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Periodontics Ch. 5
| Question | Answer |
|---|---|
| What is the primary etiological factor in periodontal disease? | Plaque (dental biofilm) and host response |
| Calculus | A very important LOCAL contributing factor. Calculus is always covered with plaque along with bacterial by-products. Serves as a “nest” for future plaque and calculus formation. |
| Calculus Formation | Supragingival and subgingival calculus mineralization occurs separately Actual mineralization can occur within 24-48 hours (anywhere from 2 days - 2 weeks) Depends on individual, salivary contents, & retention sites of plaque as well as removal ability |
| Inorganic Components of Supragingival Calculus (@ 30% mineralized) | 70 – 90% contains minerals such as calcium, phosphorus, magnesium, sodium, zinc, strontium, copper, gold, tungsten, fluorine & others Hydroxyapatite (58%), magnesium whitlockite (21%), octacalcium phosphate (12%), brushite (9%).Calcified bacteria |
| Organic Components of Supragingival Calculus (@ 30% mineralized) | Organic Mixture of protein-poly-saccharide complexes Carbohydrates found in salivary glycoproteins Salivary proteins Lipids Desquamated epithelial cells Leukocytes Microorganisms |
| Components of Subgingival Calculus (@ 60% mineralized) | Similar to supra G. Same hydroxy. content (inorganic).Less brushite (inorganic), octacalcium phosphate (inorganic). More magnesium whitlockite (inorganic) Salivary proteins are not found subgingivally Greater sodium content with increase in pocket depth |
| Supragingival | Found most abundantly opposite Wharton’s, & Stensen’s, & ducts Supra minerals derived from saliva Appears yellow-white |
| Subgingival | Sub minerals derived from GCF & inflammatory exudates May be gray, green, black, brown |
| Method of Attachment | 4 modes of attachment: Organic pellicle Mechanical locking into surface irregularities Close adaptation of calculus to cemental surface Penetration of bacteria into cementum Ease (or difficulty) of removal affected by attachment method |
| Anatomic Factors: where calculus can accumulate more readily | Root morphology:Grooves, depressions, furcations Root trunks (short), anomalies. Tooth position:Malalignment (crowding, tilting, drifting, rotating, open contacts, etc.) have been implicated in inc. plaque acc. & difficulty in plaque removal,Malocclusion |
| Iatrogenic Factors | Restorative dentistry:Restorations that are rough, improperly contoured, impinge on the biologic width, have overhangs or defective margins. Materials. Impact on periodontium during the procedure itself Orthodontics Exodontics |
| Traumatic Factors | TB, floss trauma Food impaction Chemical injury Occlusion Primary occlusal trauma Secondary occlusal trauma |
| Other traumatic factors | Tobacco use, Smoking, Alcohol. The ass. between alc use & P.D appears to be dose-dependent. > 3.5 drinks/week is ass. w/ greater pocket depths. Pts consuming > 5 drinks/week were 65% more likely to have ging. bleeding & 36% more likely to have severe LOA |
| what does etiologic mean | cause, origin, source |
| What makes plaque control difficult? | Calculus has nonmineralized areas that appear microscopically as channels that contain colonies of bacteria and other debris. |
| What was found in US adolescents? | subgingival calculus was associated with both loss of attachment and progressive periodontal disease. |
| Calculus, a significant contributing factor does not?? | directly irritate the gingiva, but provides a source of irritation from the plaque it harbors. |
| what are by products of calculus | breakdown of microorganisms or "poop" |
| How does supragingival and subgingival calculus mineralization occur? | seperately |
| how long does it take for calcification of plaque into calc? | 4-8 hours. plaque that does not develop into calculus reaches its maximum mineral content within 2 days |
| Is calculus mostly organic or inorganic? | INORGANIC |
| What are four salivary proteins | lysozyme, amylase, lactoferrin, peroxidase |
| Where is Wharton's Duct? (supragingival calc found most abundantly here) | a narrow orifice on the summit of a small papilla at the side of the frenulum linguae |
| Where is Stenson's Duct? (supragingival calc found most abundantly here) | found bilaterally buccal to the maxillary molars |
| Where are supra minerals derived from? | saliva, and appears yellow or white |
| Where are subgingival minerals derived from? | GCF and inflammatory exudates, appears gray, green, black, and brown |
Created by:
maeallyn93