dental pellicle

Summary

Summary: A thin protein film on the surface of DENTAL ENAMEL. It is widely believed to result from the selective adsorption of precursor proteins present in SALIVA onto tooth surfaces, and to reduce microbial adherence to the TEETH.

Top Publications

  1. Dawes C. Salivary flow patterns and the health of hard and soft oral tissues. J Am Dent Assoc. 2008;139 Suppl:18S-24S pubmed
    ..This nonsystematic review summarizes the effects of saliva on some of the diseases affecting the hard and soft oral tissues...
  2. Iontcheva I, Oppenheim F, Troxler R. Human salivary mucin MG1 selectively forms heterotypic complexes with amylase, proline-rich proteins, statherin, and histatins. J Dent Res. 1997;76:734-43 pubmed
  3. Lima E, Koo H, Vacca Smith A, Rosalen P, Del Bel Cury A. Adsorption of salivary and serum proteins, and bacterial adherence on titanium and zirconia ceramic surfaces. Clin Oral Implants Res. 2008;19:780-5 pubmed publisher
    ..In addition, the protein profiles and bacterial binding properties of pellicles on Ti and ZrO(2) were compared to those formed on hydroxyapatite (HA) surface...
  4. Siqueira W, Custodio W, McDonald E. New insights into the composition and functions of the acquired enamel pellicle. J Dent Res. 2012;91:1110-8 pubmed publisher
  5. van der Mei H, Rustema Abbing M, Bruinsma G, Gottenbos B, Busscher H. Sequence of oral bacterial co-adhesion and non-contact brushing. J Dent Res. 2007;86:421-5 pubmed
    ..At contact, rotary and sonic brushing performed equally well in bacterial removal, while at 4 mm, both had lost some efficacy...
  6. Hemingway C, White A, Shellis R, Addy M, Parker D, Barbour M. Enamel erosion in dietary acids: inhibition by food proteins in vitro. Caries Res. 2010;44:525-30 pubmed publisher
    ..The citrate ion may play an active stabilising role, since erosion reduction was less in the other acids. In conclusion, casein and, to a lesser extent, ovalbumin show promise as potential anti-erosive additives to drinks...
  7. Guan Y, Lath D, Graaf T, Lilley T, Brook A. Moderation of oral bacterial adhesion on saliva-coated hydroxyapatite by polyaspartate. J Appl Microbiol. 2003;94:456-61 pubmed
    ..Synthetic sodium alpha,beta-polyaspartate (PA) has been investigated as a moderator of adhesion and the subsequent biofilm formation by oral bacteria...
  8. Busscher H, White D, Atema Smit J, Geertsema Doornbusch G, De Vries J, van der Mei H. Surfactive and antibacterial activity of cetylpyridinium chloride formulations in vitro and in vivo. J Clin Periodontol. 2008;35:547-54 pubmed publisher
    ..To compare effects of three cetylpyridinium chloride (CPC) formulations with and without alcohol and Tween80 on physico-chemical properties of salivary pellicles, bacterial detachment in vitro and bacterial killing in vivo...
  9. Vitorino R, Calheiros Lobo M, Williams J, Ferrer Correia A, Tomer K, Duarte J, et al. Peptidomic analysis of human acquired enamel pellicle. Biomed Chromatogr. 2007;21:1107-17 pubmed
    ..In the case of acidic proline-rich proteins, a clearly predominance of cleavage of the Gln-Gly amide bond was evident...

More Information

Publications75

  1. Busscher H, Rustema Abbing M, Bruinsma G, de Jager M, Gottenbos B, van der Mei H. Non-contact removal of coadhering and non-coadhering bacterial pairs from pellicle surfaces by sonic brushing and de novo adhesion. Eur J Oral Sci. 2003;111:459-64 pubmed
    ..However, non-contact, sonic brushing with only a thin wet film on the substratum may leave footprints to which streptococci preferentially adhere...
  2. van der Mei H, Rustema Abbing M, Bruinsma G, de Jager M, Gottenbos B, Busscher H. Influence of weight on removal of co-adhering bacteria from salivary pellicles by different modes of brushing. Caries Res. 2004;38:85-90 pubmed
  3. van der Mei H, White D, Kamminga Rasker H, Knight J, Baig A, Smit J, et al. Influence of dentifrices and dietary components in saliva on wettability of pellicle-coated enamel in vitro and in vivo. Eur J Oral Sci. 2002;110:434-8 pubmed
  4. Yao Y, Berg E, Costello C, Troxler R, Oppenheim F. Identification of protein components in human acquired enamel pellicle and whole saliva using novel proteomics approaches. J Biol Chem. 2003;278:5300-8 pubmed
    ..MS approaches allowed identification of not only well characterized salivary proteins but also novel proteins not previously identified in pellicle...
