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Essential Microbiology for Dentistry E-Book

Essential Microbiology for Dentistry E-Book

Lakshman Samaranayake

(2011)

Additional Information

Book Details

Abstract

The new edition of this highly successful book continues to offer readers everything they require to gain a full understanding of microbiology as it relates to modern dental practice. The rich combination of easy-to-read text together with the extensive artwork programme makes Essential Microbiology for Dentistry the first choice of microbiology textbook for many students of dentistry worldwide.

  • Comprehensive coverage of the subject area makes the book suitable for all aspects of the curriculum
  • Almost 300 tables and illustrations present clinical, diagnostic and practical information in an easy-to-follow manner
  • Contains ‘Key Facts’ boxes to act as useful aide-mémoires
  • Self-assessment sections at the end of each chapter allow students to assess their understanding in key areas of knowledge
  • Addresses the subject on a strictly ‘need-to-know for the dentist’ approach [e.g. only salient bacteria are included with thumbnail sketches of viruses and fungi]
  • Contains a detailed - and now expanded - glossary and abbreviations list
  • Contains the latest organism nomenclature and information regarding unculturable bacteria and novel molecular technology
  • Includes a highly expanded section on oral biofilms and their relevance to systemic disease such as heart disease, diabetes, adverse pregnancy outcomes and nosocomial pneumonia
  • Contains a brand new section on oral immunology – prepared by guest authors – as relevant to dentistry
  • Contains a new section on the microbiology of perimplantitis
  • Presents a fully revised and expanded section on infection control in dentistry encompassing British and American guidelines

