P1-PERIO SAS 7- DENTAL CALCULUS

DENTAL CALCULUS

ADHERENT, CALCIFIED MASS ON TOOTH SURFACE & DENTAL APPLIANCES

VITAL, TIGHTLY ADHERENT, NOMINERALIZED PLAQUE

DENTAL CALCULUS IS COVERED ON THE EXTERNAL SURFACE BY?

SUPRA & SUB

TYPES OF DENTAL CALCULUS IN RELATION TO THE MARGINAL GINGIVA

SUPRAGINGIVAL CALCULUS

- CALCULUS ON CLINICAL CROWNS OF THE TEETH

- CLINICALLY VISIBLE

ABOVE THE FREE GINGIVAL MARGIN

SUPRAGINGIVAL CALCULUS IS SEEN WHERE?

SALIVARY CALCULUS

> bc it forms from saliva

SUPRAGINGIVAL CALCULUS IS ALSO CALLED?

WHITE-YELLOW

COLOR OF SUPRAGINGIVAL CAL

HARD & CLAY LIKE

CONSISTENCY OF SUPRAGINGIVAL CAL

SALIVA

SUPRAGINGIVAL CAL IS MINERALIZED VIA?

SUBGINGIVAL CAL

FORMED ON THE ROOT SURFACES

NOT CLINICALLY VISIBLE

BELOW THE FREE GINGIVAL MARGIN

SUBGINGIVAL CAL IS SEEN WHERE?

SERUMAL CALCULUS

> bc it is formed from GINGIVAL EXUDATES

OTHER TERM FOR SUBGINGIVAL CALCULUS

DARK BROWN OR GREENISH BLACK

COLOR OF SUBGINGIVAL CAL

GCF

SUBGINGIVAL IS MINERALIZED VIA?

WHARTON'S

BARTHOLIN'S

STENSON'S

WHAT ARE THE 3 SALIVARY DUCTS INVOLVED IN SUPRAGINGIVAL CAL FORMATION

LINGUAL SURFACE OF MN. ANTERIOR

BUCCAL SURFACE OF MX. MOLARS

WHAT AREAS ARE SUPRAGINGIVAL CAL MOST ABUNDANT?

WHARTON'S AND BARTHOLIN'S DUCT

THE SALIVARY DUCTS OPPOSITE ON THE LINGUAL SURFACE OF MN. ANTERIORS?

STENSON'S DUCT

THE SALIVARY DUCT OPPOSITE ON THE MX. MOLARS

RING- LIKE OR LEDGE -LIKE

CRUSTY, SPINY, NODULAR DEPOSITS

MOST COMMON MORPHOLOGIC FORM OF SUBGINGIVAL CALCULUS

CRYSTALLINE

2/3RDS OF THE INORGANIC COMPONENT OF DENTAL CALCULUS IS IN WHAT STRUCTURE?

HYDROXYAPATITE

MAGNESIUM WHITLOCKITE

OCTACALCIUM PHOSPHATE

BRUSHITE

WHAT ARE THE MAIN CRYSTAL FORM OF DENTAL CALCULUS?

ZINC

STRONTIUM

BROMINE

COPPER

MANGANESE

GOLD

ALUMINUM

TRACES OF THESE ELEMENTS ARE ALSO SEEN IN THE COMPOSITION OF CALCULUS

> ATTACHMENT BY ORGANIC PELLICLE

>MECHANICAL INTERLOCKING (RESORPTION LACUNAE & CARIES)

> PENETRATION OF CALCULUS BACT INTO CEMENTUM

> CLOSE ADAPTATION OF CALCULUS UNDER SURFACE DEPRESSION TO THE UNALTERED CEMENTUM

4 ATTACHMENTS OF CALCULUS TO TOOTH SURFACE

CALCULOCEMENTUM

A CALCULUS EMBEDDED DEEPLY INTO THE CEMENTUM IS CALLED?

