PERIODONTAL DISEASES - PLAQUE, CALCULUS AND REGRESSIVE CHANGES
(Page 2 of 4)
Calculus (Figs.
18-2,
18-3,
18-4,
18-5)
Calculus (or layterm tartar) is primarily
mineralized, dead bacteria with a little bit of mineralized salivary
proteins. Chemically it is comprised mostly of calcium phosphate, calcium
carbonate and magnesium phosphate. It is hard like bone and other mineralized
substances and firmly adherent to the tooth. Above the gingival margin, it is
called supragingival calculus. This form of calculus appears yellow or tan
and is most commonly located near large salivary sources in patients who fail
to mechanically remove plaque regularly. Supragingival calculus accumulates
preferentially along the lingual of the mandibular incisors adjacent to the
duct for the sublingual and submandibular glands, and calculus accumulates
along the buccal of maxillary molars adjacent to Stenson's duct of the
parotid gland. Calculus darkens in color with age and increases in size.
A calculus bridge is an extensive matrix of calculus that extends across
several tooth surfaces. Often a calculus bridge is associated with gingival
recession and periodontal disease. Removal of the bridge may reveal several
mobile teeth. Patients should be advised of this possiblity prior to
beginning debridement.
Subgingival calculus forms below the gingival collar and is not usually
visible, unless gingival recession has occurred. It is most often detected
with a periodontal probe or explorer as a rough mass projecting from the
cementum. Subgingival calculus is most often brown, black or green in color
from its chronic exposure to gingival crevicular fluid, blood and blood
breakdown products. It is frequently associated with the development of the
pyogenic granuloma, an epulis-like lesion on the gingiva.
Previous Page - Plaque
Next Page - Gingival Recession