7 - Role of Dental Calculus and Local Predisposing Factors Flashcards
primary cause of gingival inflammation
dental biofilm in a susceptible host
local predisposing (secondary) factor of gingival inflammation
- Calculus
- latrogenic Factors
- Malocclusion
- Complications Associated with Orthodontics
- Self-inflicted Injuries
- Chewing tobacco
when is mineralized bacterial plaque that forms on teeth, implants, and prostheses (dentures, partials, crowns, retainers)
calculus
what color is supragingival calculus
white and yellow
what are the common areas to find supragingival calculus
- buccal of maxillary molars
- lingual mandibular incisors
what empties near buccal of maxillary molars
stenson’s duct (parotid gland)
what empties near lingual of mandibular incisors
wharton’s duct (submandibular gland) and bartholin’s duct (sublingual gland)
what is the source of mineralization for supragingival calculus
saliva
what is located below marginal gingiva, not visible, detectable with an explorere or probe, dark brown or green/black, firmly attached, difficult to remove
subgingival calculus
when does subgingival calclulus become supragingival
if gingiva recedes
what does removal of subgingival plaque and calculus do
Reduces gingival inflammation
Reduces probing depths
Gains in clinical attachment (Decrease in clinical attachment level/loss)
can calculus be visible on a radiograph? can this be used to indicated the bottom of the pocket?
- yes
- location does not indicate bottom of pocket
what is the inorganic composition of calculus (70-90%)
Calcium phosphate - largest component
Calcium carbonate
Magnesium phosphate - traces
Crystalline structures
what are crystalline structures found in inorganic calculus and location
- Hydroxyapatite - most common
- Magnesium whitlockite - posterior
- Octacalcium phosphate
- Brushite - mandibular anterior
what is organic composition of calculus
- protein-polysaccharide complexes
- epithelial cells
- leukocytes
- microorganisms
what are salivary proteins that are found only in SUPRAgingival calculus
protein-polysaccharide complexes
what does calculus attach to on tooth surface
organic pellicle on cementum or enamel
how does calculus attach to tooth surface
- mechanical locking to surface irregularity
- close adaptation to depressions of cementum
- penetration into cementum
calculus is plaque that has undergone what
mineralization
mineralization starts how many days after plaque formation
1-14 days
plaque hardens thru precipitation of what crystalline salts
crystalline calcium phosphate salts
do separate foci of calcification increase in size and coalesce to form solid masses of calculus
yes
does mineralization of plaque generally start intra or extra cellulary
Mineralization of plaque generally starts extracellularly.
Some organisms calcify intracellularly.
pH is elevated by what
pH elevated by CO2 and ammonia produced by bacteria in plaque
Protein degradation
Stagnation
how does the precipitation of phosphate salts occurs
lowering precipitation constant
source of mineralization for:
supragingival calc
subgingival cal
supragingival: saliva
subgingival: serum transudate (GCF)
what is in anti-tartar toothpaste? how does it work
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)
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
calculus
iatrogenic factors in gingival inflammation
inadequate dental procedures:
Overhanging margins
Overcontoured restorations
Subgingival margins
Roughness of restoration in the subgingival area
Inadequate marginal fit (short margin)
Open contacts
does PRDP favor accumulation of plaque? what does this increase?
YES! increases: tooth mobility, gingival inflammation, and perio pocket formation
does tooth crowding make plaque control more difficult
yes duh
does malocclusion have prominent roots of teeth in buccal/lingual version with SMALL quantities of attached gingiva
YES
is malocclusion susceptible to gingival recession
YES
how can ortho create dehiscene
ortho may move tooth facially thru thin bone
malocclusion can be followed by what
recession
what are complications associated with ortho
- ortho increases plaque retension
- may lead to gingival inflammation and enlargement
what are examples of self-inflicted injuries
- toothbrush trauma
- tobacco pouchkeratosis
- chewing tobacco associated with recession
- oral jewelry
what injuries are associated with oral jewelry
recession, bone loss, fractures enamel and porcelain restorations
what is the primary etiological factor in gingivitis and periodontitis
edntal biofilm
plaque calcifies thru precipitation of what
calcium phosphate