MORE BRUSHITE & OCTACALCIUM PHOSPHATE - SUPRA

LESS BRUSHITE & OCTACALCIUM PHOSPHATE - SUB

LESS MAGNESIUM WHITLOCKITE - SUPRA

MORE MAGNESIUM WHITLOCKITE - SUB

DIFFERENCES OF SUPRA AND SUB IN COMPOSITION

PRESENT IN SUPRA

ABSENT IN SUB

DIFFERENCES OF SUPRA & SUB IN SALIVARY PROTEINTS

LESSER IN SUPRA

INCREASES W/ THE DEPTH OF THE POCKET IN SUB

DIFFERENCES IN SODIUM CONTENT OF SUPRA & SUB

MINERAL SALTS

CALCULUS IS FORMED BY THE PRECIPITATION OF WHAT?

BETWEEN THE 1ST AND 14TH DAY OF PLAQUE FORMATION

WHEN DOES A DENTAL CALCULUS START FORMING?

2 (WTF)

HOW MANY DAYS WILL IT TAKE TO MINERALIZED 50% OF PLAQUE?

60 - 90%

IN 12 DAYS HOW MANY PERCENT OF PLAQUE GETS MINERALIZED?

CALCIFICATION

THIS STARTS IN SEPARATE FOCI ON THE INNER SURFACE OF THE PLAQUE

10 WEEKS & 6 MONTHS

CALCULUS FORMATION CONTINUES UNTIL IT REACHES MAXIMUM LEVELS IN ABOUT HOW MANY DAYS?

REVERSAL PHENOMENON

A DECLINE IN CALCULUS FORMATION AFTER REACHING MAX. LEVEL DUE TO MECHANICAL WEAR FROM FOOD, LIPS CHEEKS & TONGUE IS CALLED?

BOOSTER MECHANISM

A theory where precipitation of calcium phosphate salts results from a local rise in the pH of saliva

LOSS OF CARBON DIOXIDE

PRODUCTION OF AMMONIA

WHAT ARE THE FACTORS THAT CAN LEAD TO THE RISE IN PH LEVEL?

COLLOIDAL PROTEINS IN SALIVA

They bind to calcium and phosphate ions, creating a supersaturated solution that precipitates when saliva stagnates

HYDROLYZES ORGANIC PHOSPHATE IN SALIVA = INCREASE THE CONCENTRATION OF FREE PHOSPHATE IONS

ROLE OF PHOSPHATASE IN THE PRECIPITATION OF CALCIUM PHOSPHATE SALTS

EPITACTIC CONCEPT

A theory suggesting that seeding agents induce small foci of calcification, which coalesce to form calculus.

HETEROGENOUS NUCLEATION

OTHER TERM FOR EPITACTIC CONCEPT

INTERCELLULAR MATRIX OF PLAQUE

CARBOHYDRATE PROTEIN COMPLEXES

PLAQUE BACTERIA

SUSPECTED SEEDING AGENTS IN EPITATIC CONCEPT

INHIBITION THEORY

WHAT THEORY: Calcification occurs only at specific sites due to the presence of an inhibiting mechanism at non-calcifying sites.

PYROPHOSPHATE

THIS AGENT INHIBITS CALCULUS FORMATION

PREVENTS GROWTH BY "POISONING" THE GROWTH CENTERS OF THE CRYSTAL

How does pyrophosphate prevent calculus formation according to the "Inhibition theory"?

CALCULUS WAS THE PRINCIPLE ETIOLOGIC FACTOR IN PERIODONTAL DISEASE

What was the traditional belief about the role of calculus in periodontal diseases before the 1960s?

IATROGENIC FACTORS

THIS IS A COMMON CAUSE OF GINGIVAL INFLAMMATION AND PERIODONTAL DESTRUCTION BECAUSE OF THE "FAULTS" IN DENTAL RESTORATION & PROSTHESIS

MARGINS OF THE RESTO

CONTOURS & OVERHANGING DENTAL RESTO

OCCLUSION

DENTAL MATERIALS

DESIGN OF RPD

RESTORATIVE PROCEDURES

THE 6 CHARACTERISTICS OF RESTORATION THAT ARE IMPORTANT FROM PERIODONTAL POV

BIOLOGIC WIDTH

THIS IS THE DIMENSION OF THE SOFT TISSUE. WHICH IS ATTACHED TO THE PORTION OF THE TOOTH CORONAL TO THE CREST OF THE ALVEOLAR BONE

