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BIOFILM
BIOFILM
BIOFILM
Aruna Rani
II-year PG
CONTENTS
PART I
• Introduction
• History
• Definitions
• Basic criteria for a biofilm
• Composition of biofilm
• Development of biofilm
• Characteristics of biofilm
• Classification of biofilm
• References
PART II
• Endodontic biofilm
• Detection and measurement of biofilms
• Strategies to manage biofilms
• Conclusion
• References
INTRODUCTION
The first two medical reports using the word ‘biofilm’ were published in
1981 by dentists from the University of Lund, Sweden.
Hoiby N. A short history of microbial biofilms and biofilm Infections. APMIS 2017; 125: 272–
DEFINITION OF BIOFILM
Biofilm is defined as a community of microcolonies of microorganism in an
aqueous solution that is surrounded by a matrix of glycocalyx, which also
attaches the bacterial cells to a solid substratum - Grossman
Basic structural unit of a biofilm is the micro colonies or cell cluster formed by
the surface adherent bacterial cells.
• Adsorption of inorganic and organic molecules to the solid surface, forming a thin layer
termed as conditioning layer.
• During dental plaque formation, the tooth surface is conditioned by the saliva pellicle.
STAGE 2
• Bacterial surface structures form bridges between the bacteria and the
conditioning film.
STAGE 2 : Phase 1 : Transport of microbes to surface
• Co-adhesion
• The process of recognition between
a suspended cell and a cell already
attached to substratum.
• Co-Aggregation
• Genetically distinct cells in suspension
recognize each other and clump together.
STAGE 4 : Detachment / Dispersion
• Bacteria can produce polysaccharides, either as cell surface structures (eg. Capsules)
or as extracellular excretions (eg. EPS).
Studies have reported the production of essential growth factors such as hemin by
W. recta to support the growth of fastidious organisms such as P. gingivalis
• A mature biofilm structure displays gradients in the distribution of nutrition, pH, oxygen,
metabolic products and signaling molecules within the biofilm.
• This would create different microniches that can accommodate diverse bacterial species
within a biofilm.
Qs leads to
• Exchange of genetic materials between species
antibiotic resistance
• Nutrient breakdown
• Xenobiotic metabolism
• Coordinated behaviour of biofilm
MOLECULES USED AS SIGNALS
• In gram positive bacteria- oligopeptides
• In gram negative bacteria- Acyl Homoserine lactones -AHL
• Both types of bacteria- AI-2
• In combination of bacteria and fungi- 3-oxo-C12 homoserine lactone
A. Kishen. Advanced Therapeutic Option for Endodontic biofilms. Endodontic Topics 2012, 22, 99–123.
Resistance associated with EPS :
• Diffusion barrier
• Direct neutralization of antimicrobials
• Inactivation by modified enzymes produced by bacteria (Beta-
lactamase enzymes , formaldehyde lyase and dehydrogenase)
EPS with its highly charged and interwoven structure deters penetration of
antimicrobials by ionic or electrostatic interactions.
Because the antimicrobial agents are usually positively charged and the EPS contains
negatively charged or neutral polysaccharides.
Antibiotics such as aminoglycosides, which are hydrophilic and positively charged
molecules, are retarded by the biofilm matrix for the above reason.
Resistance associated with growth rate and nutrient availability
1. Based on habitats
Percolating filters
Rhizosphere
Mammalian gut
Human environment
Ship fouling
Dental plaque
2. Taxonomic diversity
Dental biofilm
The formation of oral cavity microbiota begins at the moment of birth through
the contact between the surface of the new born’s skin and mucous membrane
of its mouth with mother’s vaginal microbiota.
Classification of dental biofilm
1. On basis of location
Teeth - Dental plaque
Mucosa
Tongue
Gums
Dental restorations
Dental operatories
One of the best known and most reported type of biofilm in the human
body
More than 1000 different species of bacteria forming plaque have been
identified so far
The studies conducted using molecular biology methods demonstrated five
dominant phylum of bacteria in dental plaque: Firmicutes, Actinobacteria,
Bacteroides, Fusobacteria, and Proteobacteria. They constitute 80–95% of
the oral cavity microflora.
• Composition :
• 80% : Water
• 20% : Inorganic & organic (80% bacteria)
• Gradually, the filamentous form grows int the cocci layer and replaces many
of the cocci.
The dorsal surface of the tongue colonized by large amounts of bacteria in the
presence of fissures, crypts and high mucosal papillae.
Mucous membranes, tonsils and the tongue can frequently harbour different
periodontal pathogens such as Actinomycetem comitans, P. gingivalis,
or P. intermedia
1. Surface Energy
Surfaces with a low surface energy usually display lower adherence to biofilms
than similar surfaces with higher surface energy.
Most dental materials, except for ceramics, have a higher surface energy than
enamel and have thus a greater risk of biofilm accumulation.
2. Surface Roughness
Increased surface roughness and complicated topography shows higher affinity
to microbes than smoother surfaces and subsequently increased difficulty in
complete removal of the biofilm by mechanical brushing.
Wet or humid parts of medical devices are favourable to the establishment and
growth of microbial biofilms and have been particularly associated with cross-
infection and cross-contamination ( Lemaitre et al, 1996 ; Hsueh et al, 1998 ;
Perola et al, 2002 ).
DUWLs and associated biofilms
Dental handpieces and ultrasonic scalers generate aerosols and fine droplets
containing planktonic microorganisms, their endotoxins and pieces of biofilm
can be inhaled into the lungs both of patients and dental healthcare staff (Fotos
et al, 1985 ; Reinthaler et al, 1988 ; Atlas et al, 1995 ; Putnins et al, 2001 ;
Pankhurst et al, 2005 ; Dutil et al, 2007 ).
ENDODONTIC BIOFILM
• Progression of infection alters the nutritional and environmental status within the root
canal.
• Root canal environment : more anaerobic and depleted nutritional levels
• Tough ecological niche for the surviving microorganisms.
• Microbes : anatomical complexities (isthmuses and deltas and in the apical portion of
RCS) shelter the adhering bacteria from cleaning and shaping procedures.
• Bacterial activities not confined to intracanal spaces, but also beyond the apical
foramen.
Ingle’s Endodontics : 6th Edition
• Endodontic bacterial biofilms can be categorized as
1. Intracanal biofilms
2. Extra radicular biofilms
3. Periapical biofilms
4. Biomaterial centered infections.
Nutrient-rich Nutrient-rich
condition after 1 week condition after 4 week
• Stage I : Adherence and micro colonies
• Stage II : Dissolution of dentin and
• Stage III : Mineralization of biofilm
- Carbonated apatite structure
• Reported in
• Asymptomatic periapical periodontitis
• Chronic apical abscesses associated with sinus tracts
• Intraradicular
• Extra radicular
• A study investigated the initial biofilm-forming ability of root canal isolates on gutta-percha points
in vitro.