WordNet

take by attacking with scaling ladders; "The troops scaled the walls of the fort"
a specialized leaf or bract that protects a bud or catkin (同)scale leaf
an ordered reference standard; "judging on a scale of 1 to 10" (同)scale of measurement, graduated table, ordered series
relative magnitude; "they entertained on a grand scale"
size or measure according to a scale; "This model must be scaled down"
the ratio between the size of something and a representation of it; "the scale of the map"; "the scale of the model"
a measuring instrument for weighing; shows amount of mass (同)weighing machine
a flattened rigid plate forming part of the body covering of many animals
an indicator having a graduated sequence of marks
(music) a series of notes differing in pitch according to a specific scheme (usually within an octave) (同)musical scale
a thin flake of dead epidermis shed from the surface of the skin (同)scurf, exfoliation
remove the scales from; "scale fish" (同)descale
reach the highest point of; "We scaled the Mont Blanc" (同)surmount
climb up by means of a ladder
measure by or as if by a scale; "This bike scales only 25 pounds"
measure with or as if with scales; "scale the gold"
pattern, make, regulate, set, measure, or estimate according to some rate or standard
an incrustation that forms on the teeth and gums (同)calculus, tophus
an appreciable consequence (especially a lessening); "it made a dent in my bank account"
an impression in a surface (as made by a blow) (同)ding, gouge, nick
a hard lump produced by the concretion of mineral salts; found in hollow organs or ducts of the body; "renal calculi can be very painful" (同)concretion
the branch of mathematics that is concerned with limits and with the differentiation and integration of functions (同)infinitesimal_calculus
of or relating to the teeth; "dental floss"
of or relating to dentistry; "dental student"

PrepTutorEJDIC

《しばしば複数形で》『てんびん』,はかり / てんびんのさら / 《重量を表す副詞[句]を伴って》…の目方(体重)がある / …‘を'てんびんではかる
(蛇・魚類などの)うろこ / うろこ状の物;(ペンキ・さび・ふけなどの)爆片 / 〈魚など〉‘の'うろこを取る;…‘の'皮をはぐ / (…から)〈ペンキなどの薄泰〉‘を'そぎ取る《+『名』+『off』(『from』)+『名』》 / (…から)〈ペンキなどが〉かげ落ちる《+『off』(『from』)+『名』》
『段階』,等級,階級 / 『比率』,縮尺 / (物差しなどの)『目盛り』 / (目盛りの付いた)『物差し』;温度計,(各種の)スケール / 『規模』,スケール / 音階 / 記数法,…進法 / …‘を'よじ登る / (…に合わせて)…‘を'調整する《+『名』+『to』+『名』》 / …‘を'縮尺で製図(設計)する
酒石(ぶどう酒が発酵する時にたるの内側に沈殿する) / 歯石
くぼみ,へこみ / …‘を'くぼませる,へこませる / へこむ,くぼむ
(くし・歯車などの)歯
〈C〉(腎臓内などにできる)結石 / 〈U〉微積分学
歯の,歯科医の / (音声が)歯音の / 歯音(など)

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2016/06/19 06:30:41」(JST)

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Heavy staining and calculus deposits exhibited on the lingual surface of the mandibular anterior teeth, along the gumline.

Calculus deposit on x-ray image

In dentistry, calculus or tartar is a form of hardened dental plaque. It is caused by precipitation of minerals from saliva and gingival crevicular fluid (GCF) in plaque on the teeth. This process of precipitation kills the bacterial cells within dental plaque, but the rough and hardened surface that is formed provides an ideal surface for further plaque formation. This leads to calculus buildup, which compromises the health of the gingiva (gums). Calculus can form both along the gumline, where it is referred to as supragingival ("above the gum"), and within the narrow sulcus that exists between the teeth and the gingiva, where it is referred to as subgingival ("below the gum").

Calculus formation is associated with a number of clinical manifestations, including bad breath, receding gums and chronically inflamed gingiva. Brushing and flossing can remove plaque from which calculus forms; however, once formed, it is too hard and firmly attached to be removed with a toothbrush. Calculus buildup can be removed with ultrasonic tools or dental hand instruments (such as a periodontal scaler).

