Microbiología e Inmunología

Know the basic physiological and morphological characteristics of different microorganisms of interest in Oral Microbiology, so that they could understand the more specific aspects of the subject.

Understand the importance of the control of microorganisms and the main methods for doing so.

Know the basics of immune system and the mechanisms of immune response activation.

Understand infectious diseases as the result of the interaction between microorganisms and host and the main mechanisms of pathogenesis of infectious diseases.

Know the etiology, pathogenesis, and antimicrobial treatment of major infectious diseases of the oral cavity.

Know and understand the rationale of antibiotic therapy and the major mechanisms of resistance of microorganisms against chemotherapy.

Get an overview of microorganisms as causative agents of systemic disease and its impact on the oral health.

To explore the basic principles of immunology which allow us to understand the different responses from the human immune system.

Unit 1: Introduction to Microbiology.
Concept of Microbiology. History. The levels of cellular organization. Main groups of microorganisms. Microbiological methods: the basics of microscopy. Microbial staining. The study of microbial populations: the culture of microorganisms.
RUNNING TIME: 0.5 Sessions

Unit 2: Morphology of bacterial cell.
Bacterial size and shape. Structure of the bacterial cell. Required elements: cell wall: structure and types, wall-less prokaryotes. The cytoplasmic membrane and mesosomes. The bacterial cytoplasm. Ribosomes. The bacterial nucleoid. Non-required elements. Glycocalix: capsule and slime. Appendix: flagella, fimbriae and Pilli. Extranuclear genetic material: plasmids. Cytoplasmic granules. The forms of resistance: esporogenesis and endospores.
RUNNING TIME: 2 Sessions

Unit 3: Bacterial metabolism and its regulation
Bacterial nutrition and his types. Nutrient transport in bacteria. Maintenance reactions: Chemotrophic obtaining of energy : respiration and fermentation. Oxidative phosphorylation and electronic transport. Anaerobic metabolism: types of anaerobic fermentation. Anaerobic respiration. Generation of reducing power. Biosynthesis: glyconeogenesis, synthesis of amino acids and nucleotides. Polymerization and assembly: synthesis of polysaccharides. Replication and transcription. Protein synthesis in prokaryotes. Assembly of bacterial wall. Integration of catabolism and anabolism: anaplerotic pathways. End-product regulation of enzyme activity: allosterism. Regulation of protein synthesis: operons. Other regulatory mechanisms.
RUNNING TIME: 2 Sessions

Unit 4: Bacterial growth and development.
Cell division in bacteria: types. Bacterial growth: nutritional and environmental factors. Phases of bacterial growth and its determination. Culture media.
RUNNING TIME: 1 Session

Unit 5: Control of bacterial growth (I). Chemical and physical agents.
Terminology and test methods. Main physical agents for microbial control. Major chemicals for microbial control. Main methods of microbial control in dentistry. Control of cross-infection.
RUNNING TIME: 1 Session

Unit 6: Control of bacterial growth. (II). Antibiotics and chemotherapy.
Definitions. Classification of antibiotics and chemotherapics. Mechanisms of action. Resistance to antibiotics. Measurement of microbial susceptibility to chemotherapic agents. Use of antibiotics in dentistry.
RUNNING TIME: 1 Session

Unit 7: Bacterial Genetics.
Bacterial variability. Phenotypic and genotypic variations. Mutation and mutagenesis. Genetic recombination: transformation and transduction. Sexuality in bacteria: bacterial conjugation. Transposons.
RUNNING TIME: 1 Session

Unit 8: General characteristics of viruses and other infectious simple forms.
Morphology and structure of virus. The generation of new viral particles: viral multiplication. Tempered viruses and lisogeny. Antiviral therapy. Viroids and prions.
RUNNING TIME: 1.5 Sessions

Unit 9: The eukaryotic microorganisms: algae, protozoa and fungi.
The eukaryotic cells. The microscopic algae. Protozoa. Fungi: structure, morphology and reproduction.
RUNNING TIME: 1 Session

