Results Thirty participants completed the study. Post-treatment questionnaires were completed by the investigator and participants to score the perceived difficulty and pressure required to remove calculus. A paired Student’s t-test was used to analyze the primary outcome ( α = 0.05). Descriptive and inferential statistics were used to analyze the amount of time used. Quadrants were randomized to either treatment or control group. Methods Patients from a dental school in Minnesota were recruited to participate in a randomized, split-mouth, cross sectional proof-of-concept study comparing time, difficulty and pressure used with hand instrumentation alone compared to the use of a calculus disruption solution and hand instrumentation. However, there is not conclusive evidence that identified periodontitis as a significant risk factor for these conditions.Purpose The purpose of this follow-up proof-of-concept study was to determine the efficacy of a revised calculus disruption solution in facilitating the removal of both supragingival and subgingival calculus in-vivo, as measured by time, difficulty, and pressure required to remove supragingival and subgingival calculus. Dental plaque bacteria have also been linked to cardiovascular disease and are associated with the birth of pre-term, low weight infants. Almost all individuals with periodontitis have considerable amounts of subgingival calculus deposits. The formation of supragingival calculus is present in all humans, but to the amount of calculus present can different. Gingival fibers attach the teeth to the gums. The chronic inflammation of the periodontium can lead to the loss of bone and weakened gingival fibers. This impacts the specialized tissues which surround and support the teeth.
Several anaerobic plaque bacteria, such as Porphyromonas gingivalis, produce antigenic proteins which trigger a strong inflammatory response in the periodontium. Subgingival plaque contains a higher proportion of anaerobic bacteria. When plaque is supragingival, the bacterial content contains a great proportion of aerobic bacteria and yeast, or bacteria which use and are able to survive in an environment containing oxygen. Calculus, in addition to other factors which cause a localized build-up of plaque, is often referred to as a secondary cause of periodontitis. Calculus is detrimental to the health of the gums because it acts as a trap for plaque. Plaque that remains in the oral cavity for long periods of time will eventually calcify and turn into calculus. While dental plaque is not the only cause of periodontitis, it is often referred to as a primary contributor. This condition is referred to as periodontitis. When the gums become chronically irritated, it can result in a loss of the connective tissue fibers which attach the gums to the teeth and bone that surrounds the tooth. This condition is referred to as gingivitis. The accumulation of plaque causes irritation and inflammation of the gums. Numerous variables can influence the formation of calculus which include age, gender, ethnic background, diet, oral hygiene, bacterial plaque composition, genetics, access to dental care, physical disabilities, systemic diseases, tobacco use and drugs or medications.
It also forms at different locations throughout the mouth. The formation of calculus can drastically vary among individuals. Both areas commonly have a high flow of saliva because of their proximity to the salivary glands. Supragingival calculus formation is most prevalent on the cheek surfaces of the upper jaw molars and on the tongue surfaces of the lower jaw incisors. The processes of calculus forming as a result of dental plaque is not well understood. Calculus buildup is usually removed using ultrasonic tools or dental hand instruments like a periodontal scaler. Brushing and flossing can remove the plaque where calculus forms, however, once it is present, calculus is too difficult to remove with a toothbrush. The formation of calculus is associated with a variety of issues which include bad breath, receding gums and chronic inflammation.
Calculus can form along the gumline and within the narrow sulcus that exists between the teeth and the gums. This leads to a buildup of calculus, which compromises the gingiva or gum’s health. This process of precipitation kills off the bacterial cells within the dental plaque, however, the process results in a rough and hardened surface which is an ideal surface for the formation of future plaque. It is caused by the accumulation of minerals from saliva and gingival crevicular fluid (GCF). Calculus or tartar on the teeth is a result of hardened dental plaque.
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