Periodontology

Question 1

What instruments are used for Calculus Detection?

Answer 1

4 instruments: 1) Perio probe 2) EXD11/12 3) SG11/12 4) ODU11/12contra angle shank design for better adaptationsmall fine tip & rounded back for easier insertion

Question 2

What are the characteristics of SUPRAgingival Calculus?

Answer 2

• whitish/yellowhard with claylike consistency – easily detachable color influenced by food pigments, tobacco

Question 3

Where is SUPRAgingival Calculus most commonly found?

Answer 3

Where the salivary glands are:LINGUAL surface of Mandibular anteriorsBUCCAL surface of Maxillary molars

Question 4

What are the characteristics of SUBgingival Calculus?

Answer 4

dark brown/black (from hemoglobin)hard and dense

Question 5

How far does the subgingival calculus extend in the periodontal pocket?

Answer 5

to the base of the pocket but DOES NOT REACH JUNCTIONAL EPITHELIUM (pocket’s always got that 1 mm shit free area at the base

Question 6

Which teeth have the least prevalence of calculus?

Answer 6

PREMOLARS :)

Question 7

How is subgingival calculus diagnosed for location and extent?

Answer 7

with an EXPLORER, like christopher columbus

Question 8

Can calculus be detected radiographically?

Answer 8

Yes, as radiopaque projections into the interproximal space. BUT BUT BUT sensitivity of radiographs for calculus detection is low so stick to your probes.

Question 9

What is the general composition of calculus?

Answer 9

70-90% inorganic content

10-30% organic content: protein-polysaccaride complexes, epithelial cells, leukocytes, bacteria

Question 10

What is the difference in composition btwn SUPRA- and SUBgingival calculus?

Answer 10

SUB: has MORE hydroxyapatite, Mg whitlockite
HIGHER ratio of Ca3(PO4)3 and has NO SALIVARY PROTEINS
SUPRA: has more brushite, octacalcium phosphate (why? bc theres a lot of calcium in saliva)

Question 11

What are the 4 models of calculus attachment?

Answer 11

1. via an organic pellicle– on enamel
2. via mechanical interlocking– into surface irregularities
3. via close adaptation– of calculus undersurface depressions to sloping mounds of cementum
4. via penetration of bacterial calculus– bacteria is NOT ALWAYS essential for calculus formation

Question 12

What is Calculus?

Answer 12

Mineralized plaque, hardened by mineral precipitation

Question 13

How quickly does calculus formation occur?

Answer 13

Within 4-8 hrs
*plaque 50% mineralized in 2 days
* 60-90% mineralized in 12 days
(may not undergo calicification at 100%)

Question 14

What provides the minerals in calculus formation in SUPRA vs SUB gingival calculus?

Answer 14

SUPRA: saliva
SUB: Gingival Crevicular Fluid

Question 15

Patients with a high concentration of ____________ in saliva are considered heavy calculus formers.

Answer 15

Phosphorus (3x more than normal)

*More calcium and less potassium as well

Question 16

Plaque has _______ more calcium than saliva.

Answer 16

2-20x

Question 17

What are the 2 theories of mineratlization?

Answer 17

1. local rise of Ca & PO4 saturation

2. Heterogeneous nucleation by seeding agents (intercellular matrix of plaque suspected

Question 18

What would cause a local rise of Ca and PO4 saturation?

Answer 18

• pH increase of saliva
• salivary colloidal proteins that bind Ca and PO4 ions
• enzymes (phosphatases & esterases) released by bacteria and cells

Question 19

True/False: Calculus contributes directly to inflammation.

Answer 19

FALSE. it does not contribute directly BUT promotes accumulation of plaque and its retention close to the gingiva

Question 20

True/False: Subgingival calculus is the cause of periodontal pockets.

Answer 20

FALSE. it’s the result of periodontal pockets.

Sterile calculus does NOT cause periodontal disease