2. DEFINITION
• CALCULUS IS A HARD DEPOSIT THAT IS
FORMED BY MINERALIZATION OF DENTAL
PLAQUE ON THE SURFACE OF NATURAL
TEETH AND DENTAL PROSTHESIS,
GENERALLY COVERED BY UNMINERALIZED
PLAQUE.
4. SUPRAGINGIVAL CALCULUS
:-
• SUPRAGINGIVAL CALCULUS IS THE TIGHTLY
ADHERENT CALCIFIED DEPOSIT THAT FORMS ON THE
CLINICAL CROWN OF THE TEETH ABOVE THE FREE
GINGIVAL MARGINS.
• IT IS CLINICALLY VISIBLE.
• IT IS ALSO CALLED “SALIVARY
CALCULUS” BECAUSE IT FORMS FROM THE
SALIVA.
6. SUBGINGIVAL
CALCULUS:-
• SUBGINGIVAL CALCULUS IS CALCIFIED DEPOSIT
THAT IS FORMED ON THE ROOT SURFACE BELOW
THE FREE MARGINAL GINGIVA.
• IT IS BELIEVED TO BE FORMED FROM THE GINGIVAL
EXUDATE AND HENCE CALLED “ SERUMAL CALCULUS”
.
8. STRUCTURE
:-
• SUPRAGINGIVAL CALCULUS ARE USUALLY WHITISH
YELLOW IN COLOUR AND CAN STAINED BY
TOBACCO OR FOOD PIGMENTS.
• ITS CONCISTENCY IS HARD AND CLAY LIKE.
• THEY DERIVE FROM MINERAL SALTS FROM SALIVARY
SECRETION,THESARE MORE ABDUNDENT ON THE
LINGUAL SURFACE OF ANTERIOR TEETH,OPPOSITE TO
“WHARTON’S DUCT” AND
“BARTHOLOIN’S DUCT” AND BUCCAL ASPECT OF
MAXILLARY MOLARS
OPPOSITE TO THE “STENSEN’S DUCT”.
10. • SUBGINGIVAL CALCULUS IS DARK BROWN OR
GREENISH BLACK IN COLOR AND THE DEPOSIT ARE
FIRMLY ATTACH TO THE TEETH SURFACE.
• THESE ARE FIRM AND HARD AND CANNOT BE
REMOVED EASILY.
• THERE ARE FOUND ON ANY ROOT SURFACE WITH A
PERIODONTAL POCKET.
• THEY ARE COMMONLY RING -LIKE OR LEDGE-LIKE
FORMATION,CRUSTY,SPINY OR NODULAR DEPOSITS.
• LESS COMMONLY SEEN AS FINGER -LIKE AND
FERN- LIKE FORMATIONS.
13. ORGANIC COMPONENTS
(IN%)
• MIXTURE OF PROTEIN POLYSACCHARIDE
COMPLEX , DESQUAMATED EPITHELIAL
CELLS, LEUKOCYTES, AND
MICROORGANISM
• PROTEINS
• LIPIDS
1.9-
9.1
5.9-
8.2
0.2
14. FORMATION OF
CALCULUS:-
• CALCULUS IS FORMED BY THE PRECIPITATION OF
MINERAL SALTS BETWEEN 1ST AND 14TH DAY OF
PLAQUE FORMATION.
• IN 2 DAYS PLAQUE CAN BE 50% MINERALIZED AND
60%-90% GETS MINERALIZED IN 12 DAYS.
• CALCIFICATION STARTS IN THE SEPARATE FOCI ON THE
INNER SURFACE OF THE PLAQUE.
• THE FOCI OF MINERALIZATION GRADUALLY INCREASES IN
SIZE AND
COALESCE TO FORM A SOLID MASS OF CALCULUS .
15. • CALCULUS FORMATION CONTINUES UNTILL IT REACHES
MAXIMUM LEVELS IN ABOUT 10 WEEKS AND 6 MONTHS,
AFTER WHICH THERE IS DECLINE IN ITS FORMATION DUE
TO MECHANICAL WEAR FROM FOOD AND FROM LIPS,
CHEEKS AND TONGUE.
• THIS DECLINE IS REFFERED TO AS “REVERSAL
PHENOMENON”.
17. BOOSTER
MECHANISM:-
• ACCORDING TO THIS THEORY, PRECIPITATION
OF CALCIUM AND PHOSPHATE SALTS RESULT
IN LOCAL RISE IN THE pH OF SALIVA .
• FACTORS SUCH AS LOSS OF CARBON
DIOXIDE AND AMMONIA COULD LEAD TO
RISE IN pH .
18. OTHER WAYS BY WHICH THE PRECIPITATION OF
CALCIUM PHOSPHATE SALTS CAN OCCUR ARE:-
1) COLLOIDAL
PROTEINS IN SALIVA BIND TO
CALCIUM AND PHOSPHATE
IONS, THUS PRODUCING A
SUPERSATURATED SOLUTION.
• WHEN SALIVA STAGNATES IN THE ORAL
CAVITY, COLLOIDS SETTLES AND RESULT IN
THE PRECIPITATION OF CLCIUM AND
PHOSPHOROUS SALTS.
19. 2) PHOSPHATASE LIBERATED FROM DENTAL PLAQUE,
DESQUAMATED EPITHELIAL CELLS OR BACTERIA PRECIPITATED
CALCIUM PHOSPHATE BY HYDROLIZING ORGANIC PHOSPHATES
IN SALIVA,THUS INCREASING THE CONCENTRATION OF FREE
PHOSPHATE ION.
20. EPITACTIC
CONCEPT:-
• ACCORDING TO THIS CONCEPT ,SEEDING
AGENTS INDUCE SMALL FOCI OF
CALCIFICATION. THESE FOCI ENLARGE AND
COALESCE TO FORM CALCULUS.
• THE SEEDING AGENTS IN CALCULUS ARE NOT
CLEARLY KNOWN, BUT SUSPECTED AGENTS
COULD BE INTERCELLULAR MATRIX OF PLAQUE,
CARBOHYDRATE-PROTEIN COMPLEX AND PLAQUE
BACTERIA.
21. INHIBITION THEORY
:-
• THIS THEORY CONSIDER THE POSSIBILITY OF
CALCIFICATION OCCURING ONLY AT SPECIAL
SITE BECAUSE THERE EXIST AN INHIBITING
MECHANISM AT NON-CALCIFYING SITES.
• WHEREVER CALCIFICATION OCCUR THE
INHIBITOR IS EITHER ALTERED OR REMOVED.
• ONE SUCH INHIBITING AGENT COULD BE
POLYSULHATE, WHICH PREVENT THE INITIAL
NUCLEUS FROM GROWING BY POSSIBILY
‘POISONING’ THE GROWTH CENTER OF CRYSTAL.
24. SECOND GENERATION
AGENTS:-
• INHIBITORS OF CRYSTAL
GROWTH:
• VITAMIN C
• PYROPHOSPHATE
• DIPHOSPHONATE
• ZINC SALT
• CALCIUM LACTATE
• SODIUM FLOURIDE
• COPOLYMER
• CITROXAIN
25. COMMERCIAL ANTICALCULUS
PRODUCT
MOUTHWASH
• CHLORHEXIDINE GLUCONATE (0.2%) IS THE
RECOMMENDED BY THE WORLD HEALTH
ORGANISATION.
• IT IS A CATIONIC BISBIGUANIDE.
• EXHIBIT ANTIPLAQUE AND ANTI BACTERIAL
PROPERTY.
• EFFECTIVE AGAINST GRAM +VE AND
GRAM –VE ORGANISMS.
