Recent technology for the detection of calculus includes miniature endoscopic system, ultrasound technology, and laser technology. The smooth and clean root surface is often considered as the endpoint of scaling and root planing. Visible and tactile sense of operator serves as a primary and important means of detection for calculus. Furthermore, increased salivary phosphates and oxalates are found to be associated with increased dental calculus formation. Alkaline saliva and high urea concentration are associated with increased dental calculus formation. The composition of saliva also determines the calculus formation in different individuals. Subgingival calculus consists of around 58% of minerals, whitlockite being primary mineral. Supragingival calculus contains an average of 37% of mineral, with octacalcium phosphate forms outer layer and hydroxiapetite forms inner layer. Calcified biofilms usually consist of brushite, octacalcium phosphate, hydroxyapatite, and whitlockite. Empty space of dental calculus consists of nonmineralized bacteria surrounded by calcified matrix. Usually, morphological analysis of calculus shows spongy appearance of calcified masses with empty spaces and tubular holes. The formation of calculus occurs when fluid phase of plaque becomes supersaturated with calculus components. ![]() ![]() Mineralization of dental plaque leads to the formation of dental calculus. Dental calculus serves as loci for retention of plaque and is only a secondary phenomenon for infectious periodontal disease and not the primary etiological factor. Untreated gingivitis eventually leads to attachment loss causing periodontitis. Pathogenic microorganisms present in dental plaque release toxins and produce enzymatic effect, thereby inducing gingivitis. Dental calculus was considered as the primary etiological factors from the period of Sumerians about 5000 years ago.
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