  5. van Nieuw Amerongen A, Bolscher J, Veerman E. Salivary proteins: protective and diagnostic value in cariology?. Caries Res. 2004;38:247-53 pubmed
    ..These are potentially suited as templates for the design of a new generation of antibiotics, since they kill a broad spectrum of microorganisms, while hardly evoking resistance, in contrast to the classical antibiotics...
  6. Busscher H, White D, van der Mei H, Baig A, Kozak K. Hexametaphosphate effects on tooth surface conditioning film chemistry--in vitro and in vivo studies. J Clin Dent. 2002;13:38-43 pubmed
    ..These surface chemistries may contribute to the unique clinical actions of hexametaphosphate established in recently reported, randomized clinical studies of tartar control, stain prevention and stain removal effects...
  7. Schupbach P, Oppenheim F, Lendenmann U, Lamkin M, Yao Y, Guggenheim B. Electron-microscopic demonstration of proline-rich proteins, statherin, and histatins in acquired enamel pellicles in vitro. Eur J Oral Sci. 2001;109:60-8 pubmed
  8. Hara A, Ando M, Gonzalez Cabezas C, Cury J, Serra M, Zero D. Protective effect of the dental pellicle against erosive challenges in situ. J Dent Res. 2006;85:612-6 pubmed
    The acquired dental pellicle helps prevent erosion, but the protection level is unknown. This in situ study tested whether a two-hour pellicle protects against different erosive challenges by orange juice...
  9. Meurman J, Ten Cate J. Pathogenesis and modifying factors of dental erosion. Eur J Oral Sci. 1996;104:199-206 pubmed
    ..Neither is there consensus as to how effective fluorides are in preventing the progression of erosive lesions, or how the chemical and structural factors of tooth tissue in general might modify this pathological process...
  10. Li J, Helmerhorst E, Leone C, Troxler R, Yaskell T, Haffajee A, et al. Identification of early microbial colonizers in human dental biofilm. J Appl Microbiol. 2004;97:1311-8 pubmed
    ..To elucidate the first colonizers within in vivo dental biofilm and to establish potential population shifts that occur during the early phases of biofilm formation...
  11. Busscher H, White D, Atema Smit J, van der Mei H. Efficacy and mechanisms of non-antibacterial, chemical plaque control by dentifrices--an in vitro study. J Dent. 2007;35:294-301 pubmed
    ..It is the aim of this paper to analyze in vitro detachment of co-aggregating oral actinomyces and streptococci from pellicle surfaces by dentifrice supernates and to study subsequent de novo streptococcal deposition...
  12. Wetton S, Hughes J, West N, Addy M. Exposure time of enamel and dentine to saliva for protection against erosion: a study in vitro. Caries Res. 2006;40:213-7 pubmed
    ..Cautiously extrapolating these in vitro data suggests that pellicle should offer erosion protection to individuals who imbibe acidic drinks at frequencies of 1 h or less...
  13. Siqueira W, Margolis H, Helmerhorst E, Mendes F, Oppenheim F. Evidence of intact histatins in the in vivo acquired enamel pellicle. J Dent Res. 2010;89:626-30 pubmed publisher
    ..The in vitro experiments show that all naturally occurring histatins in the AEP have the potential to provide some level of protection against acid injury...
  14. Ambatipudi K, Hagen F, Delahunty C, Han X, Shafi R, Hryhorenko J, et al. Human common salivary protein 1 (CSP-1) promotes binding of Streptococcus mutans to experimental salivary pellicle and glucans formed on hydroxyapatite surface. J Proteome Res. 2010;9:6605-14 pubmed publisher
    ..Thus, our data demonstrate that the host salivary protein CSP-1 binds to S. mutans cells and may influence the initial colonization of this pathogenic bacterium onto the tooth surface...
  15. Vacca Smith A, Bowen W. In situ studies of pellicle formation on hydroxyapatite discs. Arch Oral Biol. 2000;45:277-91 pubmed
    ..It is apparent that this in situ model could be used in screening potential antiplaque agents...
