Calculus Flashcards
whats phase 1 therapy?
diagnosing, treatment planning and disease control
whats phase 2 therapy?
surgical phase
Calculus is basically mineralized what?
plaque, plaque also builds on top of the calculus
What does calculus attach to?
teeth, crowns, prosthesis, dental implants
What did hippocrates think of calclulus?
he noted the deleterious effects on teeth it caused
what did Albucasis discover?
jthe relationship between calculus and disease and the need for removal
what are the 3 steps in calculus formation?
pellicle formation, plaque formation, mineralization
Pellicle important points
composed of mucoproteins, Acellular, forms within minutes after being wiped of teeth
Plaque formation important points
microorganisms bind to the pellicle and form colonies ( rod and cocci), by 5th day plaque is mostly filamentous orgs. , They allgrow together to form a cohesive plaque layer.
mineralization occurs within …..
24-72 hours
what is heterogenous nucleation?
when mineralization centers grow large enough to connect.
whats mineral precipitation result from?
a rise in PH of saliva which causes precipitation of calcium phosphate. Colloidal proteins bind calcium phosphate making a supersaturated solution
what are the 4 different crystals of calcium phosphate?
brushite
octa calcium phosphate
hydroxyapatite
whitlockite
rate of calculus formation is rapid for how long before pleauing?
4 weeks
What different ways does calcium attach?
- via pellicle on cementum and enamel
- mechanical locking on surface irregularities
- close adaptation to slping mounds of cementum
what color is supragingival calculus?
white or whitish ( can be localized or generalize)
most common places for supragingival calculus are….
buccal surfaces of maxillary molars
lingual of mandibular ant.
what are the compositions of the 4 different crystaline forms of supragingival calculus?
OCP = Predominant mineral in exterior layers HA = Dominant in the inner layers of long standing calculus W = Only in small proportions B = Only in newly formed calculus
what is the average mineral content in supragingival calculus?
37%
subgingival calculus is usually what color and why?
brown or black. It reflects the presensce of bacterial and blood products
what probably happened if you find someone with black calculus that appears supragingival?
it started out sub and the gums receeded so now its supra.
which crystaline form is most dominant in subgingival calculus?
whitlockite with small proportions of magnesia (3%)
- hydroxyapatite but at very low amount
what can be used to detect subgingival calculus?
explorer, Perio probe, surgical exploration is best
how would you retract the gingiva if you wanted to while searching for sub-g calculus?
air blast
most common exploror for sub-g exploring is….
11/12 ODU
why arnt radiographs reliable for sub-g calculus detection?
2-d picture of 3-d object.
- it could be hiding ex. furcations, crown margins, restorations…….
what is the absolute most reliable means for determining sub-G calculus?
surgical exploration
what is the root of all evil?
bacteria and plaque
what causes periodontal disease?
bacteria and plaque
why is calculus a SECONDARY etiologic factor of periodontis?
presence of calculus makes it impossible to remove plaque.
calculus prevents pts from clearing plaque.
calculus does not come in direct contact of gingival tissue.
describe the guinea pig experiment
researchers took calculus off a patient with periodontal disease and seperated it into 2 peices and sterilized one of them. They made guinea pigs eat them and the pigs that ate the not sterilized calculus developed infection while the pigs that ate the sterilized piece did not.
what is calculus always covered by?
unmineralized layer of viable bacterial plauqe.
prevention of calculus is by….
daily removal professional prophylaxis ( every 3-6 months)
pyrophsophatases
occur naturally in saliva and chelate ( stick to) calcium slowing the rate of nucleation and calcification
sodium hexametaphosphate ( SHMP)
is a large polyphosphate molecule with multiple calcium binding sites
- very effective calculus inhibitor
zinc
basically binds in calciums spot on the pellicle
gantrez
copolymer of methylvinyl ether and maleic acid
- binds calcium ions inhibiting plaque mineralization