Unit 10: Microbial ecosystems. The oral ecological system.
Microbial ecosystems. Main types of organism association. The normal microbiota. Oral ecological system. Bacterial films.
RUNNING TIME: 1 Session

Unit 11: Host-Parasite interaction. Introduction to Immnunolgy
Basics on immunity. Innate immunity and adquired immunity. Componenent of immune system: cells, tissues, antigens and other proteins of the immune system. Cells of the innate immunity and their activities. Phagocitosis. Complement system. Humoral immunity: maturation, activation and effector functions of B lymphocytes. Cellular immunity: maturation, activation and effector functions of T lymphocytes. Effects of defense mechanisms against microorganisms. Hypersensitivity reactions and autoimmunity. Immunization.
RUNNING TIME: 5 Sessios

Unit 12: Infection and disease.
Definitions: pathogenicity and virulence. The defense against infectios: microbial antigens. Effects of immune mechanisms on microorganisms. Inmunización. Hypersensitivity reactions and autoimmunity. Immunization. Virulence factors and pathogenicity of bacteria. Pathogenesis of viral infections. Models of infection. Transmission of infectious diseases. Control of cross-infection.
RUNNING TIME: 3 Sessions

Unit 13: Introduction to microbial taxonomy.
Species concept in Microbiology. Nomenclature. Types of bacterial classification. Classification of prokaryotes. Classification of viruses. Methods of microbial identification: Identification assays.
RUNNING TIME: 1 Session

Unit 14: Major bacteria in oral pathology.
Oral streptococci. Other Posibacteria: Gram (+) Cocci, Lactobacillus, Eubacterium, Togobacteria: Veillonella and Selenomonas. Actinobacteeria: Actinomyces, Corynebacterium, Propionibacterium, Rothia, and Bifidobacterium. Negibacteria: Bacteria G (-) aerobic and facultative: Eikenella, Campylobacter, Capnocytophaga, and Aggregatibacter (Actinobacillus). Anaerobic bacteria, Porphyromonas, Prevotella, Tannerella, Bacteroides, Fusobacterium
RUNNING TIME:1 Session

Unit 15: The dental plaque
Overview of teeth anatomy. Mechanisms of bacterial adhesion of to oral tissues. Dental plaque: composition and structure. Formation and maturation of dental plaque. Dental tartar.
RUNNING TIME: 1 Session

Unit 16: The dental caries
Dental caries: definition and clinical description. Etiology of dental caries: main bacteria involved. Pathogenesis of dental caries. Microbiological control of dental caries.
RUNNING TIME: 1 Session

Unit 17: The periodontal disease.
Clinical classification of periodontal diseases. Etiology of chronic periodontal disease. Pathogenesis of chronic periodontal disease. Other infectious diseases of periodontium: acute gingivitis (pregnancy, streptococcal, U.N.A.G), agresive periodontitis (localized and generalized), gingival and periodontal abscess. Perimplantitis
RUNNING TIME: 2 Sessions

Unit 18: Infection of the pulp and periapical tissues.
Etiology of pulpal changes: microorganisms involved and entry pathways. Pathogenesis and control of pulpal and periapical infections. Complications caused by the spread oral infections.
RUNNING TIME: 1 Session

Unit 19: Other infections of the oral cavity.
Focal infections with oral origin: concept and main routes of spreading. Infections of the salivary glands. Pericoronitis. Halitosis. Major viral infections of the oral cavity: herpetic gingivostomatitis, hand-foot-mouth disease, Herpangina, viral parotiditis, papillomavirus caused warts and condylomas. Viral hepatitis. HIV infection Oral candidiosis: pathogenesis, clinical features and treatment. Other fungal infections with oral manifestations: Histoplasmosis, aspergillosis and cryptococcosis. Parasitic protozoa of the oral cavity.
RUNNING TIME: 2 Sessions