  16. Wiegand A, Bliggenstorfer S, Magalhaes A, Sener B, Attin T. Impact of the in situ formed salivary pellicle on enamel and dentine erosion induced by different acids. Acta Odontol Scand. 2008;66:225-30 pubmed publisher
    ..To investigate and compare the protective impact of the in situ formed salivary pellicle on enamel and dentine erosion caused by different acids at pH 2.6...
  17. Li J, Helmerhorst E, Corley R, Luus L, Troxler R, Oppenheim F. Characterization of the immunologic responses to human in vivo acquired enamel pellicle as a novel means to investigate its composition. Oral Microbiol Immunol. 2003;18:183-91 pubmed
    ..The results open up the possibility that immunization with human pellicle and mAbs production can be employed to identify hitherto unknown constituents of pellicle...
  18. Siqueira W, Oppenheim F. Small molecular weight proteins/peptides present in the in vivo formed human acquired enamel pellicle. Arch Oral Biol. 2009;54:437-44 pubmed publisher
    ..The aim of this study was to investigate the type and the nature of peptides present in the in vivo formed human acquired enamel pellicle...
  19. Joiner A, Schwarz A, Philpotts C, Cox T, Huber K, Hannig M. The protective nature of pellicle towards toothpaste abrasion on enamel and dentine. J Dent. 2008;36:360-8 pubmed publisher
    ..To determine the protective nature of pellicle towards toothpaste abrasion...
  20. Hannig C, Spitzmüller B, Miller M, Hellwig E, Hannig M. Intrinsic enzymatic crosslinking and maturation of the in situ pellicle. Arch Oral Biol. 2008;53:416-22 pubmed publisher
    ..It has been supposed that the pellicle undergoes maturation after protein adsorption. The aim of the present study was to investigate enzyme activities with an impact on intrinsic maturation processes in in situ formed pellicles...
  21. Hannig C, Hannig M, Attin T. Enzymes in the acquired enamel pellicle. Eur J Oral Sci. 2005;113:2-13 pubmed
    ..This review summarizes the present state of research on enzymes and their functions in the dental pellicle. Theoretically, all enzymes present in the oral cavity could be incorporated into the pellicle, but ..
  22. Siqueira W, Helmerhorst E, Zhang W, Salih E, Oppenheim F. Acquired enamel pellicle and its potential role in oral diagnostics. Ann N Y Acad Sci. 2007;1098:504-9 pubmed
    ..Recent developments in both pellicle collection methods and nanoscale sensing technologies have brought the exploitation of pellicle analysis into the realm of point-of-care oral diagnostics...
  23. Wunder D, Bowen W. Action of agents on glucosyltransferases from Streptococcus mutans in solution and adsorbed to experimental pellicle. Arch Oral Biol. 1999;44:203-14 pubmed
    ..These data indicate that the nature of the inhibitor is important, and also whether the Gtf enzyme is in solution or adsorbed to saliva-coated hydroxylapatite...
  24. McDonald E, Goldberg H, Tabbara N, Mendes F, Siqueira W. Histatin 1 resists proteolytic degradation when adsorbed to hydroxyapatite. J Dent Res. 2011;90:268-72 pubmed publisher
    ..This study shows for the first time that binding to hydroxyapatite confers intact histatin 1 with resistance to proteolytic degradation...
  25. Kindblom C, Davies J, Herzberg M, Svensater G, Wickstrom C. Salivary proteins promote proteolytic activity in Streptococcus mitis biovar 2 and Streptococcus mutans. Mol Oral Microbiol. 2012;27:362-72 pubmed publisher
    ..mitis biovar 2 and S. mutans...
  26. Hannig C, Becker K, Häusler N, Hoth Hannig W, Attin T, Hannig M. Protective effect of the in situ pellicle on dentin erosion - an ex vivo pilot study. Arch Oral Biol. 2007;52:444-9 pubmed
    ..The aim of the present ex vivo study was to evaluate the erosive effects on pellicle coated dentin...
  27. Yao Y, Grogan J, Zehnder M, Lendenmann U, Nam B, Wu Z, et al. Compositional analysis of human acquired enamel pellicle by mass spectrometry. Arch Oral Biol. 2001;46:293-303 pubmed
    ..Unique features of the oral environment such as enzymatic activities or mineral surface properties may account for these differences between in vivo and in vitro pellicle formation...
  28. Li J, Helmerhorst E, Troxler R, Oppenheim F. Identification of in vivo pellicle constituents by analysis of serum immune responses. J Dent Res. 2004;83:60-4 pubmed
    ..The polyclonal antibody approach provided a powerful method for the identification of various pellicle proteins, including some which show mineral homeostasis or antimicrobial activity...
