Dental Calculus Classification

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Questions and Answers

What is the primary cause of gingival inflammation?

  • Faulty restoration
  • Tobacco use
  • Bacterial plaque (correct)
  • Radiation therapy

Which type of calculus is located coronal to the gingival margin?

  • Exogenous calculus
  • Supragingival calculus (correct)
  • Endogenous calculus
  • Subgingival calculus

Among the following, which calculus is classified according to the source of mineralization?

  • Salivary calculus (correct)
  • Moderate calculus formers
  • Heavy calculus formers
  • Endogenous calculus

What is a characteristic feature of supragingival calculus?

<p>Hard with a claylike consistency (B)</p> Signup and view all the answers

Which of the following locations is most common for supragingival calculus to develop?

<p>Buccal surface of maxillary molars (B)</p> Signup and view all the answers

Which classification includes individuals that do not form calculus?

<p>Non-calculus formers (A)</p> Signup and view all the answers

Which duct is associated with salivary flow over the facial surfaces of the upper molars?

<p>Stensen's duct (C)</p> Signup and view all the answers

What is a common visual observation of supragingival calculus?

<p>White to yellowish in color (D)</p> Signup and view all the answers

Which of the following components is NOT a major inorganic constituent of supragingival calculus?

<p>Iron (C)</p> Signup and view all the answers

Which crystal form is found most frequently in supragingival calculus?

<p>Hydroxyapatite (A)</p> Signup and view all the answers

What observable change can occur after removing subgingival plaque and calculus?

<p>Reduction in gingival inflammation (A)</p> Signup and view all the answers

Which statement about the clinical visibility of subgingival calculus is accurate?

<p>It becomes exposed only when gingival tissue recedes. (A)</p> Signup and view all the answers

How does the composition of subgingival calculus generally differ from supragingival calculus?

<p>Subgingival calculus contains more magnesium white-lockite. (C)</p> Signup and view all the answers

What proportion of inorganic content in supragingival calculus can be attributed to calcium?

<p>39% (A)</p> Signup and view all the answers

Which crystal form is more commonly found in the mandibular anterior region?

<p>Brushite (A)</p> Signup and view all the answers

Which statement correctly describes the sodium content in relation to the depth of the pocket?

<p>Sodium content increases with the depth of the pocket. (D)</p> Signup and view all the answers

What is the clinical visibility of dental calculus during an examination?

<p>It is not visible on routine clinical examination. (C)</p> Signup and view all the answers

How does supragingival calculus form?

<p>Through precipitation of mineral salts from saliva. (C)</p> Signup and view all the answers

What factor affects the attachment of calculus to dental implants?

<p>Attachment is less intimate due to lower micro porosities in implants. (B)</p> Signup and view all the answers

Which mechanism is NOT involved in the attachment of calculus to teeth?

<p>Chemical bonding with salivary proteins. (D)</p> Signup and view all the answers

Which statement about the mineralization of dental plaque is correct?

<p>Plaque can become 50% mineralized within 2 days. (C)</p> Signup and view all the answers

What is the primary source of mineralization for subgingival calculus?

<p>Gingival crevicular fluid. (C)</p> Signup and view all the answers

Which characteristic of calculus formation is true?

<p>Calculus can form in completely germ-free conditions. (A)</p> Signup and view all the answers

Flashcards

Dental Calculus Formation

Dental calculus is hardened dental plaque, formed by mineral salt precipitation within plaque.

Calculus Attachment (Teeth)

Calculus attaches to teeth by organic pellicle, mechanical interlocking, close adaptation, and bacterial penetration.

Calculus Attachment (Implants)

Calculus attachment to implants is weaker than to teeth, due to implant surface characteristics.

Calculus Mineralization

Calculus formation timeline varies. Starts 4-8 hours after plaque formation in 50% in two days and mineralization is complete in 12 days. Formation of old calculus takes months-years.

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Plaque to Calculus Transition

Plaque mineralizes to form calculus. Early plaque has little inorganic material, while calculus has significantly more.

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Calculus Mineralization Source (Supragingival)

Saliva is the source of mineral for supra gingival calculus formation.

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Calculus Mineralization Source (Subgingival)

Gingival crevicular fluid provides the minerals for subgingival calculus formation.

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Calculus and Microorganisms

Calculus can form even without microorganisms, but saliva is the main mineral source for supra-gingival calculus, and gingival crevicular fluid for sub-gingival.

