify Species or Morphotypes
    • Effect of Different Therapies on the Subgingival Microbiota
       • Supragingival Plaque Removal
    • Scaling and Root Planning
    • Periodontal Surgery
    • Systemically Administered Antibiotics
       • Amoxicillin Only and Combined with Metronidazole
       • Other Antibiotic Agents
    • The Impact on Therapy of Organisms Growing in Biofilms
    • Recolonization of Periodontal Pockets
    • Is Elimination of Pathogens the Microbiological Goal of Periodontal Therapy?
    • Microbial Diagnosis as a Guide to Therapeutic Decisions
    • Usefulness of Microbiological Testing
    • Conclusion
7. Future Trends in Therapy
    • Use of Antagonistic Strains to Reduce Adhesion of Periodontal Pathogens
       • Adhesion to Surfaces
       • Antagonistic Strains
       • Conclusion
    • Guiding Periodontal Pocket Recolonization
    • Vaccination To Prevent Alveolar Bone Loss
    • Efficacy of an Antimicrobial Peptide Against Oral Bacteria
    • Controlling Inflammation To Control Periodontitis
       • Endogenous Resolving Molecules
       • Resolution Phase of Acute Inflammation
       • Endogenous Resolving Molecules as Therapeutic Agents
       • Prevention of Periodontitis
       • Treatment of Periodontitis
       • Biofilm and Inflammatory Periodontitis
8. Summary
Glossary
References