  29. Hannig M, Fiebiger M, Güntzer M, Döbert A, Zimehl R, Nekrashevych Y. Protective effect of the in situ formed short-term salivary pellicle. Arch Oral Biol. 2004;49:903-10 pubmed
    ..However, pellicle does not completely inhibit the erosive action of citric acid under the conditions of the present study...
  30. Ruhl S, Sandberg A, Cisar J. Salivary receptors for the proline-rich protein-binding and lectin-like adhesins of oral actinomyces and streptococci. J Dent Res. 2004;83:505-10 pubmed
    ..These findings suggest the involvement of specific adhesins in bacterial recognition of many adsorbed salivary proteins and glycoproteins...
  31. Hannig M, Joiner A. The structure, function and properties of the acquired pellicle. Monogr Oral Sci. 2006;19:29-64 pubmed
  32. Vacca Smith A, Bowen W. The effects of milk and kappa-casein on salivary pellicle formed on hydroxyapatite discs in situ. Caries Res. 2000;34:88-93 pubmed
    ..These data suggest that milk and kappa-casein may influence pellicle formation in vivo...
  33. Koo H, Vacca Smith A, Bowen W, Rosalen P, Cury J, Park Y. Effects of Apis mellifera propolis on the activities of streptococcal glucosyltransferases in solution and adsorbed onto saliva-coated hydroxyapatite. Caries Res. 2000;34:418-26 pubmed
    ..There is a need to identify the active compounds of propolis...
  34. Hannig M, Balz M. Protective properties of salivary pellicles from two different intraoral sites on enamel erosion. Caries Res. 2001;35:142-8 pubmed
    ..In conclusion, site-dependent differences of buccally and lingually in vivo formed 24-hour pellicles have minor importance concerning the pellicle-induced protection of the enamel surface against erosive changes...
  35. Hannig C, Ruggeri A, Al Khayer B, Schmitz P, Spitzmüller B, Deimling D, et al. Electron microscopic detection and activity of glucosyltransferase B, C, and D in the in situ formed pellicle. Arch Oral Biol. 2008;53:1003-10 pubmed publisher
    ..Glucosyltransferases (GTFs) represent a virulence factor of mutans streptococci. The aim of the present in situ study was to investigate the distribution of different GTF-isoforms in the pellicle...
  36. van der Mei H, Engels E, De Vries J, Busscher H. Effects of amine fluoride on biofilm growth and salivary pellicles. Caries Res. 2008;42:19-27 pubmed
    ..The major effect of AmF treatment, however, was a reduction brought about in biofilm viability...
  37. Hannig C, Spitzmüller B, Al Ahmad A, Hannig M. Effects of Cistus-tea on bacterial colonization and enzyme activities of the in situ pellicle. J Dent. 2008;36:540-5 pubmed publisher
    ..Polyphenols are expected to have antibacterial properties. Cistus is a tea rich in polyphenols. The aim of the present in situ study was to investigate the effect of Cistus-tea on the pellicle and on the initial oral biofilm...
  38. Dige I, Raarup M, Nyengaard J, Kilian M, Nyvad B. Actinomyces naeslundii in initial dental biofilm formation. Microbiology. 2009;155:2116-26 pubmed publisher
    ..The participation of A. naeslundii in the initial stages of dental biofilm formation may have important ecological consequences...
  39. Siqueira W, Zhang W, Helmerhorst E, Gygi S, Oppenheim F. Identification of protein components in in vivo human acquired enamel pellicle using LC-ESI-MS/MS. J Proteome Res. 2007;6:2152-60 pubmed
    ..A high intersubject consistency in pellicle composition was observed...
  40. Vitorino R, Calheiros Lobo M, Duarte J, Domingues P, Amado F. Peptide profile of human acquired enamel pellicle using MALDI tandem MS. J Sep Sci. 2008;31:523-37 pubmed publisher
    ..Fragments present in the AEP show a predominance of cleavage points located at Arg, Tyr and Lys residues. Obtained data suggest that proteolytic activity could influence AEP formation and composition...
  41. Ash A, Wilde P, Bradshaw D, King S, Pratten J. Structural modifications of the salivary conditioning film upon exposure to sodium bicarbonate: implications for oral lubrication and mouthfeel. Soft Matter. 2016;12:2794-801 pubmed publisher
    ..3) of SB reduces the gel-like structure of mucins present in the pellicle by disrupting disulphide bridging of the mucins via the ionization of their cysteine's thiol group, which has an isoelectric point of ≈8.3. ..
