Giant Dental Calculus Case Study

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Giant Dental Calculus in the Retromolar Region of a Young Female: A Case Report


Calculus consists of mineralized bacterial plaque that is formed on natural teeth surfaces . Based on its relation with gingival margin it is divided into supragingival or subgingival.
Supragingival calculus is commonly seen over the buccal surfaces of maxillary molars and lingual surfaces of mandibular anterior teeth. The predisposing factor for calculus formation has to be ruled out. In the present case of a 25 year- old female , 3x2 cm large indurated mass was found in the left side of retromolar region and radiograph was taken. After surgical removal, an embedded crown portion was evident along with an indurated mass. Biochemical analysis
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INTRODUCTION The term 'calculus ' was originated in the 18th century, for accidental or incidental mineral buildups in human and animal bodies, like kidney stones and minerals on teeth2. Saliva from the parotid gland is seen on the facial surfaces of upper molars through Stenson 's duct, whereas the orifices of Wharton 's duct and Bartholin 's duct empty onto lingual surfaces of the lower incisors from the submandibular and sublingual glands. This ultimately leads to the formation of calculus particularly in poor oral hygiene cases2,12. Calculus consists of mineralized bacterial plaque which is evident on the surfaces of natural teeth and dental prostheses. Calculus is classified as supragingival or subgingival, according to its relation to the gingival margin2,6,9.

As Supragingival calculus is located coronal to the gingival margin it is clearly visible in the oral cavity. Usually appears white or whitish yellow in color, hard with claylike consistency, and can be easily detached from the tooth surface. After removal may recur rapidly especially in the lingual areas of the mandibular incisors2,6,9,10. The color is influenced by contact with substances like tobacco and food pigments. It may be localized or
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The inorganic portion consists of 75.9% calcium phosphate, 3.1% calcium carbonate, CaCO3; and traces of magnesium phosphate, Mg3(PO4)2 and other metals4. The principal inorganic components are calcium, 39%; phosphorus, 19%; carbon dioxide, 1.9%; magnesium, 0.8%; and trace amounts of sodium, zinc, strontium, bromine, copper, manganese, tungsten, gold, aluminum, silicon, iron and fluorine5. At least two-thirds of the inorganic content is crystalline in structure, as hydroxyapatite, approximately 58%; magnesium whitlockite, approximately 21%; octacalcium phosphate, approximately 12%; brushite, approximately 9%. Hydroxyapatite and octacalcium phosphate are detected most frequently in 97% to 100% of all supragingival calculus constituting its bulk6. Inorganic composition of calcified dental tissues, Dental calculus, salivary duct calculus are similar2. On gingival recession subgingival calculus becomes exposed and is therefore reclassified as supragingival. Hence supragingival calculus is composed of both supragingival calculus and previous subgingival calculus. After the removal of subgingival plaque and calculus marked improvement in gingival inflammation and probing depths with a gain in clinical attachment is observed 8

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