Unit 20: Main microorganisms causing systemic diseases
Extracellular penetrating bacteria: Pyogenic G (+)cocci (Staphylococcus, Strepctococcus) Pyogenic G (-) cocci and bacilli (Neisseria, Bordetella, Haemophilus), enteric bacteria (Enterobacteriaceae, Campylobacter and Helicobacter) pseudomonadales (Pseudomonas, Legionella). Other extracellular bacteria (Listeria, Brucella). Fungal-like bacteria (Actinomycetaceae, Mycobacterium). Toxigenic bacteria (Bacillus, Clostridium, Corynebacterium, Vibrio). Non-sporulated anaerobic bacteria(Bacteroides, Fusobacterium). Spirochetes (Treponema, Borrelia). Ricketssia, Chlamydia and Mycoplasma. RNA viruses: picornavirus, Togavirus, reovirus, and paramyxovirus Ortomixovirus. Retroviral onc ogenes. DNA virus: Papovavirus, adenovirus, herpesvirus and poxvirus Helminth infestations.
RUNNING TIME: 2 Sessions

RECOMMENDED GENERAL TEXTS
“Microbiología oral 2ª ed” Liébana y otros. MacGrawHill-Interamericana
“Microbiología Estomatológica. Fundamentos y guía práctica 2ºED”. Negroni. Panamericana
“Essential Microbiology for dentistry 5ºed. L. Samaranayake. Elsevier (2018)


SPECIFIC TEXTS ON INMUNOLOGY
“Inmunología básica: Funciones y trastornos del sistema inmunitario 7ª Ed". ABBAS, A.K.; LICHTMAN, A.H.; PILLAI, S. Elsevier España, 2024.
"Inmunología celular y molecular 10ª Ed." ABBAS, A.K., LICHTMAN, A.H. y PILLAI, S. Elsevier España, 2022
"Inmunología: Biología y patología del sistema inmunitario 5ª Ed.". REGUEIRO, J.R., LOPEZ, C., GONZÁLEZ, S., MARTÍNEZ, E. Editorial Médica Panamericana, 2021

TEXTS APPLIED TO THE GENERAL AND SYSTEMATIC PART.
“Microbiología Médica 2ª ED.” Murray, Kobayashi, Pfaller y Rosenthal. Harcourt-Brace
“Microbiología” Walker. McGraw-Hill Interamericana.
“Microbiología Médica” Mims, Playfair, Roitt, Wakelin y Williams. Harcourt-Brace Mosby.

SPECIFIC TEXTS ON BUCAL MICROBIOLOGY
“Infecciones orofaciales. Diagnóstico y Tratamiento” Bascones y Manso. Ediciones Avances
“Caries”. Thylstrop y Fejerstov. Doyma.
“Periodontologia Clínica” Carranza. Interamericana.
“Bases Biológicas de la Caries Dental”. Menaker. Salvat

ARTICLES OF REVIEW AND SCIENTIFIC DIVULGATION
In many of the units specific bibliography in qualified scientific divulgations magazines as Investigación y Ciencia (Scientific American) or Mundo Científico (La Recherche) will be advised.

SOME WEB SITES OF INTEREST
http://www.microbelibrary.org maintained by the American Society of Microbiology and interesting collection of drawings and images
http://www.geocities.com/CapeCanaveral/3504/gallery.htm. Culture collections and clinical samples.
http://www.dsmz.de/microorganisms/bacterial_nomenclature.php maintained by the German Culture collection. Updates names of microbial genera and species
http://www.freemedicaljournals.com/htm/esp.htm allows free access to various medical journals. Good page for literature searches.

