[Scanning electron microscope study of early bacterial penetration of human enamel in initial caries]

Bacterial penetration of enamel during initial manifestations of the carious process was studied in intact buccal enamel of 8 impacted third permanent molars. After cleaning them from organic plaque, each buccal plane was cut into five segments, one of them serving as a control specimen and the other four being fixed into slots on partial prostheses of our volunteers. The specimens were left in oral cavity for 7, 14, 21 and 28 days, where they were exposed to the action of cariogenic factors. After removal of the organic plaque, the specimens were broken in two and the bacterial penetration into enamel was observed on the fractured cross-section using scanning electron microscope. In 4 specimens from the group orally exposed during a 7-day period, individual coccoid or bacilliform bacteria were found to have penetrated 5-10 microns deep. The number of bacteria and the depth of their penetration into enamel increased with the duration of oral exposition. Among the specimens orally exposed during 28 days, bacteria were observed to be present both individually and in colonies, penetrating to the depth of 60-90 microns. These bacteria could quite easily communicate with saliva and plaque via the pore system, which allowed them to produce metabolites, including lactic acids. This, in turn, allowed them to penetrate through the enamel, thus altering both the course and rate of the carious process progression.