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Questions and Answers
What role does non-mineralized plaque on the calculus surface play in relation to gingivitis?
What role does non-mineralized plaque on the calculus surface play in relation to gingivitis?
Which mineralization theory suggests that plaque may initiate calcification by chelating calcium from saliva?
Which mineralization theory suggests that plaque may initiate calcification by chelating calcium from saliva?
What is the implication of sub gingival calculus in relation to periodontal pockets?
What is the implication of sub gingival calculus in relation to periodontal pockets?
What is suspected to play an active role in the formation of seeding agents during calculus formation?
What is suspected to play an active role in the formation of seeding agents during calculus formation?
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Which mineralization theory posits that bacterial metabolism alters the environmental pH to promote mineralization?
Which mineralization theory posits that bacterial metabolism alters the environmental pH to promote mineralization?
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Which type of organisms have been noted for their ability to form intracellular apatite crystals that contribute to mineralization?
Which type of organisms have been noted for their ability to form intracellular apatite crystals that contribute to mineralization?
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What is the correct relationship between fat acids and calcium or magnesium in calculus development?
What is the correct relationship between fat acids and calcium or magnesium in calculus development?
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Which of the following theories focuses on the modification of the environment by microorganisms to facilitate mineralization?
Which of the following theories focuses on the modification of the environment by microorganisms to facilitate mineralization?
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What effect do anti-calculus dentifrices have on the formation of calculus?
What effect do anti-calculus dentifrices have on the formation of calculus?
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Which mineral component is found in significantly higher amounts in heavy calculus formers compared to non-calculus formers?
Which mineral component is found in significantly higher amounts in heavy calculus formers compared to non-calculus formers?
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What initiates the process of calcification in dental plaque?
What initiates the process of calcification in dental plaque?
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What role do microorganisms play in the mineralization of calculus?
What role do microorganisms play in the mineralization of calculus?
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In terms of the mineralization theories, what is primarily responsible for maintaining a supersaturated solution of calcium phosphate salts?
In terms of the mineralization theories, what is primarily responsible for maintaining a supersaturated solution of calcium phosphate salts?
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Which enzyme is mentioned to potentially initiate calcification by hydrolyzing fatty esters?
Which enzyme is mentioned to potentially initiate calcification by hydrolyzing fatty esters?
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What is the relationship between phosphorus levels and calculus formation?
What is the relationship between phosphorus levels and calculus formation?
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How does the initiation of calcification vary among different teeth in the same individual?
How does the initiation of calcification vary among different teeth in the same individual?
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How does the sodium content in salivary calculations change with depth?
How does the sodium content in salivary calculations change with depth?
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What is the primary mechanism by which dental calculus attaches to tooth surfaces?
What is the primary mechanism by which dental calculus attaches to tooth surfaces?
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Which statement accurately reflects the mineralization process of calculus?
Which statement accurately reflects the mineralization process of calculus?
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What is true about the role of microorganisms in calculus formation?
What is true about the role of microorganisms in calculus formation?
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Which material is the source of mineralization for supragingival calculus?
Which material is the source of mineralization for supragingival calculus?
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Which characteristic distinguishes calculus attachment on implants versus natural teeth?
Which characteristic distinguishes calculus attachment on implants versus natural teeth?
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What best describes the time frame for mature crystalline composition of dental calculus?
What best describes the time frame for mature crystalline composition of dental calculus?
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What is the expected sodium content behavior at increased depths of periodontal pockets?
What is the expected sodium content behavior at increased depths of periodontal pockets?
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Study Notes
Dental Calculus
- The primary cause of gum inflammation is bacteria, plaque, and other contributing factors like bad bites, poor restorations, complications from orthodontic work, self-harm, tobacco use, and radiation therapy.
- Calculus is mineralized bacterial plaque that forms on teeth and dental prosthetics. It's categorized as supragingival (above the gum line) or subgingival (below the gum line) depending on its location relative to the gum.
Classification of Dental Calculus
-
Location:
- Supragingival calculus
- Subgingival calculus
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Source of Mineralization (Jenkins & Stewart, 1966):
- Salivary calculus
- Serumal calculus
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Surface (Melz, 1950):
- Exogenous
- Endogenous
-
Initiation and Rate of Accumulation:
- Calculus formers are categorized based on these factors.
Calculus Appearance and Distribution
- Supragingival Calculus: Located above the gum line, typically white or yellowish, hard, and clay-like. It's easily seen and frequently recurs, especially on the lingual side of lower front teeth. Commonly found on the buccal surfaces of upper molars and the lingual surfaces of lower anterior teeth. Saliva from the parotid gland (Stensen's duct) affects the upper molars, while the submandibular and sublingual glands (Wharton's duct and Bartholin's duct) affect the lower incisors.
- Subgingival Calculus: Located below the gum line, not routinely visible. It can be detected by feeling with a dental explorer. Subgingival calculus can be found with careful dental instrumentation.
Calculus Composition
- Inorganic Content: Composed of 70-90% inorganic material, primarily calcium phosphate, with other trace minerals such as sodium, zinc, strontium, bromine, copper, manganese, tungsten, aluminum, and silicon. The most common crystal forms are hydroxyapatite, magnesium whitlockite, octacalcium phosphate, and brushite.
- Organic Content: Includes protein-polysaccharide complexes, desquamated epithelial cells, leukocytes, and various microorganisms.
Calculus Attachment
- Calculus attaches to the tooth through:
- Organic pellicle on the cementum
- Mechanical interlocking with surface irregularities
- Adaptation of calculus under surfaces to the surrounding tooth shape
- Deep penetration into cementum
Calculus Formation
- Calculus is hardened dental plaque.
- Mineralization begins within 4-8 hours of plaque formation, progressing to around 50% after 2 days and 60-90% in 12 days, although full mineralization can take months to years to mature.
Theories of Mineralization
- Mineral Precipitation: A rise in saliva pH leads to precipitation of calcium phosphate salts.
- Seeding Agents: Small foci of calcification develop, accumulating to form larger masses.
Role of Microorganisms
- Microorganisms are not always necessary for calculus formation.
- Some organisms (e.g., filamentous organisms, diphtheroids, Bacterionema, Veillonella) can form intracellular apatite crystals, actively participating in calcification.
Etiologic Significance
- Non-mineralized plaque is the primary irritant for gingivitis.
- The underlying calcified portion provides a fixed nidus for further plaque accumulation and closely associates with the gums.
- Calculus may be a consequence, not the cause, of periodontal pockets.
- Removing calculus and plaque is essential for effective periodontal treatment.
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Description
Explore the different types and classifications of dental calculus in this quiz. Learn about supragingival and subgingival calculus, mineralization sources, and their appearances. Perfect for those studying dental hygiene and oral health.