  42. Hannig C, Spitzmüller B, Hannig M. Transaminases in the acquired pellicle. Arch Oral Biol. 2009;54:445-8 pubmed publisher
    ..52 mU/cm(2)). The ALT-activity of the centrifuged saliva was 26.62+/-11.09 mU/ml (AST 35.98+/-29.35 mU/ml). AST as well as ALT are present in the in situ pellicle layer and may contribute to the intrinsic maturation of pellicle proteins. ..
  43. Davey M, Costerton J. Molecular genetics analyses of biofilm formation in oral isolates. Periodontol 2000. 2006;42:13-26 pubmed
  44. Dorkhan M, Svensäter G, Davies J. Salivary pellicles on titanium and their effect on metabolic activity in Streptococcus oralis. BMC Oral Health. 2013;13:32 pubmed publisher
    ..Further studies are needed to clarify the mechanisms underlying the effect of surface contact on metabolic activity as well as to identify the salivary proteins responsible for enhancing the effect. ..
  45. Forss H, Seppa L, Alakuijala P. Plaque accumulation on glass ionomer filling materials. Proc Finn Dent Soc. 1991;87:343-50 pubmed
    ..The presence of silver in the silver glass ionomers may have affected the initial adherence of bacteria. ..
  46. Veeregowda D, van der Mei H, Busscher H, Sharma P. Influence of fluoride-detergent combinations on the visco-elasticity of adsorbed salivary protein films. Eur J Oral Sci. 2011;119:21-6 pubmed publisher
  47. Hahnel S, Rosentritt M, Burgers R, Handel G, Lang R. Candida albicans biofilm formation on soft denture liners and efficacy of cleaning protocols. Gerodontology. 2012;29:e383-91 pubmed publisher
    ..The highest efficacy for the removal of Candida albicans biofilms was identified for NaOCl. Chemical denture cleaners appear to have rather low efficacy to remove mature Candida albicans biofilms. ..
  48. Cárdenas M, Elofsson U, Lindh L. Salivary mucin MUC5B could be an important component of in vitro pellicles of human saliva: an in situ ellipsometry and atomic force microscopy study. Biomacromolecules. 2007;8:1149-56 pubmed
    ..Therefore, these large mucins can be responsible for the increased resistance of HWS films on hydrophobic substrates and can protect the intraoral surfaces against surface-active components present in oral health care products. ..
  49. Turssi C, Faraoni J, Rodrigues A, Serra M. An in situ investigation into the abrasion of eroded dental hard tissues by a whitening dentifrice. Caries Res. 2004;38:473-7 pubmed
    ..The results suggest that whitening dentifrices may not increase the wear of acid-softened enamel but may have a more deleterious effect on dentine than regular toothpastes. ..
  50. Kensche A, Reich M, Kümmerer K, Hannig M, Hannig C. Lipids in preventive dentistry. Clin Oral Investig. 2013;17:669-85 pubmed publisher
    ..Against the background of current scientific and empirical knowledge, edible oils might be used as oral hygiene supplements but a decisive benefit for the oral health status is questionable. ..
  51. Joiner A, Muller D, Elofsson U, Arnebrant T. Ellipsometry analysis of the in vitro adsorption of tea polyphenols onto salivary pellicles. Eur J Oral Sci. 2004;112:510-5 pubmed
    ..Therefore, black tea and its polyphenol components are indicated to have a profound effect on in vitro pellicle modification. Similar effects were observed for tannic acid. ..
  52. Young W, Khan F. Sites of dental erosion are saliva-dependent. J Oral Rehabil. 2002;29:35-43 pubmed
  53. Pickles M, Evans M, Philpotts C, Joiner A, Lynch R, Noel N, et al. In vitro efficacy of a whitening toothpaste containing calcium carbonate and perlite. Int Dent J. 2005;55:197-202 pubmed
  54. Young W, Khan F, Brandt R, Savage N, Razek A, Huang Q. Syndromes with salivary dysfunction predispose to tooth wear: Case reports of congenital dysfunction of major salivary glands, Prader-Willi, congenital rubella, and Sjögren's syndromes. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2001;92:38-48 pubmed
    ..Thus, the syndromes, unrelated in many respects, underline the importance of normal salivation in the protection of teeth against tooth wear by erosion, attrition, and abrasion...
