Calculus removal and the prevention of its formation

Patients with dental calculus have increased saliva and gingival crevicular fluid fetuin-A levels but no association with fetuin-A polymorphisms

“…However, not all the plaque becomes calcified 6 and some patients with deficient oral hygiene may not present dental calculus; the reason for this situation is still unknown. Genetic factors are known to play an important role in determining an individual's susceptibility to stone disease and can act in the calcification process.…”

“…The development, amount and composition of dental calculus varies from case to case and also from region to region within the oral cavity. 5,6 Other factors that influence calculus formation are age, gender, eating habits, oral care, bacterial composition, host response, systemic diseases and prescribed medications. 7 Futhermore, it is thought that genetic factors can play a role on calcification.…”

Surface area and volume determination of subgingival calculus using laser fluorescence

“…LF technology for calculus detection will be of benefit for conservative periodontal therapy undertaken by dentists or dental hygienists, since these clinicians will be able to check root surfaces which have been debrided, to ensure that the endpoint has been achieved -namely that all deposits of calculus have been removed, regardless of whether hand curettes, ultrasonic scalers, potassium-titanyl-phosphate, Er:YAG or Er,Cr:YSGG lasers have been used. This is an important consideration because less experienced general dentists and dental hygienists are not as effective at producing calculusfree surfaces in periodontal pockets as experienced specialist periodontists [13]. With increasing use of lasers in debriding root surfaces or enhancing the effects provided by conventional periodontal instruments [14][15][16], it is important that quality assurance measures such as LF are deployed into clinical periodontal practice.…”

“…In making an assessment of how LF scores correlate to the presence of calculus, the existing indices, such as the Volpe Manhold index, the calculus index, the calculus surface index, and others, which have been used in clinical investigations [1][2][3] are not suitable as they have limited accuracy and reliability [9], and cannot be utilised for scoring subgingival calculus deposits which are hidden by their very nature [10][11].…”

“…Subgingival deposits of calculus provide a reservoir for bacteria, and so must be removed during treatment [1,2]. Because they are hidden from view, dental practitioners rely on tactile examination of the roots of teeth using a periodontal probe [3,4], checking for areas of roughness.…”