Podcast
Questions and Answers
What is the primary composition of dental calculus?
What is the primary composition of dental calculus?
Which component is not a crystalline structure of dental calculus?
Which component is not a crystalline structure of dental calculus?
Which statement accurately differentiates between supra and sub calculus?
Which statement accurately differentiates between supra and sub calculus?
Where is dental calculus most likely to attach?
Where is dental calculus most likely to attach?
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What is the role of dental calculus in dental disease progression?
What is the role of dental calculus in dental disease progression?
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Which location is least likely to have dental calculus attachment?
Which location is least likely to have dental calculus attachment?
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How long after plaque biofilm formation does dental calculus typically begin to form?
How long after plaque biofilm formation does dental calculus typically begin to form?
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Which of the following describes the mineral derivation in dental calculus?
Which of the following describes the mineral derivation in dental calculus?
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What role do phosphatases and proteases have in the process of calculus formation?
What role do phosphatases and proteases have in the process of calculus formation?
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Which of the following classifications is NOT used for categorizing calculus formers?
Which of the following classifications is NOT used for categorizing calculus formers?
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What is the primary component of the calcified mass known as calculus?
What is the primary component of the calcified mass known as calculus?
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What factors can influence the rate of calculus accumulation?
What factors can influence the rate of calculus accumulation?
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Which of the following methods is least effective in detecting calculus?
Which of the following methods is least effective in detecting calculus?
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Why is it important for clinicians to understand calculus formation?
Why is it important for clinicians to understand calculus formation?
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What happens to calcification inhibitors in saliva during the process of calculus formation?
What happens to calcification inhibitors in saliva during the process of calculus formation?
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Which of these is a common characteristic of slight calculus formers?
Which of these is a common characteristic of slight calculus formers?
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Study Notes
### Dental Calculus
- Mineralized bacterial biofilm
- Forms 48 hours - 2 weeks after plaque formation
- Composed of 10-30% organic and 70-90% inorganic material
Composition
- Organic: Plaque bacteria, dead epithelial cells and white blood cells
- Inorganic: Calcium, phosphate, magnesium, magnesium phosphate, calcium carbonate
Crystalline Structure
- Calcium brushite
- Octocalcium phosphate
- Calcium hydroxyapatite
- Magnesium whitlockite
Crystalline Content Variation
- Can vary due to location: anterior or posterior, supra or sub, and age of calculus
- Can also differ based on the individual
Relevance
- Significant role in the progression of dental disease
- Contributes to gingivitis and periodontitis
Other Locations
- Common sites of attachment: gingival crevice, root surface with periodontal pockets, prosthesis, restoration ledges, imbricated teeth, occlusal surfaces
Sub vs. Supra Calculus
- Supragingival calculus is above the gum line
- Subgingival calculus is below the gum line
- Subgingival calculus can become supragingival calculus based on location and other factors
Method of Attachment
- Acquired pellicle
- Penetration into enamel, cementum or dentine
- Tooth irregularities from previous instrumentation
Calculus Formation
- Organic matrix acts as a seeding agent
- Phosphatases and proteases from bacteria degrade calcification inhibitors in saliva
- This leads to the formation of insoluble calcium phosphate crystals, which coalesce to form calcified mass of plaque known as calculus
Calculus Formation Rate
- Varies from person to person
- Different teeth can be affected differently
- Can vary over time in the same person
- Individuals can be classified as heavy, moderate, slight, or non-calculus formers
Detection
- May be visible clinically
- Can be detected on radiographs
Clinical Impact
- Calculus contributes to periodontal disease
- Influences plaque accumulation
- Harbors bacteria
- Contributes to inflammation and tissue destruction
- Creates difficult-to-clean surfaces
- Can lead to gingival recession and tooth mobility
- Can affect restorative procedures and implant stability
Impact on Clinician and Patient
- Clinicians need to educate patients on calculus and its impact on oral health
- Regular dental cleanings are important to remove calculus and prevent its formation
- Patients need to maintain good oral hygiene practices at home
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