Caries Ecology Revisited: Microbial Dynamics and the Caries Process
Caries Ecology Revisited: Microbial Dynamics and the Caries Process
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DOI：
10.1159/000159604
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发表时间：
2008-01-01
期刊：
影响因子：
4.2
通讯作者：
Nyvad, B.
中科院分区：
文献类型：
--
作者：
Takahashi, N.;Nyvad, B.
在本文中，我们提出了龋齿生态假说的扩展，以解释牙菌斑细菌表型/基因型特性的动态变化与龋齿过程的脱矿/再矿化平衡之间的关系。牙菌斑代表了一个微生物生态系统，其中非变形菌（主要是非变形链球菌和放线菌）是负责维持牙齿表面动态稳定性（动态稳定阶段）的关键微生物。微生物酸适应和随后的“低pH”非变形菌的酸选择通过促进脱矿/再矿化平衡从“净矿物质增益”向“净矿物质损失”（产酸阶段）的转变，在破坏斑块稳态的稳定方面发挥着关键作用。一旦建立了酸性环境，变形链球菌和其他耐酸细菌可能会通过维持以“净矿物质损失”（耐酸阶段）为特征的环境来增加并促进病变发展。因此，高比例的变形链球菌和/或其他耐酸细菌可以被认为是特别快速的龋齿进展部位的生物标志物。这一系列事件可能会将龋齿病变的表面纹理从光滑变为粗糙（牙釉质）或从硬变为软（牙本质）。只要解决了生物膜的产酸/尿酸特性，这些临床表面特征就可以在病变发展的任何阶段逆转。因此，从生态学的角度来看，不仅描述哪些细菌与龋齿有关，而且了解细菌的作用也很重要。版权所有 (C) 2008 S. Karger AG，巴塞尔
In this essay we propose an extension of the caries ecological hypothesis to explain the relation between dynamic changes in the phenotypic/genotypic properties of plaque bacteria and the demineralization/remineralization balance of the caries process. Dental plaque represents a microbial ecosystem in which non-mutans bacteria (mainly non-mutans streptococci and Actinomyces) are the key microorganisms responsible for maintaining dynamic stability on the tooth surface (dynamic stability stage). Microbial acid adaptation and subsequent acid selection of 'low-pH' non-mutans bacteria play a critical role for destabilizing the homeostasis of the plaque by facilitating a shift of the demineralization/remineralization balance from 'net mineral gain' to 'net mineral loss' (acidogenic stage). Once the acidic environment has been established, mutans streptococci and other aciduric bacteria may increase and promote lesion development by sustaining an environment characterized by 'net mineral loss' (aciduric stage). Hence, high proportions of mutans streptococci and/or other aciduric bacteria may be considered biomarkers of sites of particularly rapid caries progression. This cascade of events may change the surface texture of caries lesions from smooth to rough (enamel) or hard to soft (dentin). These clinical surface features can be reversed at any stage of lesion development provided that the acidogenic/aciduric properties of the biofilm are resolved. From an ecological point of view it is therefore not only important to describe which bacteria are involved in caries, but also to know what the bacteria are doing. Copyright (C) 2008 S. Karger AG, Basel