6 - Calculus, Local Factors, and Smoking Flashcards
What are 4 modes of calculus attachment as found by Zander?
Zander 1953: Light Microscopy. Found 4 modes of calculus attachment: 1) to the secondary cuticle (believed to be formed by the epithelial attachment as it contacts cementum) 2) to microscopic irregularities in cementum where Sharpey’s fibers used to attach 3) by penetration of bacterial matrix into cementum 4) into mechanical undercuts of cemental resorption areas. Modes 3 and 4 are most common.
What are the modes of calculus attachment as found by Canis?
Light microscopy, SEM, and TEM confirmed ¾ of Zanders modes: 1) cuticular attachment 2) mechanical locking into undercuts 3) direct attachment to microscopic irregularities (possibly into previous Sharpey fiber inseration areas). Most common mode of attachment was calculus directly abuting tooth surface with no penetration into tooth surface. Penetration of calculus organism into the tooth surface was not observed under LM or TEM.
Is bacteria present in calculus?
Tan 2004: Viable bacteria is present within supragingival calculus. Complete removal of mineralized deposits from tooth is crucial.
Is calculus alone capable of causing tissue irritation?
Allen and Kerr 1965: Sterilized calculus causes tissue irritation, suppuration, and even abscesses formation. Bacteria harbored in calculus contributes to chronic infection.
Can you still get healing after perio surgery if you leave pehind calculus?
Fujikawa 1988: In beagle dogs after flap surgery, inflammation was more intense when calculus was left behind but decreased with time. In the presence of very good oral hygiene (no plaque), calculus had a minimal inflammatory effect.
Where is calculus found in intrabony defects?
Richardson 1990: In intrabony defects, the most apical extent of calculus was usually found approximately halfway to the depth of the defect. Attachment apparatus repaired to level of calculus groove, thus questioning the need for thorough root planing to full depth of the osseous defect.
What did the Sri Lankan study find regarding calculus?
Anerud 1991: Sri Lankan/Norwegian study looking at calculus. The vast majority of patients have some amount of calculus, but the amount of calculus in a particular individual is heavily influenced by OH, habits and access to dental care. Calculus formation was bilaterally symetrical.
What are mechanisms by which smoking causes periodontal disease?
- Decreases neutrophil motility. 2. Decreases fibroblast proliferation and attachment (direct cyototoxic effect). 3. Decreases oxygen perfusion and tension due to vasoconstrictive action of nicotine. 4. Alters bacteria from commensal to pathogenic (GUGLIELMETTI) 6. Increase in MMP-8 (PERSSON) 7. Decrease in production of TIMPS (MMP inhibitors). 8. Increase in production of AGEs 9. Increased production of pro-inflammatory cytokines (GIANNOPOULOU) 10. Cigarettes also impair certain immunologic functions. 11. Suppress OPG (LAPPIN)
Tomar and Asma told us what from NHANES?
Used NHANES III data. Current smokers were 4x more likely to have periodontitis than never smokers. There was an apparent dose-response relationship noted (OR of 2.79 with ≤ 9 cigarettes to OR of 5.88 with ≥ 31 cigarettes per day). At ≥11 years there was no difference noted in prevalence of periodontal disease for former smokers and never smokers.
Can you get periodontitis from environmetal tobacco smoke?
Sutton
Exposure to environmental tobacco smoke is associated with an increased risk of periodontitis. 28% more likely
What is the risk of the recurrence of periodontitis after being treated for ChP in smokers?
Costa 2019 (current lit 2019): The OR for recurrence of periodontitis in former smokers was OR = 2.80, while current smokers had OR = 5.97. Those that had quit smoking more recently were more at risk for recurrence of periodontitis compared to those who quit smoking for a longer interval
Are the bacteria present in smokers different?
Guglielmetti 2014: In matched PD sites in patients with periodontal disease, smokers had significantly greater numbers of A.a, P.g, and T. f. Especially A.a than never-smokers. However, the confidence intervals in this article were extremely wide.
Contradicts Salvi experimental gingivitis
What do smokers have higher levels of that interferes with wound healing post perio sx?
Persson 2003: Smokers may respond less favorably to periodontal surgery due to sustained levels of MMP-8 post-surgery compared to lower levels of MMP-8 found in non-smokers.
Are smokers more likely to have gingivitis?
Salvi:
Experimental gingivitis study like Loe. Bacterial species in plaque and periodontal parameters similar between smokers and non-smokers in gingivitis.
Contradicts Guglielmetti
What is the effect of smoking on different markers?
Lappin 2007: Smoking suppresses OPG suppression in a dose-dependent manner. OPG suppression may be one of the mechanisms associated with smokers having bone resorption seen in periodontal disease.
Giannopoulou - At baseline higher IL-8 (NP recruitment) and lower IL-4 (protective)
