Patterns of de novo plaque formation in the human dentition

The objective of the present clinical trial was to carefully assess the pattern of de novo plaque formation in the human dentition. 10 subjects aged 24-29 years were recruited for the study. None of the participants showed signs of destructive periodontitis. At the start of the preparatory period, they were given a thorough dental prophylaxis and oral hygiene instruction. For the next 2 weeks, the participants were carefully monitored and 1 x every 2 days examined with respect to plaque and gingivitis. At the re-examinations, they were also given professional tooth cleaning and instruction in proper plaque control measures. Towards the end of this 2-week period, the Day 0 examination was performed which revealed that the gingival tissues of all participants were in excellent clinical health. Following the Day 0 examination, all 10 subjects were exposed to professional tooth cleaning. During the next 14 days, they abolished all mechanical tooth cleaning efforts but were examined with respect to plaque on Days 1, 4, 7 and 14. The amount of plaque formed was examined using the criteria of the Plaque Index system (PlI). Each of 6 surfaces of each tooth in the dentition was given a score from 0 to 3. The results from the re-examinations demonstrated that in humans with clean teeth and normal gingiva, the abolishment of mechanical tooth cleaning rapidly resulted in de novo plaque formation. Most plaque, as assessed by the plaque index system, formed during the first 4 days of no tooth cleaning after which moderate additional amounts of plaque formed. It was observed that the mean PlI values for individuals, for groups of teeth and tooth surfaces, provide a proper overall estimation of plaque build up. The dynamics of plaque formation between examinations and in different parts of the dentition were more easily disclosed by the data describing % distributions of different score categories and the transition between scores from one examination to the next. The total amount of plaque formed on various tooth surfaces was best presented by so called "plaque pattern displays". The results also revealed that (i) the mandibular dentition harbored more plaque than the maxillary dentition, (ii) there was a difference in the mean PlI scores between the molar and the anterior tooth regions in the maxilla, but in the mandible such a difference could not be observed (except on Day 1), (iii) plaque accumulated most at the approximal surfaces and least at the palatal surfaces, and that (iv) differences in PlI scores between groups of teeth and tooth surfaces observed on Day 4 persisted through the Day 14 examination.