Dental Plaque: Meaning, Causes And Treatment

Dental Plaque: Meaning, Causes And Treatment

Grat is a viable tissue/organ that after removal from donor site is implanted/transplanted within the host tissue, which is then repaired, restored and remodeled.

Bone Graft Material

An ideal bone graft material should have biologic acceptability, predictability, clinical feasibility, minimal postoperative hazards, minimal postoperative squeal and good patient acceptance.

Classification of Bone Graft Materials

Depending on sources

• Nonvital bone graft
  • Allograft (human bone): Freeze dried bone allograft
  • Xenograft: Anorganic bovine bone
• Vital bone graft
  • Intraoral: Osseous coagulum, bone blend, bone harvested from extraction site
  • Extraoral: Iliac crest graft

“Risk Factors For Developing Dental Plaque”

According to Naser (1999)

• Human bone
  • Autogenous grafts
    • Extraoral
    • Intraoral
  • Allografts
    • Fresh frozen bone
    • Freeze dried bone allograft
    • Decalcified freeze dried bone allograft
• Bone substitutes
  • Xenografts
    • Bovine-derived hydroxyapatite
    • Coralline calcium carbonate
  • Alloplasts
  • Absorbable
    • Nonsintered hydroxyapatite
    • α- and β-tricalcium phosphate
    • Calcium sulfate
  • Non absorbable
    • Bioglass
    • HTR polymer

“How To Prevent Dental Plaque Naturally”

According to the mode of action:

• Osteogenic: New bone is formed by bone forming cells contained in the graft
• Osteoinductive: Bone formation is induced in the surrounding soft tissues immediately adjacent to the graft.
• Osteoconductive: Grafted material does not contribute to new bone formation but serves as scaffold for bone formation originating from adjacent host bone.

Autografts

Intraoral site

• Osseous coagulum:

“The Role Of Brushing And Flossing In Controlling Dental Plaque”

This technique uses small particles of donor bone, hence it provides additional surface area for the interaction of cellular and vascular elements.

• Sources:
  • Lingual ridge on the mandible, exostosis, tori, edentulous ridges, bone distal to the terminal tooth.
  • In this technique a bur is used in the donor site to reduce it to small particles which when coated with blood becomes coagulum and is placed in the defect.
• Bone blend:
  • In this technique bone is removed from the pre-determined site with chisels or rongeur forceps, placed in the autoclaved plastic capsule with a few drops of saliva, and triturated for sixty seconds to a workable plastic like mass and is packed into the bony defect.
• Bone swaging:
  • This technique requires presence of an edentulous area adjacent to the defect from which the bone is pushed into contact with root surface without fracturing the bone at its base.

“What Happens If Dental Plaque Is Untreated”

Extraoral Site

• Iliac autografts/extraoral hip marrow: The use of iliac cancellous bone marrow has shown good result in bony defects with varying number of wall and furcation defects.Disadvantage: Additional surgical trauma.

Allografts

• Allograft is the tissue transfer between individuals of same species but of non – identical genetic composition.
• Allografts were utilized in an attempt to stimulate bone formation in the intrabony defects to avoid additional surgical insult which is associated with the use of autogenous grafts.
• There are two types of allografts used clinically i.e.
  • Freeze dried bone graft: It is an osteoconductive material which has varying results.
  • Demineralized freeze dried bone grafts: Demineralization process exposes the components of bone matrix which are known as bone morphogenic protein e.g. osteogenin which is a bone inductive protein isolated from extracellular matrix of human bones. So it is an osteoinductive material.

“Comprehensive Overview Of Dental Plaque Symptoms”

Xenografts

• Recently, an inorganic, bovine derived bone marrow under the brand name Bio-Oss is successfully used for both periodontal defects and implant surgery. It is the porous bone mineral matrix from bovine cancellous or cortical bone.
• Bio-Oss is biocompatible with adjacent tissue, eliciting no systemic immune response.
• Periodontally Bio-Oss is used as a graft material which is covered by resorbable membrane. The membrane prevents migration of fibroblasts and connective tissue into the pores between granules of the graft.
• Since allografts are foreign to organism so they have potential to prove an immune reaction.

Corel Derived Materials

They are of two types i.e. natural coral and coral derived porous HA. Both of these are biocompatible.

“Understanding The Causes Of Dental Plaque Buildup”

Alloplasts/Non-bone Graft Material

• Non-bone graft materials have also been used for restoration of periodontium.
• Some of them are sclera, dura, cartilage, plaster of Paris, ceramics and coral derived materials
• All alloplastic materials are conducive in nature

Bioactive Glass

It consists of sodium and calcium salts, phosphates and silicon dioxide with particle size ranging from 90 to 170 µm or 300 to 355 µm.