Flashcards in Periodontology Deck (20):
What instruments are used for Calculus Detection?
4 instruments: 1) Perio probe 2) EXD11/12 3) SG11/12 4) ODU11/12*contra angle shank design for better adaptation*small fine tip & rounded back for easier insertion
What are the characteristics of SUPRAgingival Calculus?
* whitish/yellow*hard with claylike consistency -- easily detachable* color influenced by food pigments, tobacco
Where is SUPRAgingival Calculus most commonly found?
Where the salivary glands are:*LINGUAL surface of Mandibular anteriors*BUCCAL surface of Maxillary molars
What are the characteristics of SUBgingival Calculus?
*dark brown/black (from hemoglobin)*hard and dense
How far does the subgingival calculus extend in the periodontal pocket?
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
Which teeth have the least prevalence of calculus?
How is subgingival calculus diagnosed for location and extent?
with an EXPLORER, like christopher columbus
Can calculus be detected radiographically?
Yes, as radiopaque projections into the interproximal space. BUT BUT BUT sensitivity of radiographs for calculus detection is low so stick to your probes.
What is the general composition of calculus?
70-90% inorganic content
10-30% organic content: protein-polysaccaride complexes, epithelial cells, leukocytes, bacteria
What is the difference in composition btwn SUPRA- and SUBgingival calculus?
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)
What are the 4 models of calculus attachment?
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
What is Calculus?
Mineralized plaque, hardened by mineral precipitation
How quickly does calculus formation occur?
Within 4-8 hrs
*plaque 50% mineralized in 2 days
* 60-90% mineralized in 12 days
(may not undergo calicification at 100%)
What provides the minerals in calculus formation in SUPRA vs SUB gingival calculus?
SUB: Gingival Crevicular Fluid
Patients with a high concentration of ____________ in saliva are considered heavy calculus formers.
Phosphorus (3x more than normal)
*More calcium and less potassium as well
Plaque has _______ more calcium than saliva.
What are the 2 theories of mineratlization?
1. local rise of Ca & PO4 saturation
2. Heterogeneous nucleation by seeding agents (intercellular matrix of plaque suspected
What would cause a local rise of Ca and PO4 saturation?
* pH increase of saliva
* salivary colloidal proteins that bind Ca and PO4 ions
* enzymes (phosphatases & esterases) released by bacteria and cells
True/False: Calculus contributes directly to inflammation.
FALSE. it does not contribute directly BUT promotes accumulation of plaque and its retention close to the gingiva