The study of the subject of Microbiology and Immunology will provide the student with knowledge of the microbial world that is important for their professional development, both in the field of cross-infection control and in the diagnosis and treatment of many oral pathologies.
At the end of the course, the student will be able to diagnose and evaluate the progression of infectious diseases of the oral cavity and understand the usefulness of hygienic measures to control them. Finally, you will be able to evaluate the options for antibiotic therapy in the treatment of infections, either as a sole treatment or as an adjuvant to other therapeutic actions in restorative or reparative dentistry.
Know the immunological sciences on which Dentistry is based to ensure correct oral-dental care. These knowledge, skills and competences coincide with those of the following in the degree thesis.

Knowledge
Con01. Know the biomedical sciences on which Dentistry is based to ensure proper oral-dental care. These sciences must include appropriate content on Microbiology and Immunology
Con03. Know the scientific method and have critical capacity to assess established knowledge and new information.
Con04. Know the scientific principles of sterilization, disinfection and antisepsis necessary to prevent cross infections in dental practice.
Con07. Know the clinical and laboratory diagnostic procedures and tests, know their reliability and diagnostic validity and be competent in interpreting their results.
Con16. Provide a global approach to oral care and apply the principles of health promotion and prevention of oral diseases.
Con17. Educate and motivate patients in the prevention of oral diseases, control pathogenic oral habits, instruct them on proper oral hygiene, dietary and nutritional measures and, in short, on all methods of maintaining oral health.
Con27 Know the general processes of becoming ill, healing and repairing, including infection, inflammation, bleeding and coagulation, scarring, trauma and alterations of the immune system, degeneration, neoplasia, metabolic alterations and genetic disorders.
Con29 Know the oral manifestations of systemic diseases.
Con46 Manage acute infections, including pharmacological prescription and simple surgical aspects.
Con51 Treat both pharmacologically and surgically the inflammatory processes of periodontal and/or peri-implant tissues, including supra and subgingival periodontal instrumentation techniques.

Skills
H/D03. Know how to identify the patient's concerns and expectations, as well as communicate effectively and clearly, both orally and in writing, with patients, family members, the media and other professionals.
H/D04. Understand and recognize the social and psychological aspects relevant to the treatment of patients.
H/D07. Promote independent learning of new knowledge and techniques, as well as motivation for quality.
H/D11. Understand the basic biomedical sciences on which Dentistry is based to ensure proper oral-dental care.
H/D14. Know the general processes of the disease, including infection, inflammation, immune system disorders, degeneration, neoplasia, metabolic disorders and genetic disorders.
H/D15. Be familiar with the general pathological characteristics of diseases and disorders that affect organic systems, specifically those that have oral repercussions.
H/D16. Understand the fundamentals of action, indications and efficacy of drugs and other therapeutic interventions, knowing their contraindications, interactions, systemic effects and interactions on other organs, based on the available scientific evidence.
H/D17. Understand and recognize the principles of ergonomics and safety at work (including cross-infection control, radiological protection and occupational and biological diseases).
H/D18. Know, critically assess and know how to use the sources of clinical and biomedical information to obtain, organize, interpret and communicate scientific and health information.
H/D19. Know the scientific method and have critical capacity to assess established knowledge and new information. Be able to formulate hypotheses, collect and critically assess information to solve problems, following the scientific method.
H/D21. Know how to perform a complete oral examination, including the appropriate radiographic and complementary exploration tests, as well as obtaining adequate clinical references.
H/D23. Establish the diagnosis, prognosis and adequate therapeutic planning in all clinical areas of Dentistry, being competent in the diagnosis, prognosis and preparation of the dental treatment plan for patients requiring special care, including medically compromised patients (such as diabetics, hypertensive patients, immunosuppressed patients, anticoagulated patients, among others) and patients with disabilities.
H/D25. Know and apply the basic treatment of the most common oral-dental pathology in patients of all ages. Therapeutic procedures should be based on the concept of minimal invasion and on a global and integrated approach to oral-dental treatment.
H/D26. Know how to plan and carry out multidisciplinary, sequential dental treatments. and integrated limited complexity in patients of all ages and conditions and patients requiring special care.
H/D27. ​​Propose and propose preventive measures appropriate to each clinical situation.
H/D29. Recognize the determinants of oral health in the population, both genetic and those dependent on lifestyle, demographic, environmental, social, economic, psychological and cultural.
H/D30. Recognize the role of the dentist in prevention and protection actions against oral diseases, as well as in the maintenance and promotion of health, both at individual and community level.

