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Questions and Answers
What is the primary composition of dental calculus?
Which component is not a crystalline structure of dental calculus?
Which statement accurately differentiates between supra and sub calculus?
Where is dental calculus most likely to attach?
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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?
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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?
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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?
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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?
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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?
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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?
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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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