[The role of Streptococcus mutans in human caries]. / Ruolo dello Streptococcus mutans nella carie umana.

Definite proof has been found that S. mutans, and probably S. sobrinus and lactobacilli, are responsible for caries in man. The aciduria of S. mutans encourages the selection inside the plaque and is directly responsible for its cariogenicity. Other aciduric species, as S. sobrinus, cause caries on the smooth surface of the tooth, where the principal causes of the rampant caries reside. If during the eruption of the tooth the fissures become colonized in depth by S. mutans, the development of caries becomes a highly probable event. Instead, if the colonization of the tooth by S. mutans takes place after the fissure depth have been occupied by other microbic species not cariogenic, it is probable that the caries will not manifest or will appear in a less severe form. In conclusion, the knowledge already acquired on the ecology of S. mutans and the mechanism of cariogenesis clearly indicate that all factors that interfere with the colonization of the tooth by S. mutans can greatly reduce the incidence of caries in man.

[Anticaries vaccination: present and future prospects]. / Vaccinazione anticarie: presente e prospettive future.

Despite the encouraging decline in dental caries observed in recent years in many populations, millions of children still risk tooth decay. Along with established methods of prevention, caries vaccines have the potential of making a highly valuable contribution to disease control. Compelling evidence has shown that Streptococcus mutans is the principal etiologic agent of dental caries, therefore a vaccine directed to this microorganism could significantly reduce the caries incidence. In experimental models with rodents, both peroral and parenteral immunization have provided protection against S. mutans infection and dental caries. In primates only parenteral immunization has given positive results, and there have been conflicting results in studies on human peroral immunization. Presently there is no conclusive evidence which shows that antibodies to S. mutans can protect against dental caries in humans. Among the S. mutans antigens that could be used as a vaccine, only some protein antigens have given protection in primates. One of these has been produced in large amounts and is ready for testing in humans. Another antigen, the enzyme complex glucosyltransferase, has shown protection in rodents and the effect of peroral administration of this antigen is now being tested in humans. While awaiting results of clinical trials with available vaccines, much additional experimental work is needed to understand the complex phenomenon of caries. New information will permit the development of more efficacious vaccines against the caries.

[Microbiological diagnosis of tetanus and serological verification of the immunological status. Serological monitoring in the course of therapy and prophylaxis]. / Diagnosi microbiologica del tetano e verifica sierological dello stato immunitario. Monitoraggio sierologico nel corso della terapia e della profilassi.

The tests for tetanus aetiological diagnosis are briefly surveyed: with particular attention to Passive Haemagglutination on Turkey Red Blood Cells (P.H./T.R.B.C.), for the assessment of antitoxin serum level. The P.H./T.R.B.C. proves a valuable tool in different occasions: -in patients, to control the immunotherapy; -in subjects at risk, to apply a correct prophylaxis; -in the whole population, to verify the outcome of compulsory vaccination.