Competencies
Comp01. Ability to analyze and synthesize.
Comp02. Ability to organize and plan.
Comp03. Oral and written communication in one's own language.
Comp06. Information management skills (ability to search for and analyze information from various sources).
Comp07. Problem solving.
Comp08. Decision making.
Comp16. Ethical commitment
Comp17. Ability to apply knowledge in practice.
Comp18. Research skills.
Comp19. Ability for independent learning
Comp20. Ability to adapt to new situations.
Comp21. Ability to generate new ideas (creativity)
Comp24. Ability to work independently.

As a projection in the following courses of the degree, you will obtain a knowledge base that will facilitate a better understanding of subjects from subsequent courses as part of infectious diseases in Dental Pathology and Therapeutics, Periodontics and Preventive and Community Dentistry.

As an added benefit, the course will always try to give a scientific vision of the everyday world, looking for examples from daily life for a better understanding of the scientific foundations of the subject.

Theory:

The content of the subject will be developed through theoretical classes of about 50 minutes long with the support of various audiovisual material. An attempt will always be made to promote the participation of students in the discussion of those aspects of the subject of greatest relevance or difficulty in understanding, trying in any case that these participations are not too concrete and abundant to significantly delay the development of the class without providing solutions to general problems. It is highly recommended to bring the subject “up to date” since the concepts explained in previous topics are the necessary support to advance in the explanation of the subject in an understandable way.


Virtual classroom.

It will propose the completion of work, tests will be conducted "on-line" continuous evaluation once the presentation of each topic or thematic block is completed. The scripts and objectives of the different topics explained will be posted in this space, as well as most of the audiovisual material. Of particular relevance is the existence of a tutoring forum in which students are encouraged to participate in solving the doubts raised by their classmates, always under the supervision of the teacher.


The practical classes:

Will be held in the Microbiology laboratory of the Faculty of Medina and Dentistry of Santiago for a week. So students can understand the sequential development of microbiological techniques and can work with material obtained by themselves better than with crops provided by the teacher. The objective of the practices is to ensure that the students “believe” the existence of microorganisms and that they do the “isolation” and bacterial identification procedure that is carried out in hospitals in an automated way so that they are able to understand the foundation of these "magic machines". They also acquire the necessary practice for handling sterile material and aseptic work techniques.

The evaluation will be carried out through an exam and the continuous evaluation of the students for their participation and attitude during the theoretical and practical classes. The exam consists of approximately 70 multiple choice questions with five possible solutions of which only one is correct, incorrect answers do not have a negative score, and a set (10-15) of short writing questions. Test questions represent 65-70% of the exam grade and short questions the other 30-35%. As a guide to the value of the different aspects evaluated:

The exam represents 70-80% of the final grade (the test represents between 60 and 70% and the short questions the remaining 30-40%)
Participation in class and seminars will be valued at the teacher's discretion up to 10%
The virtual classroom grade will be obtained from the activities and tests carried out and represents 20%


In order to be evaluated, at least 45% of the exam grade and at least 30% of the grade in the contents of each knowledge area must be obtained. The percentage corresponding to participation in class and presentation of seminars will be used to increase the grade obtained, only if 50% of the exam grade is overcomed.

Approximately three hours per each theory session (the duration of each unit is included in the contents section).

It is advisable to have previously attended to a course of biology. If this is not the case many of the basic concepts of structure and metabolism of microorganisms may be completely unknown.
It is also very advisable to study the matter "every day" since the concepts explained in the previous topics are needed to support progress in the explanation of the new subject in a comprehensible manner.

The running time assessed to every unit in the "contents" could be slightly modified according to course evolution