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Dental Calculus

Mineralized bacterial plaque found on teeth and dental prostheses.

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Supragingival Calculus

Calculus located above the gumline, visible in the mouth.

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Subgingival Calculus

Calculus located below the gumline. This is harder to see.

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Calculus Classification by Location

Calculus is classified based on its position relative to the gumline (supragingival or subgingival).

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Common Calculus Locations

Maxillary molars (buccal) and mandibular incisors (lingual) are frequent spots for calculus formation.

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Calculus Color Factors

Calculus color is affected by materials like tobacco and food pigments.

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Calculus Recurrence

Supragingival calculus often reappears after removal, especially on lingual surfaces of mandibular incisors.

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Calculus Formation Types

Individuals are categorized as non-calculus, slight, moderate, or heavy calculus formers based on their calculus buildup tendency.

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Subgingival Calculus Location

Calculus located below the gum line, not visible during routine exams.

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Subgingival Calculus Detection

Evaluated by carefully feeling with dental instruments.

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Subgingival Calculus Appearance

Hard, dense, often dark brown or greenish black.

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Supragingival Calculus Composition

Mostly inorganic (70-90%), primarily calcium phosphate.

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Calculus Crystal Forms

Hydroxyapatite & Octacalcium phosphate are most common in calculus.

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Subgingival vs. Supragingival Calculus

Subgingival has more magnesium-based crystals and less brushite/octacalscium phosphate than supragingival.

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Calculus Effects - Removal

Removal reduces inflammation and improves probing depths.

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Calculus Inorganic Composition

Calcium phosphate is the major inorganic component of calculus.

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Study Notes

Dental Calculus

  • The main cause of gum inflammation is bacterial plaque, other factors include calculus, bad bite, faulty dental work, orthodontic issues, self-harm, tobacco use and radiation therapy.
  • Calculus is mineralized bacterial plaque forming on natural teeth and dental prosthetics.
  • Calculus is classified as supragingival or subgingival based on its position relative to the gumline.

Classification of Dental Calculus

  • Location:

    • Supragingival calculus is above the gumline.
    • Subgingival calculus is below the gumline.
  • Source of Mineralization:

    • Salivary calculus
    • Serumal calculus (Jenkins, Stewart 1966)
  • Surface:

    • Exogenous
    • Endogenous (Melz 1950)
  • Initiation and rate of accumulation:

    • Calculus formers are categorized based on these factors.

Supra and Sub-gingival Calculus

  • Supragingival calculus: Usually appears white or yellowish, hard, and clay-like. Often found on the buccal surfaces of upper molars and the lingual surfaces of lower incisors, affected by materials like tobacco and food coloring. Can be widespread throughout the mouth.
  • Subgingival calculus: Located below the gumline, not easily seen during routine checkups. Evaluated by tactile perception with tools like dental explorers.

Calculus Composition

  • Inorganic: Composed of approximately 70-90% inorganic materials, with calcium phosphate being the main component (76%), carbonates, and trace amounts of other metals.
  • Organic: Mixture of protein-polysaccharide complexes, dead cells (epithelial), WBCs, and various microorganisms.

Calculus Attachment

  • Calculus adheres to teeth via organic tissue, mechanical interactions with irregularities, and a close adaptation to existing tooth structures (like resorption lacunae or gently sloping areas)
  • Calculus penetration is similar to penetration processes on bone areas.
  • Calculus attachment to implants involves less intimate contact and can be easily removed from titanium implants.

Calculus Formation

  • Calculus is formed from plaque mineralisation.
  • Mineralization starts within 4-8 hours of plaque development, reaching 50% mineralisation in 2 days, and 60-90% in 12 days.
  • Full development of mature crystalline composition can sometimes take months or years.

Role of Microorganisms in Calculus Formation

  • Microbes are not always essential for calculus formation.
  • Calculus develops in germ-free rodents, while saliva is the source for supra-gingival and gingival crevicular fluid for sub-gingival calculus formation.
  • Some microbes have the ability to form intracellular apatite crystals.

Etiological Significance

  • Non-mineralized plaque on calculus surface is a primary irritant initiating gingivitis.
  • Mineralized portion of calculus contributes to continued plaque accumulation and can lead to periodontal pockets.
  • Removal of calculus and plaque is a key step in periodontal treatment.

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