Table of Contents

Section Title Page Action Price
Front cover cover
Essential Microbiology for Dentistry i
Copyright page iv
Preface v
Table of contents vii
Chapter 1 Introduction 1
A note on emerging and re-emerging infections 1
About this book 2
Further reading 3
Part 1 General microbiology 5
Part 1 text 5
Chapter 2 Bacterial structure and taxonomy 7
Eukaryotes and prokaryotes 7
Morphology 7
Shape and size 7
Arrangement 7
Gram-staining characteristics 9
Structure 9
Structures external to the cell wall 9
Flagella 9
Fimbriae and pili 9
Glycocalyx (slime layer) 9
Capsule 10
Cell wall 10
Bacteria with defective cell walls 10
Cytoplasmic membrane 11
Mesosome 11
Cytoplasm 11
Nuclear material or nucleoid 11
Ribosomes 11
Cytoplasmic inclusions 11
Bacterial spores 11
Clinical relevance of bacterial spores 11
Taxonomy 12
Genotypic taxonomy 12
How do organisms get their names? 13
Further reading 14
Review questions (answers on p. 351) 14
Chapter 3 Bacterial physiology and genetics 15
Bacterial physiology 15
Growth 15
Nutritional requirements 15
Oxygen and hydrogen 15
Carbon 15
Inorganic ions 15
Organic nutrients 15
Reproduction 15
Bacterial growth cycle 15
Growth regulation 15
Aerobic and anaerobic growth 16
Bacterial genetics 16
The bacterial chromosome 17
Replication 17
Genes 18
Genetic variation in bacteria 18
Mutation 18
Base substitution 18
Frame shift mutation 18
Insertion 18
Gene transfer 18
Conjugation 18
Transduction 18
Transformation 19
Transposition 19
Recombination 19
Plasmids 19
Clinical relevance of plasmids 20
Transposons 21
Recombinant DNA technology in microbiology 21
Gene cloning 21
Gene probes 21
DNA probes 21
Oligonucleotide probes 21
RNA probes 21
DNA/RNA probes and oral microbiology 22
Polymerase chain reaction 22
Materials 22
Method 22
PCR and its variations 23
Nested PCR 23
Multiplex PCR 23
Real-time PCR 24
Why is PCR so widely used? 24
Other techniques for genetic typing of microorganisms 25
Restriction enzyme analysis 25
Restriction fragment length polymorphism 25
Pulsed-field gel electrophoresis 25
Pyrosequencing 25
The era of ‘-omics’ 25
Genomics 25
Proteomics 25
Transcriptomics 25
Metabolomics 25
Further reading 26
Review questions (answers on p. 351) 26
Chapter 4 Viruses and prions 27
Structure 27
Viral nucleic acid 27
Viral protein 27
Viral lipid and carbohydrate 27
Virus symmetry 27
Taxonomy 29
DNA viruses 29
Papovaviruses 29
Papillomavirus 29
Polyomavirus 29
Adenoviruses 29
Herpesviruses 29
Structure 30
Poxviruses 30
Parvoviruses 30
Hepadnaviruses 30
RNA viruses 30
Picornaviruses 30
Orthomyxoviruses 30
Paramyxoviruses 31
Coronaviruses 31
Retroviruses 31
Other RNA viruses 31
Viroids 31
Viral replication 32
Pathogenesis of viral infections 33
Cellular antiviral response 33
Prions and prion diseases 33
Prion-induced diseases or transmissible spongiform encephalopathies 33
Kuru 33
Creutzfeldt–Jakob disease 33
Variant Creutzfeldt–Jakob disease 33
Fatal familial insomnia 33
Gerstmann–Straussler–Scheinker syndrome 34
Pathogenesis 34
Transmission 34
Prevention and dental implications 34
North American guidelines 34
British guidelines 34
Further reading 35
Review questions (answers on p. 351) 35
Chapter 5 Pathogenesis of microbial disease 37
General aspects of infection 37
Virulence 37
Communicable diseases 37
Natural history of infectious disease 37
Pathogenesis of bacterial disease 38
Determinants of bacterial pathogenicity 38
Transmission 38
Adherence to host surfaces 38
Biofilm formation 38
Invasiveness 39
Pyogenic inflammation 40
Granulomatous inflammation 40
Toxigenicity 40
Toxin production 40
Endotoxins 40
Exotoxins 41
Neurotoxins 41
Enterotoxins 42
Miscellaneous exotoxins 42
Pathogenesis of viral disease 42
Entry of viral infections 42
Skin and mucosa 43
Oropharynx and intestinal tract 43
Respiratory tract 43
Genitourinary tract 44
Mechanisms of viral spread in the body 44
Local spread on body surfaces 44
Lymphatic spread 44
Viraemia and spread to organs 44
Central nervous system and peripheral nerve spread 44
Virus and host cell interactions 45
Permissive infection 45
Haemadsorption 45
Giant cell formation 45
Non-permissive infection 45
Latent viral infections 46
Chronic infections 46
