Microbial induction of dentinal caries in human teeth in vitro.

The ability of Lactobacillus casei, Streptococcus sobrinus, Actinomyces viscosus, and Streptococcus salivarius to induce dental caries was determined in vitro. A class I cavity (depth: 2mm) was prepared in extracted human caries-free premolars to make dentin blocks. The blocks were inoculated with these four bacterial strains in a monoinfective fashion and were incubated under anaerobic conditions. In addition to the monoinfection groups, mixed-infection groups of L. Casei with S. sobrinus or A. viscosus were also prepared. Half of the culture medium was renewed every 3 days, and the pH of the medium was measured. After 4 or 12 wk, these dentin blocks were prepared by Brown-Brenn staining and by contact microradiography for light microscopic observation and for immunohistochemical staining. The final pH of the S. salivarius group was the highest among the experimental groups, at approximately 5.1; that of the others was approximately 4.3. Bacterial invasion into the dentinal tubules was observed in all but the S. salivarius group. Among the monoinfection groups, the S. sobrinus group showed the highest invasion rate, followed by the A. Viscosus group and the L. casei group. The invasion rate was also high in the mixed-infection groups. Immunohistochemical staining revealed invasion only by L. casei, and not by S. sobrinus and A. viscosus. The invasion rate by L. casei was higher in the mixed-infection group with either S. sobrinus or A. viscosus than in the monoinfection groups. These findings suggest that lactobacillus might play an important role in the initiation and progress of dentinal caries, and that this bacterial species might exhibit a cooperative cariogenicity when it coexists with other bacterial species that surpasses its individual cariogenicity.