EPITHELIAL & CONNECTIVE TISSUE MEASUREMENT; 2.04mm

THE BIOLOGIC WIDTH IS THE SUM OF ________ AND STATED TO BE _______

OCCLUSAL ADJUSTMENT

CONTRAINDICATED IN THE TREATMENT OF BRUXISM

TONGUE THRUSTING

FORCEFUL WEDGING OF THE TONGUE AGAINST THE TEETH

PLUNGER CUSPS

cusps that tend to forcibly wedge food into interproximal spaces

MATERIAL ALBA

SOFT WHITE CHEESE LIKE DEPOSITS ON THE TEETH; CAN BE EASILY REMOVE

EXTRINSIC STAIN

DO NOT CONTRIBUTE TO GINGIVAL INFLAMMATION ONLY AN ESTHETIC CONCERN

ORANGE

EXTRINSIC STAIN IN ANTERIOR TEETH DUE TO POOR ORAL HYGIENE

BROWN

COLOR STAIN OF DARK COLORED BEVERAGES

DARK BROWN/BLACK

COLOR STAIN OF TOBACCO USE

YELLOW BROWN

COLOR STAIN OF CHX AND STANNOUS FLUORIDE

BLACK

COLOR STAIN OF CONSUMPTION OF IRON

> thin lines on cervical 3rd

GREEN & YELLOW

COLOR STAIN OF CHROMOGENIC BACTERIA

BLUISH GREEN

COLOR STAIN OF METALLIC DUST

WAERHAUG (1978)

DEMONSTRATED THAT SUBGINGIVAL RESTORATIONS ARE PLAQUE RETENTIVE AREAS THAT ARE INACCESSIBLE TO SCALING INSTRUMENTS

= FLAT NOT FAT

<0.5mm WIDER THAN THE CEJ & FURCATION AREAS

- FLUTED/BARRELED OUT

ACCORDING TO BECKER AND KALDAHL (1981) BUCCAL & LINGUAL CROWN CONTOURS SHOULD BE _________

GIC - bc of fluoride content

PORCELAIN - bc of the highly-polished surface

2 restorative/dental materials that is acceptable from a periodontal POV

primary trauma from occlusion

the type of tissue injury from a poorly constructed restoration that can cause occlusal disharmony

FPD

This prosthesis is more acceptable than RPD in a periodontal POV

food impaction

forceful wedging of food into the periodontium by occlusal forces

loss of proximal contact

one of the most common cause for food impaction

lateral food impaction

what type of food impaction will occur when the gingiva is enlarged by periodontitis or by recession

third molars

extraction of this tooth results in vertical defects distal to the 2nd molar and appears more often in people OVER 25 yrs old than those younger than 25

inflammation of palatal mucosa

open bite leads to?

plaque accumulation & PERIODONTAL ATROPHY

deep bites leads to?

INJURY to periodontium

occlusal disharmony leads to?

GINGIVAL RECESSION

FACIALLY- displaced teeth leads to?

difficulty of plaque control

irregular alignment of teeth & spacing between teeth leads to?

mouth breathing

this habit is often associated with gingivitis

erythema, edema, enlargement, and diffuse shiny appearance

What are the gingival changes associated w/ MOUTH BREATHING

tongue thrusting

An important contributing factor in the PATHOLOGIC TOOTH MIGRATION

GINGIVITIS TOXICA

This type of gingivitis seen in people who CHEW TOBACCO; characterized by the destruction of the gingiva & alveolar bone loss

toothbrush trauma

type of trauma that causes acute or chronic gingival changes

TOOTH BRISTLES embedded and retained on the gingiva

common cause of the ACUTE GINGIVAL ABSCESS

BRUXISM

CLENCHING

what are the occlusal neurosis or parafunctional habits

bruxism

clenching and grinding of teeth when the individual is not eating

clenching

closure of the jaws under VERTICAL PRESSURE

NOCTURNAL/ NONSTRESS BRUXISM

DIURNAL/ STRESS BRUXISM

2 types of bruxism

FACET PATTERNS

the clinical feature of bruxism and is used for diagnosing

REM (RAPID EYE MOVEMENT)

according to sleep studies the bruxism that happens during this state of sleep is the MOST DAMAGING

maxillary stabilization appliance

most effective means of treating bruxism and ideal for nocturnal bruxism