Oncogenic infections 46
Slow virus infections 46
Transmission of viral infections and infection control 46
Host determinants of viral infection 46
Pathogenesis of fungal disease 46
Koch’s postulates 46
Further reading 47
Review questions (answers on p. 351) 47
Chapter 6 Diagnostic microbiology and laboratory methods 49
Diagnostic microbiology 49
Clinical request 49
Provision of clinical information 49
Collection and transport of specimens 49
Laboratory analysis 49
Interpretation of the microbiology report and use of information 50
Laboratory methods 50
Microscopic methods 50
Light microscopy 50
Bright-field or standard microscopy 50
Dark-ground microscopy 51
Phase-contrast microscopy 51
Fluorescence microscopy 52
Electron microscopy 52
Light microscopy and stains 52
Gram stain technique 52
Staining characteristics 52
Ziehl–Neelsen technique 52
Other stains 52
Detection of microbes by probing for their genes 52
Polymerase chain reaction 52
Nucleic acid probes 52
Cultural methods 52
Bacteriological media 53
Preparation of solid media and inoculation procedure 53
Liquid media 54
Media for blood culture 54
Transport media 54
Bacteriological transport media 54
Viral transport medium 54
Atmospheric requirements and incubation 55
Bacterial identification 55
Biochemical tests 55
Commercial identification kits 56
Method 56
Subtyping organisms 56
Genetic typing 56
Immunological methods 57
Identification of organisms using immunological techniques 57
Agglutination 57
Slide agglutination 57
Latex agglutination 57
Immunofluorescence 57
Enzyme-linked immunosorbent assay 57
Detection of antibodies in a patient’s serum 57
Laboratory investigations related to antimicrobial therapy 58
Susceptibility of organisms to antimicrobial agents 58
Laboratory testing for antimicrobial sensitivity 58
Disc diffusion test 58
Assessment of MIC and MBC 59
Method 59
Appropriate specimens in medical microbiology 60
Appropriate specimens for oral infections 60
Purulent infections 61
Mucosal infections 61
Periodontal infections and caries 61
Laboratory isolation and identification of viruses 61
Direct microscopy of clinical material 61
Isolation and identification from tissues 62
Tissue culture 62
Serodiagnosis of viral infections 62
Serological tests 63
Serodiagnosis using multiple antigen systems 63
Molecular amplification methods for rapid viral diagnosis 63
Diagnosis of fungal infections 63
Candidal infections 63
Germ tube test 63
Histopathology 64
Other laboratory investigations 64
Further reading 65
Review questions (answers on p. 351) 65
Chapter 7 Antimicrobial chemotherapy 67
Bacteriostatic and bactericidal antimicrobial agents 67
Mode of action of antimicrobials 67
Principles of antimicrobial therapy 67
Choice of drug 67
Spectrum of activity of antimicrobial agents 68
Combination therapy 68
Antimicrobial prophylaxis 69
Aims 69
Prescribing an antimicrobial agent 69
Is there an infective aetiology? 69
Have relevant specimens been taken before treatment? 69
When should the treatment be started? 69
Which antimicrobial agent? 69
Pharmacodynamics of antimicrobials 70
Dosage 70
Duration of treatment 70
Route of administration 70
Distribution 70
Excretion 70
Toxicity 70
Drug interactions 70
Failure of antimicrobial therapy 70
Antibiotic resistance in bacteria 70
Mechanisms of antibiotic resistance (Table 7.4) 71
Inactivation of the drug 71
Altered uptake 71
Modification of the structural target of the drug 71
Altered metabolic pathway 71
Emergence of drug-resistant bacteria and the role of the clinician 71
Antimicrobials commonly used in dentistry 71
Antibacterial agents 71
Penicillins 71
Phenoxymethylpenicillin (penicillin V) 72
Part 2 Basic immunology (contributed by Drs Liwei Lu, Brian M Jones and Glen C Ulett) 79
Part 2 text 79
Chapter 8 The immune system and the oral cavity 81
The immune system: general considerations 81
The innate immune system 81
Mechanical and chemical barriers 81
Defensins and cathelicidins 81
Phagocytosis 82
Pathogen-associated molecular patterns, pattern-recognition receptors and Toll-like receptors 82
Natural killer cells 83
Acute-phase proteins 83
Interferon 84
Complement 84
Alternative activation 84
Classical activation 85
