Calculus a predisposing factor for periodontitis

2. Calculus
Dr Annie V Issac

3.  Definition
 Type
 Composition
 Formation
 Mode of attachment

4. Material albe
Plaque
structured, resilient yellow greyish substance
that adheres tenaciously to the intra oral hard
surfaces including restorations.
Soft accumulation of bacteria and tissue
cells that lack the organised structure o
the plaque and are easily displaced by
water

5. Mineralised plaque
calculus

6. DEFINITION
 Dental calculus is an adherent calcified
calcifying mass that forms on the surface of
natural teeth and dental prosthesis covered
on its external surface by vital, tightly
adherent non-mineralized plaque

7. TYPE
Calculus
Subgingival calculus Supragingival calculus
above the free gingival
margin
Below gingival
margin

8. colour White/ whitish yellow Dark brown
shape hard, clay like
consistency
Flatten ed to
conform with
pressure from the
pocket
consistency Moderately hard Brittle
Attachment Easily detached fom
tooth
Firmly attached to
the tooth
Location Coronal to gingival
margin
Apical to gingival
margin
visibility Visible in the oral
cavity
Not visible
source saliva From GCF

9. composition
Inorganic(70%-90%)
Elemetns/Compound/Crystals
Organic
Carbohydrate/proteins/polysaccarides/desq
epithelial cells
Bacteria

10. inorganic components
 The principal inorganic components are
 Ca-39%
 p-19%
 Mg- .8%

11. Trace amounts of
 Sodium
 Strontium
 zinc bromin
 Copper
 Manganese
 Tungsten
 gold,
 Aluminium
 flourine

12.  Calcium phosphate-75.9%Ca3(po4)2
 Calcium carbonate –CaCo3
 magnesium phosphate

13. 4 main crystals
 Inorganic components are crystalline in
nature4 main crystals are
 Hydroxyapatite 58%
 Magnesium whitlokite
 Octacalcium phosphate 12%
 Brushite 9%

14. HA Mg
Whitelocite
Octacalcium
phosphate
Brushite
Supragingival
calculus
Subgingival
calculus
Posterior
region
Supragingival
calculus
Subgingival
calculus
Common in
mandibular
antetiors

15. Attachment to the tooth surface
1. Attachment by means of organic pellicle
2. Penetration of calculus bacteria into
cementum.
3. Mechanical locking into surface irregularities
4. Close adaptation of calculus under surface
depressions to the gently sloping mounds of
unaltered cementum surface.

16. CALCULUS FORMATION
 Mineralization starts within 4-8 hours
 50% mineralization completed within 2days
 60-90% mineralization completed within 12
days
 After reaching the maximum mineralization
,mineral content start to decrease is called
Reverse Phenomina

17. THEORIES OF CALCULUS
FORMATION
1. MINERAL PRECIPITATION THEORY
2. SEEDING THEORY OR EPITACTIC
CONCEPT OR HETROGENOUS
NUCLEATION THEORY

18. MINERAL PPT THEORY
 Loss of Co2 / formation Ammonia due to
protein degradation by plaque bacteria
 Rise Ph of saliva and decrease in precipitation
constant lead precipitation of minerals

19.  Colloidal protein in saliva bind to Ca/P, with
saliva stagnation colloidal protein settles
down and minerals get precipitated
 Phosphatase enzyme produced by bacteria
hydrolize organic phosphate lead to release
of Phosperous that mineralize plaque

20. Epitactic concept /
Heterogenous nucleation
 Seeding agents induce small foci of
calcification that enlarge and coalesce to
form calcified mass.

21. Definition
TYPE
SUPRA GINGIVAL
SUBGINGIVAL
MATERAL
ALBA
PLAQUE
CALCULUS
COMPOSITION
ORGANIC
INORGANIC
Main
content
• Ca-39%
• p-19%
• Mg-
compound
• Calcium phosphate-
• Calcium carbonate
• magnesium phosphate
crystals
• Ha
• MgWhitelockite
• Brushite
• Octacalcium
INORGANIC

22. Ppt theory
Epitactic
theory
Reverse phenomena
Calculus formation prominent on which site and
why
calculocementum
Mode of
attachment
Mechanical
locking
Penetration of
bacteria into
cementum
Slops on
under surface
Organic
pellicle