Calculus

Question 1

What is Calculus and its formation

Answer 1

Calculus is mineralised plaque, found supra or subgingivally
Usually has unmineralised plaque present on the surface.
Can form on clinical crowns of teeth, dentures and other appliances

Calculus forms as a result of deposition of minerals into the biofilm organic matrix.
Pellicle formation 2) Biofilm formation 3) Mineralisation

Source of minerals for sup-gingival calculus is saliva
Source of minerals for subgingival calculus is GCF and inflammatory exudate. → w more inflammation, more minerals available for min. of subgingival biofilm

Question 2

Calculus detection

Answer 2

Detection:
1) Visual, gentle use of AIR (to RETRACT TISSUES for observation), tactile sensitivity (perio probe/calculus detection explorer eg 11/12)–feel for ROUGHNESS, LEDGES against crown/root
1.2) Gingival tissue colour change - dark subgingival calculus may reflect thru thin margin
2) Dental floss → fraying/shedding of floss interproximally due to rough surface of calculus (but won’t detect sub. In deep pockets.)
3) Radiographs: thick n highly mineralised subgingival calculus can also b detected as radiopaque spurs on root surfaces

Question 3

Supragingival vs subgingival calculus

Answer 3

Supragingival calculus occurs coronal to margin of gingiva, is covered w biofilm.
Usually WHITE OR YELLOW in colour, amorphous and BULKY.
Occurs interproximally under contact area, cervical along Bu/Li margins around crowded teeth, and areas of inadequate disturbance of the biofilm.
Moderately hard deposits, newer deposits are less dense and hard. Porous surface covered w non-mineralised biofilm.

Subgingival calculus occurs APICAL TO GINGIVAL MARGIN, is covered w biofilm.
Usually DARK BROWN/BLACK in colour.
Brittle and flintlike. HARDER AND DENSER than supragingival calculus.
Flattened to conform to pressure frm the pocket wall. Can extend to bottom of pocket, follows contour of soft tissue attachment.
Usually heaviest on proximal surfaces and lightest on buccal surfaces.
Occurs with or without associated supragingival calculus deposits.

Question 4

Why remove calculus?

Answer 4

1) Remove source of bacteria and subsequent host response
2) To improve periodontal health - (prevent pocket dvpt)
3) Improve bad breath
4) Improve aesthetics

Calculus is covered by a layer of biofilm – when contacts gums results in gingivitis - host inflammation response to bacterial antigens

Subgingival biofilm located on surface of calculus contains pathogenic bacteria that cause inflammation and destruction of gingival tissues → leads to CAL, dvpt n deepening of the POCKET

Calculus is predisposing factor in pocket formation → POROUS, ROUGH SURFACE is a TRAP FOR stains, plaque, dood debris → aesthetic problems and halitosis