Structure of dental plaque and the plaque-enamel interface in human experimental caries.

This study describes the ultrastructure of dental plaque and the plaque-enamel interface after 2 and 3 weeks' exposure to a cariogenic challenge. Five dental students carried a total of 25 specimens of smooth surface enamel in intraoral acrylic appliances. During the initial 3 days the volunteers refrained from oral hygiene and performed nine daily mouthrinses with 10% (w/v) solutions of sucrose. After the 3rd day the volunteers cleaned their natural teeth, whereas the experimental sites were left undisturbed except for nine daily extraoral 5-min immersions in 5% (w/v) solutions of sucrose. Clinically, three patterns of colonization were observed after 3 days. At the histological level the experimental bacterial deposits also exhibited three distinctly different structural patterns after 2 and 3 weeks. Individual patterns consistently differed with regard to the microbial composition, the structural organization of the deposits, and the presence or absence of crystal-like material. However, in all individuals a layer of densely packed gram-positive bacteria resembling Actinomyces was consistently present close to the enamel surface. In 1 individual the microbial deposits were dominated by large bacteria, the ultrastructure of which conformed to the description of Stomatococcus mucilaginosus. These findings may partly explain pronounced individual variations in the rate of caries lesion development and progression in vivo.