Etymology

Calcis, in Greek, was a term used for various kinds of stones, coming from the term for limestone. This spun off many modern words, including "calculate" (use stones for mathematical purposes), and "calculus", which came to be used, in the 18th century, for accidental or incidental mineral buildups in human and animal bodies, like kidney stones and minerals on teeth.^[1]

Tartar, on the other hand, originates in Greek as well, but as the term for the white encrustation inside casks, aka potassium bitartrate commonly known as cream of tartar. This came to be a term used for calcium phosphate on teeth in the early 19th century.^[2]

Calculus composition

Calculus is composed of both inorganic (mineral) and organic (cellular and extracellular matrix) components. The mineral proportion of calculus ranges from approximately 40–60%, depending on its location in the dentition,^[3] and consists primarily of calcium phosphate crystals organized into four principal mineral phases: octacalcium phosphate, hydroxyapatite, whitlockite, and brushite. The organic component of calculus is approximately 85% cellular and 15% extracellular matrix.^[3] Cell density within dental plaque and calculus is very high, consisting of an estimated 200,000,000 cells per milligram.^[4]^[5] The cells within calculus are primarily bacterial, but also include at least one species of archaea (Methanobrevibacter oralis) and several species of yeast (e.g., Candida albicans). The organic extracellular matrix in calculus consists primarily of proteins and lipids (fatty acids, triglycerides, glycolipids, and phospholipids),^[3] as well as extracellular DNA.^[4]^[6] Trace amounts of host, dietary, and environmental microdebris are also found within calculus, including salivary proteins,^[7] plant DNA,^[8] milk proteins,^[9] starch granules,^[10] textile fibers,^[11] and smoke particles.^[12]

Calculus formation

The processes of calculus formation from dental plaque are not well understood. Supragingival calculus formation is most abundant on the buccal (cheek) surfaces of the maxillary molars and on the lingual (tongue) surfaces of the mandibular incisors.^[13] These areas experience high salivary flow because of their proximity to the parotid and sublingual salivary glands. Subgingival calculus forms below the gumline and is typically darkened in color by the presence of black-pigmented bacteria,^[13] whose cells are coated in a layer of iron obtained from heme during gingival bleeding.^[14] Dental calculus typically forms in incremental layers^[15] that are easily visible using both electron microscopy and light microscopy.^[7] These layers form during periodic calcification events of the dental plaque,^[13] but the timing and triggers of these events are poorly understood. The formation of calculus varies widely among individuals and at different locations within the mouth. Many variables have been identified that influence the formation of dental calculus, including age, gender, ethnic background, diet, location in the oral cavity, oral hygiene, bacterial plaque composition, host genetics, access to professional dental care, physical disabilities, systemic diseases, tobacco use, and drugs and medications.^[13]

Clinical significance

Plaque accumulation causes the gingiva to become irritated and inflamed, and this is referred to as gingivitis. When the gingiva become so irritated that there is a loss of the connective tissue fibers that attach the gums to the teeth and bone that surrounds the tooth, this is known as periodontitis. Dental plaque is not the sole cause of periodontitis, however it is many times referred to as a primary aetiology. Plaque that remains in the oral cavity long enough will eventually calcify and become calculus.^[13] Calculus is detrimental to gingival health because it serves as a trap for increased plaque formation and retention; thus, calculus, along with other factors that cause a localized build-up of plaque, is referred to as a secondary aetiology of periodontitis.

When plaque is supragingival, the bacterial content contains a great proportion of aerobic bacteria and yeast,^[16] or those bacteria which utilize and can survive in an environment containing oxygen. Subgingival plaque contains a higher proportion of anaerobic bacteria, or those bacteria which cannot exist in an environment containing oxygen. Several anaerobic plaque bacteria, such as Porphyromonas gingivalis,^[17] secrete antigenic proteins that trigger a strong inflammatory response in the periodontium, the specialized tissues that surround and support the teeth. Prolonged inflammation of the periodontium leads to bone loss and weakening of the gingival fibers that attach the teeth to the gums, two major hallmarks of periodontitis. Supragingival calculus formation is nearly ubiquitous in humans,^[18]^[19]^[20] but to differing degrees. Almost all individuals with periodontitis exhibit considerable subgingival calculus deposits.^[13] Dental plaque bacteria have been linked to cardiovascular disease^[21] and mothers giving birth to pre-term low weight infants,^[22] but there is no conclusive evidence yet that periodontitis is a significant risk factor for either of these two conditions.^[23]

Prevention

One effective way to prevent the buildup of calculus is through twice daily toothbrushing and flossing (which removes dental plaque) and regular cleaning visits based on a schedule recommended by the dental health care provider. Calculus accumulates more easily in some individuals, requiring more frequent brushing and dental visits. There are also external factors that facilitate the accumulation of calculus, including smoking and diabetes. While toothpaste with an additive ingredient of zinc citrate has been shown to produce a statistically significant reduction in plaque accumulation, it is of such a small degree that its clinical importance is questionable.^[24] Some calculus may form even without plaque deposits, by direct mineralisation of the pellicle.

Calculus in animals

Calculus formation in animals is less well studied than in humans, but it is known to form in a wide range of species. Domestic pets, such as dogs and cats, frequently accumulate large calculus deposits.^[25] Animals with highly abrasive diets, such as ruminants and equids, rarely form thick deposits and instead tend to form thin calculus deposits that often have a metallic or opalescent sheen.^[26] In animals, calculus should not be confused with crown cementum,^[27] a layer of calcified dental tissue that encases the enamel crown and is gradually worn away through abrasion.