Membrane attack 85
Biological effects of complement activation 85
Inflammation 86
The adaptive immune system 86
Cells of the immune system 87
The lymphoid organs 87
Antigen recognition 88
Major histocompatibility complex 88
The TCR and generation of T cell diversity 88
The BCR, generation of B cell diversity and isotype selection 88
Deletion of anti-self reactivities 88
T cell differentiation 88
B cell differentiation 89
Peripheral tolerance 89
Disorders of the Immune System 89
Oral defence mechanisms 90
Innate immune mechanisms 90
The oral mucosal epithelium 91
Antigen-non-specific defence chemicals in oral secretions (Table 8.3) 91
Functionality of salivary defence constituents 93
Microbial interactions and the normal oral flora 93
Adaptive immunity in oral health and disease 93
Oral lymphoid tissues 94
S-IgA in oral defence 94
PCD in response to oral microbes 94
Further reading 96
Review questions (answers on p. 351 & p. 352) 96
Chapter 9 The immune response 99
Antibodies 99
Cytokines 99
B cell activation 100
Antigen processing and presentation 101
Processing of endogenous antigens 102
Processing of exogenous antigen 103
T-helper subsets 104
Target cell killing 104
Activation of macrophages 105
Regulation of the immune response 105
Anti-idiotypic antibody 105
Regulatory T cells 105
Immunological memory 106
Memory B cells 106
Memory T cells 106
Further reading 107
Review questions (answers on p. 352) 107
Chapter 10 Immunity and infection 109
Immunity to bacteria 109
Summary of defence mechanisms 109
Bacterial evasion strategies 109
Damage caused by immune responses to bacteria 109
Immunity to viruses 110
Summary of defence mechanisms 110
Viral evasion strategies 111
Damage caused by immune responses to viruses 111
HIV and AIDS 111
Immunity to parasites 113
Summary of defence mechanisms 113
Parasite evasion strategies 113
Damage caused by immune responses to parasites 114
Immunity to fungi 114
Vaccination 114
Passive immunization 114
Active immunization 114
New approaches to vaccine development 115
Further reading 117
Review questions (answers on p. 352) 117
Part 3 Microbes of relevance to dentistry 119
Part 3 text 119
Chapter 11 Streptococci, staphylococci and micrococci 121
Streptococci 121
General properties 121
Part 4 Infections of relevance to dentistry 193
Part 4 text 193
Chapter 23 Infections of the respiratory tract 195
Normal flora 195
Important pathogens of the respiratory tract 195
Infections of the upper respiratory tract 195
Sore throat syndrome 195
Part 5 Oral microbiology 263
Part 5 text 263
Chapter 31 Normal oral flora, the oral ecosystem and plaque biofilms 265
Normal oral flora 265
A note on the nomenclature of oral flora 265
Flora of the oral cavity 265
Gram-positive cocci 265
Genus Streptococcus 265
mutans group 265
salivarius group 265
anginosus group 266
mitis group 266
Anaerobic streptococci 266
Genus Stomatococcus 266
Genera Staphylococcus and Micrococcus 266
Gram-positive rods and filaments 266
Genus Actinomyces 266
Genus Lactobacillus 266
Genus Eubacterium 266
Genus Propionibacterium 266
Other notable Gram-positive organisms 267
Gram-negative cocci 267
Genus Neisseria 267
Genus Veillonella 267
Gram-negative rods – facultative anaerobic and capnophilic genera 267
Genus Haemophilus 267
Genus Aggregatibacter 267
Genus Eikenella 268
Genus Capnocytophaga 268
Gram-negative rods – obligate anaerobic genera 268
Genus Porphyromonas 268
Genus Prevotella 268
Genus Fusobacterium 268
Genus Leptotrichia 268
Genus Wolinella 268
Genus Selenomonas 269
Genus Treponema 269
A note on unculturable bacteria 269
Oral protozoa 269
Genus Entamoeba 269
Genus Trichomonas 269
The oral ecosystem 269
The oral environment 269
Oral habitats 270
Buccal mucosa and dorsum of the tongue 270
Teeth 271
Crevicular epithelium and gingival crevice 271
Prosthodontic and orthodontic appliances 271
Factors modulating microbial growth 271
Anatomical factors 271
Saliva 271
Gingival crevicular fluid 271
Microbial factors 272
Miscellaneous factors 272
Local environmental pH 272
Oxidation–reduction potential 272
Antimicrobial therapy 272
Diet 272
Iatrogenic factors 272
Nutrition of oral bacteria 272
Acquisition of the normal oral flora 273
