Thursday, November 10, 2011

A NOTE ON DENTAL CALCULUS


Dental calculus

For the periodontal diseases:
  •     The primary etiologic factor is: Is the dental plaque.
  •       The associated factor: is the dental calculus, it helps in new formation of the plaque.
  •       The modifying factor: is a systemic disease, it aggravates the disease when the plaque is presents.

 Calculus:
  •    Is a mineralized dental plaque that occurs in the tooth surfaces & dental prosthesis, it has many forms:
  •    Bridging over the gingival margin.
  •     Follow the festooning shape of the dentition.
  •     Lobular form.
  •     In case of malalignment :àprotected area for the plaque à calculus

 Classification:
             Supragingival                  &               subgingival calculus..
         Generally: both can occur together or one may appear alone.

Subgingival calculus: 
  •      Gingival fluid origin.
  •       Below the crest of the gingival margin.
  •       Hard, dark& flint like.
  •       Greenish black or dark brown in color.
  •       Firmly attached to the tooth, can’t be seen and detected by explorer No.621 probe.
  •       Extent nearly to the base of the pocket in chronic periodntitis, but doesn’t reach the Junctional epithelium.

 Supragingival calculus:    
  •     Saliva origin.
  •    Coronal to the gingival margin. Can be composed of supra &sub gingival calculus.
  •    Hard, clay like consistency, White, white yellowish in color& its color may be affected by the tobacco or food stain.
  •     Easy to be seen in the oral cavity, may be generalized or localized.
  •     Easy to be removed &usually recurrent especially in the: Lower incisors. 
  • Most common location :near to the orifices of the S. glands’ ducts

Parotid gland’s duct ”stenson”----->opposite to buccal surface of maxillary molars.

Submandibular “bartholine” & sublingual “wharton” ducts ----->Lingual surface of lower incisors.
it’s shape : either covers the occlusal surfaces or  bridge like structure over interdental papilla.

                                                Calculus contents:


Inorganic contents:70-90%
       
        Organic contents

2/3 of the calculus inorganic component is in crystalline form ;there are  4 types of crystals .

The crystals are:
hydroxyappatite ,58% à
magnesium white locate,21%  àmost in post
octacalcium phosphate,12% Brushite, 9% àmost in mandibular anteriors.
Detected more frequently in supragingival calculus.
Constitute the bulk.

Generally 2 or more crystals are detected in the calculus.

Incidence of 4 crystals à varies with age of calculus.


Mixture of  :
Protein-poly saccharide complex + desquamated host cells (leukocytes & host cells) + microorganisms.

Carbohydrates (1.9-9.1%):
Glucose , glactose   ,mannose ,arabinose ,rhamnose glucoric acid ,glactouric acid glucoseamine & glactose amine. à all are present in saliva except :
Rhaminose  &  arabinose .

Salivary proteins (5.9-8.2%):
Most are amino acids.

lipids 0.2%:nutral fat ,fatty acids ,cholesterol ester, phospholipids & cholesterol.

*Contents:
          The differences
    Supra gingival calculus
Between:
Sub gingival calculus

hydroxyappatite:
Ca Ph :
Mg white:
brushite:
ratio of Ca/Ph:
sodium contents:

salivary proteins:
             Equal.  
More.
Less.
More.
Low.  
Increase with the depth of PD pocket.
Yes                
            Equal
Less.
More
Less.
Higher.


No.



Calculocementum:
Is the calculus has morphological appearance similar to cementum. This is because the calculus is interdigitates the cementum & no differences between them.

Mode of attachment of the calculus to the tooth surface:
  • Close adaptation under surface depression.
  • In sub gingival calculus.
  • By organic pellicle (very weak)
  • Penetration of the bacteria to the cementum.
  • Mechanical interlocking to the surface irregularities: resorption lacuna or caries, in the cementum by sharpies fibers.                          

Calculus formation:
Calculus is the dental plaque that undergoes mineralization.
Calcification starts                      4-8 hrs   after plaque.
50 % become mineralized after   2 days.
60-90                                          12 days.
  • Plaque can be daily removed at home by brushing but the calculus is
  • not ,it is only removed clinically by the dentist .
  • Calculus formation à the bacterial action will stopped (adv) but it will act as stagnation area for new plaque accumulationà (protection for plaque). 
  • Early plaque contains small amount of inorganic material but it will increase as the plaque develops into calculus. 
  • All plaque doesn’t necessarily undergo calcification.
  • It reaches a plateau of maximal mineral by 2 days.
  • Microorganisms are not always essential in calculus formation. 
  • Plaque has ability to conc. The Ca at  2-20 times it’s level in saliva. 
  • There is a suggestion that Ph is more critical than Ca in plaque mineralization.
  • Early plaque of heavy former àmore Ca ,3 times Ph &less K than non calculus former.




5 comments:

  1. Well written article.

    please amend

    Submandibular - Wharton's
    Sub lingual - Duct of Rivineus / Bartholin's

    ReplyDelete
  2. click here

    very good information. definitely something people should prevent with good dental health

    ReplyDelete
  3. I'm still understanding from you, but I'm making an attempt to achieve my ambitions. I undoubtedly enjoy studying every thing that is posted on your internet site.Keep the stories coming. I preferred it!.
    dental schools in chicago

    ReplyDelete
  4. Thanks for sharing such as great information...
    Healthy teeth and gums are essential to your child’s overall good health. Injured, diseased or poorly developed teeth can result in poor nutrition, painful and dangerous infections, and problems with speech development and self-image.

    Read More Child Dental Care Tips.

    ReplyDelete
  5. Child Dental Fairfield is paramount. Consistent check-ups and educating young ones on oral hygiene are vital for nurturing lifelong healthy smiles.

    ReplyDelete

Share

+1 this blog

you might also like

Related Posts Plugin for WordPress, Blogger...