7 - Role of Dental Calculus and Local Predisposing Factors

Question 1

primary cause of gingival inflammation

Answer 1

dental biofilm in a susceptible host

Question 2

local predisposing (secondary) factor of gingival inflammation

Answer 2

1. Calculus
2. latrogenic Factors
3. Malocclusion
4. Complications Associated with Orthodontics
5. Self-inflicted Injuries
6. Chewing tobacco

Question 3

when is mineralized bacterial plaque that forms on teeth, implants, and prostheses (dentures, partials, crowns, retainers)

Answer 3

calculus

Question 4

what color is supragingival calculus

Answer 4

white and yellow

Question 5

what are the common areas to find supragingival calculus

Answer 5

1. buccal of maxillary molars
2. lingual mandibular incisors

Question 6

what empties near buccal of maxillary molars

Answer 6

stenson’s duct (parotid gland)

Question 7

what empties near lingual of mandibular incisors

Answer 7

wharton’s duct (submandibular gland) and bartholin’s duct (sublingual gland)

Question 8

what is the source of mineralization for supragingival calculus

Answer 8

saliva

Question 9

what is located below marginal gingiva, not visible, detectable with an explorere or probe, dark brown or green/black, firmly attached, difficult to remove

Answer 9

subgingival calculus

Question 10

when does subgingival calclulus become supragingival

Answer 10

if gingiva recedes

Question 11

what does removal of subgingival plaque and calculus do

Answer 11

Reduces gingival inflammation
Reduces probing depths
Gains in clinical attachment (Decrease in clinical attachment level/loss)

Question 12

can calculus be visible on a radiograph? can this be used to indicated the bottom of the pocket?

Answer 12

• yes
• location does not indicate bottom of pocket

Question 13

what is the inorganic composition of calculus (70-90%)

Answer 13

Calcium phosphate - largest component
Calcium carbonate
Magnesium phosphate - traces
Crystalline structures

Question 14

what are crystalline structures found in inorganic calculus and location

Answer 14

1. Hydroxyapatite - most common
2. Magnesium whitlockite - posterior
3. Octacalcium phosphate
4. Brushite - mandibular anterior

Question 15

what is organic composition of calculus

Answer 15

1. protein-polysaccharide complexes
2. epithelial cells
3. leukocytes
4. microorganisms

Question 16

what are salivary proteins that are found only in SUPRAgingival calculus

Answer 16

protein-polysaccharide complexes

Question 17

what does calculus attach to on tooth surface

Answer 17

organic pellicle on cementum or enamel

Question 18

how does calculus attach to tooth surface

Answer 18

• mechanical locking to surface irregularity
• close adaptation to depressions of cementum
• penetration into cementum

Question 19

calculus is plaque that has undergone what

Answer 19

mineralization

Question 20

mineralization starts how many days after plaque formation

Answer 20

1-14 days

Question 21

plaque hardens thru precipitation of what crystalline salts

Answer 21

crystalline calcium phosphate salts

Question 22

do separate foci of calcification increase in size and coalesce to form solid masses of calculus

Answer 22

yes

Question 23

does mineralization of plaque generally start intra or extra cellulary

Answer 23

Mineralization of plaque generally starts extracellularly.
Some organisms calcify intracellularly.

Question 24

pH is elevated by what

Answer 24

pH elevated by CO2 and ammonia produced by bacteria in plaque
Protein degradation
Stagnation

Question 25

how does the precipitation of phosphate salts occurs

Answer 25

lowering precipitation constant

Question 26

source of mineralization for:
supragingival calc
subgingival cal

Answer 26

supragingival: saliva
subgingival: serum transudate (GCF)

Question 27

what is in anti-tartar toothpaste? how does it work

Answer 27

sodium pyrophosphate
- Sodium pyrophosphate is soluble
- Calcium phosphate not yet bonded to tooth will be attracted to sodium pyrophosphate
- Soluble compound forms instead of calcium phosphate (calculus)

Question 28

what is a contributing factor, covered by layer of non-mineralized plaque, and provides nidus for plaque accumulation and retains it close to the gingiva

Answer 28

calculus

Question 29

iatrogenic factors in gingival inflammation

Answer 29

inadequate dental procedures:

Overhanging margins
Overcontoured restorations
Subgingival margins
Roughness of restoration in the subgingival area
Inadequate marginal fit (short margin)
Open contacts

Question 30

does PRDP favor accumulation of plaque? what does this increase?

Answer 30

YES! increases: tooth mobility, gingival inflammation, and perio pocket formation

Question 31

does tooth crowding make plaque control more difficult

Answer 31

yes duh

Question 32

does malocclusion have prominent roots of teeth in buccal/lingual version with SMALL quantities of attached gingiva

Answer 32

YES

Question 33

is malocclusion susceptible to gingival recession

Answer 33

YES

Question 34

how can ortho create dehiscene

Answer 34

ortho may move tooth facially thru thin bone

Question 35

malocclusion can be followed by what

Answer 35

recession

Question 36

what are complications associated with ortho

Answer 36

• ortho increases plaque retension
• may lead to gingival inflammation and enlargement

Question 37

what are examples of self-inflicted injuries

Answer 37

1. toothbrush trauma
2. tobacco pouchkeratosis
3. chewing tobacco associated with recession
4. oral jewelry

Question 38

what injuries are associated with oral jewelry

Answer 38

recession, bone loss, fractures enamel and porcelain restorations

Question 39

what is the primary etiological factor in gingivitis and periodontitis

Answer 39

edntal biofilm

Question 40

plaque calcifies thru precipitation of what

Answer 40

calcium phosphate