  55. Lussi A, Hellwig E, Zero D, Jaeggi T. Erosive tooth wear: diagnosis, risk factors and prevention. Am J Dent. 2006;19:319-25 pubmed
    ..To provide an overview on diagnosis, risk factors and prevention of erosive tooth wear, which is becoming an increasingly important factor when considering the long- term health of the dentition...
  56. Razak F, Rahim Z. The anti-adherence effect of Piper betle and Psidium guajava extracts on the adhesion of early settlers in dental plaque to saliva-coated glass surfaces. J Oral Sci. 2003;45:201-6 pubmed
    ..It is therefore suggested that the plant extracts, in expressing their anti-adherence activities, could have altered the hydrophobic nature of the bonding between the bacteria and the saliva-coated glass surfaces...
  57. Yu D, Schemehorn B, Luo D, Kohut B, Parikh R, Santos S. Stain removal efficacy of two new fluoride dentifrices containing essential oils. Am J Dent. 2000;13:23C-25C pubmed
    ..To assess in vitro the stain removal efficacy of two new antiplaque/antigingivitis dentifrices utilizing a modification of a previously validated Stookey method...
  58. Hannig M, Khanafer A, Hoth Hannig W, Al Marrawi F, Acil Y. Transmission electron microscopy comparison of methods for collecting in situ formed enamel pellicle. Clin Oral Investig. 2005;9:30-7 pubmed
    ..Electrophoretical analysis of recovered pellicle fractions indicate that combination of sponge-rubbing followed by EDTA treatment can be recommended for stepwise removal of the globular and basal pellicle layers...
  59. Hannig C, Huber K, Lambrichts I, Gräser J, D Haen J, Hannig M. Detection of salivary alpha-amylase and lysozyme exposed on the pellicle formed in situ on different materials. J Biomed Mater Res A. 2007;83:98-103 pubmed
    ..Both enzymes are distributed randomly on the surface of the pellicle, irrespective of the underlying substratum...
  60. Nobbs A, Vickerman M, Jenkinson H. Heterologous expression of Candida albicans cell wall-associated adhesins in Saccharomyces cerevisiae Reveals differential specificities in adherence and biofilm formation and in binding oral Streptococcus gordonii. Eukaryot Cell. 2010;9:1622-34 pubmed publisher
    ..albicans with host and bacterial molecules, thus leading to effective colonization within polymicrobial communities...
  61. Kose R, Mitani I, Kasai W, Kondo T. "Nanocellulose" as a single nanofiber prepared from pellicle secreted by Gluconacetobacter xylinus using aqueous counter collision. Biomacromolecules. 2011;12:716-20 pubmed publisher
  62. Okuda K, Hanada N, Usui Y, Takeuchi H, Koba H, Nakao R, et al. Inhibition of Streptococcus mutans adherence and biofilm formation using analogues of the SspB peptide. Arch Oral Biol. 2010;55:754-62 pubmed publisher
    ..To characterize the analogue peptide biological activities, we investigated its binding and inhibiting effects, and the role of its amino acid moities...
  63. Gonzalez Cabezas C, Jiang H, Fontana M, Eckert G. Effect of low pH on surface rehardening efficacy of high concentration fluoride treatments on non-cavitated lesions. J Dent. 2012;40:522-6 pubmed publisher
    ..This study aimed to compare the surface rehardening and fluoride uptake effect of 2%-NaF solutions at different pH on non-cavitated caries-like lesions with two different levels of demineralization...
  64. Shimotoyodome A, Kobayashi H, Tokimitsu I, Hase T, Inoue T, Matsukubo T, et al. Saliva-promoted adhesion of Streptococcus mutans MT8148 associates with dental plaque and caries experience. Caries Res. 2007;41:212-8 pubmed
    ..In conclusion, the present findings suggest the initial S. mutans adhesion, modulated by salivary protein adsorption onto the enamel surface, as a possible correlate of susceptibility to dental plaque and caries...
  65. Pilch S, Williams M, Cummins D. In vitro efficacy of Colgate Total advanced fresh. Compend Contin Educ Dent. 2003;24:10-3; quiz 42 pubmed
    ..These results have been corroborated by clinical study results...
  66. Garcia Godoy F, Hicks M. Maintaining the integrity of the enamel surface: the role of dental biofilm, saliva and preventive agents in enamel demineralization and remineralization. J Am Dent Assoc. 2008;139 Suppl:25S-34S pubmed
    ..Dental caries is an infectious disease, and it affects 90 percent of late adolescents and young adults in the United States. It is a complex disease that occurs along the interface between the dental biofilm and the enamel surface...