Dental plaque biofilm 273
Composition 273
Distribution 273
Microbial adherence and plaque biofilm formation 273
Plaque biofilm formation 273
Detachment 274
Further notes on biofilms 274
Calculus formation 275
Structure 275
The role of oral flora in systemic infection 275
Further reading 278
Review questions (answers on p. 354) 278
Chapter 32 Microbiology of dental caries 279
Epidemiology 279
Classification 279
Clinical presentation 279
Diagnosis 279
Aetiology 279
Host factors 280
Tooth structure 280
Flow rate and composition of saliva 280
Diet 280
Microbiology 281
Specific and non-specific plaque hypothesis 281
The role of mutans streptococci 281
The role of lactobacilli 281
The role of Actinomyces spp. 281
The role of Veillonella 282
Plaque metabolism and dental caries 282
Ecological plaque hypothesis 282
Management of dental caries 283
Patient evaluation 283
Microbiological tests in caries assessment 283
Microbiology of root surface caries 284
Prevention of dental caries 284
Sugar substitutes 284
Fluoridation 284
Fissure sealants 284
Control of cariogenic plaque flora 284
Mechanical cleansing techniques 284
Antimicrobial agents 284
Active immunization against dental caries 285
Passive immunization 285
Replacement therapy 285
Further reading 285
Review questions (answers on p. 354 & p. 355) 286
Chapter 33 Microbiology of periodontal disease 287
Classification of periodontal disease 287
Ecology of the gingival crevice and the periodontal pocket 287
Aetiological factors 287
Host tissues 287
Host defence factors 287
Polymorphonuclear leukocytes 288
Antibody 288
Microorganisms in subgingival plaque biofilm 288
Microbiological studies of periodontal plaque flora 289
Specific and non-specific plaque hypotheses 289
The specific plaque hypothesis 289
The non-specific plaque hypothesis 289
The ecological plaque hypothesis 290
Clinical implications 290
Periodontal health and disease 290
A note on the role of viruses in periodontal disease 290
Relationship between chronic marginal gingivitis and periodontitis 291
Chronic marginal gingivitis 291
Clinical presentation 291
Pathogenesis 292
The initial lesion 292
The early lesion 292
The established lesion 292
Microbiology 292
Treatment 292
The transition from gingivitis to periodontitis 292
Chronic periodontitis (formerly adult periodontitis) 292
Morbidity 292
Clinical presentation 292
Pathogenesis 293
Microbiology 293
Spirochaetes 293
Porphyromonas, Prevotella and Tannerella spp. 293
Capnocytophaga and corroding bacteria 293
Aggressive periodontitis 293
Localized and generalized aggressive periodontitis (formerly localized/generalized juvenile periodontitis) 293
Morbidity 293
Initiation and course 294
Part 6 Cross infection and control 323
Part 6 text 323
Chapter 36 Principles of infection control 325
Cross infection 325
Principles of infection transmission 325
Source of infection 325
Standard infection control 325
Evolution of universal precautions, standard precautions and additional precautions (or transmission-based precautions) 326
A note on the management of potential carriers of transmissible spongiform encephalopathy or prion diseases 326
Mode of transmission 326
Airborne infection 327
Infection via sharps and needlestick injuries 327
Mode of entry 327
Infection control procedures 327
Further reading 328
Review questions (answers on p. 355) 328
Chapter 37 Infection control procedures in dentistry 329
Practice management and staff development 329
Infection control: specific practical features 329
Patient evaluation 329
Personal protection 329
Personal hygiene 329
Hand care 330
Clinic clothing 330
Barrier protection 330
Gloves 331
Contact dermatitis and latex hypersensitivity 331
Eye shields 332
Face masks 332
Rubber dam isolation 332
A note on pre-procedural mouthrinse 332
Aspiration and ventilation 332
Handling sharps and related injuries 332
Sharps injury protocol 332
Immunization procedures 332
Bacille Calmette–Guérin vaccine 333
Answers to review questions 351
Glossary of terms and abbreviations 357
Index 367
A 367
B 368
C 369
D 371
E 371
F 372
G 372
H 373
I 374
J 375
K 375
L 375
M 375
N 376
O 376
P 377
Q 378
R 378
S 379
T 381
U 381
V 382
W 382
X 382
Y 382
Z 382