2024 Tooth Accumulated Materials (PDF)

DEPARTMENT OF ORAL MEDICINE AND PERIODONTOLOGY S SIMONS 2024  Characteristics Origen Development Prevention Examination Evaluation Treatment Instruction TOOTH TOOTHACCUMULATED ACCUMULATE...

DEPARTMENT OF ORAL MEDICINE AND PERIODONTOLOGY S SIMONS 2024  Characteristics Origen Development Prevention Examination Evaluation Treatment Instruction TOOTH TOOTHACCUMULATED ACCUMULATED MATERIALS MATERIALS CHARACTERISTICS Translucent,thin,amorphous,a cellular organic film Tenacious membranous layer Adheres to surfaces of teeth, restorations, calculus & other firm surfaces of oral cavity Thickness from 0.1 -0.8 nm  Exhibits histochemical and ultra structural features Stains + for sugars and proteins Does not bind dyes Does not contain heme or melanin Due to tannins - brownish colour  Minutes after external material is removed Composed of glycoproteins - selectively absorbed by the hydroxyapatite of the tooth surface Absorbed material becomes a highly insoluble coating over the teeth etc. Usually greatest around gingival margin 1. ACID PRECIPITATION 2. ENZYMATIC ENHANCEMENT 3. SELECTIVE ADSORPTION 1. SUBSURFACE PELLICLE – CONT- TOOTHSTRUCTURE 2. SURFACE PELLICLE- Unstained LING/BUC/PAL 3. SURFACE PELLICLE- Stained STAINS-NAKED EYE SUPRAGINGIVAL PELLICLE- SALIVA SUBGINGIVAL PELLICLE - GCF 1. PROTECTIVE Pellicle appears to provide a barrier against acids, thus may aid in reducing dental caries formation 2. LUBRICATION Pellicle keeps surface moist 3. NIDUS FOR BACTERIA Pellicle participates in plaque formation aiding the adherence of microorganisms 4. ATTACHMENT OF CALCULUS  CHARACTERISTICS Informal accumulation Loosely adherent, unstructured white/grayish white masses of oral debris & bacteria (bulky, soft , clearly visible) Resembles cottage cheese Forms over dental plaque, surfaces of teeth & gingiva Bacterial count high / for plaque significantly lower Vigorous rinsing & water spray/ oral irrigation can remove materia alba  Gingival inflammation Tooth surface demineralization Dental caries WHEN DO MATERIA ALBA COLLECT? OPEN CONTACT AREAS MOBILITY OF TEETH IRREGULARITIES OF OCCLUSION PREVENTION OF MATERIA ALBA SELF CLEANSING WITH TONGUE , SALIVA, LIPS TOOTHBRUSHING AND FLOSSING ROLE PERIODONTAL DISEASE  Aetiological factor – periodontal disease Dense,organized bacterial systems embedded in an intermicrobial matrix Adheres loosely to teeth, calculus deposits, other firm surfaces Bacterial adherence and growth Water irrigation only removes outer layer of loose organisms 500 – 700 bacterial species – 1 gr plaque 70% dry weight bacteria Carbohydrates & saliva 24 hrs – brushing 48 hrs – naked eye 2 GROUPS 1. Supragingival 2. Subgingival Also described as pit & fissure plaque black stained plaque SUPRAGINGIVAL PLAQUE white,yellowish,layer along gingival margin of tooth increases rapidly SUBGINGIVAL PLAQUE not easily diagnosed clinically occurs below gingival margin observed due to staining 2 STAGES: REVERSIBLE STAGE Adheres loosely to tooth surface - means of hydrogen bonds & electrostatic attraction IRREVERSIBLE STAGE There is a firmer specific adhesion of bacteria to acquired pellicle, tooth surface calculus and restorations  Provides nutrients carbohydrates hard fibrous diet Food - Growth Adequate nutrients sugar plaque Bacteria – sugar –store - main nutrient Rapidly – sleep- saliva flow Mechanical action – eating- remove plaque  P/D – Good health (teeth/gingiva) NB – development/promotion/ recurrence PD Plaque has undergone mineralization DEF: Deposit of calcium and phosphate salts - unstable Tightly adherent/porous /rough Small empty cells/not harmful Creates gingival lesions/ promotes inflammation Free surface of calculus covered by living microorganisms   Similar in histology, chemistry and Organic and inorganic components microbiology  Exhibits differences % vary –age/hardness of deposit  Constituents – different sources Double problem  Plaque- causative agent Toxic products  Calculus – contributing factor –plaque Permeable accumulation -hinders removal Ideal medium  Distribution- areas most difficult to access during plaque removal procedures Unaesthetic stains  Mineralization 24-48 hours Health of gingiva  Fully mineralized 10-20 days Absence of proper oral care Individual tendency Self cleansing mechanism – plaque Roughness – toothsurface removal Personal plaque control measures SUPRAGINGIVAL CALCULUS yellow/ white accretion develop secondary staining largest amount - opening of salivary ducts also crowns of teeth out of occlusion, neglected teeth, dentures & dental appliances  Clinical crowns Darken with age Amorphous/bulky Recurrence after removal Shape determined –anatomy, contour, pressure Clay like/ porous Moderately hard Surface – non mineralized plaque  brown, black harder than supragingival calculus localized (single tooth or group of teeth)& generalized (throughout the mouth) Normally flat – pressure - pocket Stains – blood pigments Surface – plaque Below gingival margin Often interproximally Buccally less frequent Rings and ledges Organic components similar Calcium, magnesium and fluoride No salivary proteins Microscopic amounts – periodontal pockets Excellent reservoir  clinical inspection radiographic examination  Forms in layers more or less parallel with toothsurface  70 - 80 % inorganic salts (15-20% organic compounds)  small amounts magnesium / sodium carbornate / fluoride  several crystalline forms ( main hydroxyappatite and Octocalcium phosphate) Brushite magnesium whitlokite bulk= proteins + carbohydrates + small amount lipids CALCULUS FORMATION ATTACHMENT TO TEETH 3 STAGES TENACIOUS ATTACHMENT  Initial attachment  underlying pellicle has calcified has a close approximation  Growth and organization to tooth surface  surface irregularities are also  mineralization penetrated by crystals of calculus  Several theories have been proposed as to why plaque mineralizes It’s said that the truth lies between these theories 1. Bacterial theory 2. Carbon dioxide theory 3. Epitaxis theory