Dental Calculus PDF

Dental Calculus Oral Dental Sciences Rhona Mann Learning outcomes By the end of the session students should be able to: Define dental calculus Classify dental calculus by its varying locations Explain the contents and crystalline structure of dental calculus Briefly explain the differen...

Dental Calculus Oral Dental Sciences Rhona Mann Learning outcomes By the end of the session students should be able to: Define dental calculus Classify dental calculus by its varying locations Explain the contents and crystalline structure of dental calculus Briefly explain the different theories on the formation of dental calculus Describe the differences of supra and sub calculus Describe the varying appearances of calculus and adherence to the tooth surface Explain relevance of dental calculus in the progression of dental disease Dental Calculus Prior learning – Dental Biofilm Mineralised bacterial biofilm Occurs 48 hours – 2 weeks After plaque biofilm formation Composition Organic Inorganic 10-30% 70-90% Magnesium phosphate Plaque bacteria Calcium carbonate Dead epithelial Calcium cells/WBC’s phosphate Crystal of dental calculus Calcium brushite Octocalcium Calcium Magnesium phosphate Hydroxyapatite Whitlockite Crystalline content may vary due to: Location Location Posterior Supra or sub The individual Anterior Age of calculus Relevance? Location Other locations Other common sites of attachment:  Gingival crevice  Root surface with periodontal pockets  Prosthesis  Restoration ledges  Imbricated teeth  Occlusal surfaces Location in relation to gingivae When does sub become supra? Differences? Location? Colour? Texture? Mineral derivation? Let's discuss!! Method of Attachment Ways calculus can be attached to a surface:​ ​ Acquired Pellicle​ Penetration into enamel , cementum or dentine​ Tooth irregularities e.g. from previous instrumentation​ So.....why??  An element in the organic matrix acts as a seeding agent  The process is increased by phosphatases & proteases released from bacteria – that degrade calcification inhibitors in saliva  This leads to formation of insoluble calcium phosphate crystals which coalesce to form calcified mass of plaque called CALCULUS  Calculus formation rate: Calcification & the rate of calculus accumulation vary from ​ Person to person​ Different teeth​ Different times in the same person ​ On the basis of these differences, persons may be classified as ​ 1. Heavy​ 2. Moderate​ 3. Slight calculus formers ​ 4. Non-calculus formers​ Detection: Well, sometimes you can't miss it!! Radiographs: Let's think about other ways we can detect Calculus …..... And finally: Let's discuss the impact on you, the Clinician? And the impact on your patient??  A clinical guide to periodon Reading references tology: Pathology of period ontal disease (nature.com) ​ ​ ​ Image References  https://link.springer.com/chapter/10.1007/978-3-662-46623-0_3  https://www.researchgate.net/figure/SEM-image-of-whitlockite-crystals_fig35_241834538  https://www.emergencydentalservice.com/dental-education/calculus-teeth  https://www.researchgate.net/figure/A-Teeth-from-a-chronic-periodontal-patient-presented-dental- calculus-gingival_fig2_320300224  https://www.nature.com/articles/s41579-018-0089-x  https://www.quora.com/What-is-the-difference-between-to-be-a-human-and-humanity  Empowering Your Patients: From Compliance to Concordance | SpringerLink  https://www.nature.com/articles/sj.bdj.2016.39  https://www.researchgate.net/figure/Heavy-encrustation-of-calculus-and-plaque-arrowed-on- maxillary-a-and-mandibular_fig1_256291459  https://pocketdentistry.com/etiology-and-risk-factors-biological-complications/  https://forma.co.uk/ask-dr-raj-kumar/implant-disease/