Archaeological significance

Dental calculus has been shown to contain well preserved DNA and protein in archaeological samples.^[28]

Sub-gingival calculus formation and chemical dissolution

Sub-gingival calculus (tartar) is composed almost entirely of two components: fossilized anaerobic bacteria whose biologic composition has been replaced by calcium phosphate salts, and calcium phosphate salts that have joined the fossilized bacteria in calculus formations. The initial attachment mechanism and the development of mature calculus formations are based on electrical charge. Unlike calcium phosphate, the primary component of teeth, calcium phosphate salts exist as electrically unstable ions. The following minerals are detectable in calculus by X-ray diffraction: brushite (CaHPO₄·2H₂O), octacalcium phosphate (Ca₈H₂(PO₄)₆.5H₂O), magnesium-containing whitlockite (Ca₉(MgFe)(PO₄)₆PO₃OH), and carbonate-containing hydroxyapatite (approximately Ca₅(PO₄)₃(OH) but containing some carbonate).^[29]

The reason fossilized bacteria are initially attracted to one part of the subgingival tooth surface over another is not fully understood; once the first layer is attached, ionized calculus components are naturally attracted to the same places due to electrical charge. The fossilized bacteria pile on top of one another, in a rather haphazard manner. All the while, free-floating ionic components fill in the gaps left by the fossilized bacteria. The resultant hardened structure can be compared to concrete; with the fossilized bacteria playing the role of aggregate, and the smaller calcium phosphate salts being the cement. The once purely electrical association of fossilized bacteria then becomes mechanical, with the introduction of free-floating calcium phosphate salts. The "hardened" calculus formations are at the heart of periodontal disease and treatment.

References

^ "Online Etymology Dictionary". etymonline.com.
^ "Online Etymology Dictionary". etymonline.com.
^ ^a ^b ^c "Supragingival calculus: formation and control". Critical Reviews in Oral Biology and Medicine 13 (5): 426–441. 2002. doi:10.1177/154411130201300506. PMID 12393761.
^ ^a ^b "Dental biofilms: difficult therapeutic targets". Periodontology 2000 28 (1): 12–55. 2002. doi:10.1034/j.1600-0757.2002.280102.x. PMID 12013340.
^ "Periodontal microbial ecology". Periodontology 2000 38 (1): 135–187. 2005. doi:10.1111/j.1600-0757.2005.00107.x. PMID 15853940.
^ "A New Era in Paleomicrobiology: Prospects for Ancient Dental Calculus as a Long-Term Record of the Human Oral Microbiome". Philosophical Transactions of the Royal Society B 370 (1660): 20130376. 2014. doi:10.1098/rstb.2013.0376.
^ ^a ^b "Pathogens and host immunity in the ancient human oral cavity". Nature Genetics 46 (4): 336–344. 2014. doi:10.1038/ng.2906. PMC 3969750. PMID 24562188.
^ "The human oral microbiome". Journal of Bacteriology 192 (19): 5002–5017. 2010. doi:10.1128/JB.00542-10. PMC 2944498. PMID 20656903.
^ "Direct evidence of milk consumption from ancient human dental calculus". Scientific Reports 4: 7104. 2014. doi:10.1038/srep07104. PMC 4245811. PMID 25429530.
^ "Starch granules, dental calculus and new perspectives on ancient diet". Journal of Archaeological Science 36 (2): 248–255. 2009. doi:10.1016/j.jas.2008.09.015.
^ "Dirty teeth and ancient trade: evidence of cotton fibres in human dental calculus from Late Woodland, Ohio". International Journal of Osteoarchaeology 21 (6): 669–678. 2011. doi:10.1002/oa.1173.
^ "Neanderthal medics? Evidence for food, cooking, and medicinal plants entrapped in dental calculus". Naturwissenschaften 99 (8): 617–626. 2012. doi:10.1007/s00114-012-0942-0. PMID 22806252.
^ ^a ^b ^c ^d ^e ^f "Calculus removal and the prevention of its formation". Periodontology 2000 55 (1): 167–188. 2011. doi:10.1111/j.1600-0757.2010.00382.x. PMID 21134234.
^ "Phototargeting oral black-pigmented bacteria". Antimicrobial Agents and Chemotherapy 49 (4): 1391–1396. 2005. doi:10.1128/aac.49.4.1391-1396.2005. PMC 1068628. PMID 15793117.
^ Schroeder HE (1969). Formation and Inhibition of Dental Calculus. Hans Huber Publishers. ISBN 9783456002354.
^ Clayton YM, Fox EC., YM; Fox, EC (1973). "Investigations into the mycology of dental calculus in town-dwellers, agricultural workers and grazing animals.". J Periodontol 44 (5): 281–285. doi:10.1902/jop.1973.44.5.281. PMID 4572515.
^ "Complete genome sequence of the oral pathogenic bacterium Porphyromonas gingivalis strain W83". Journal of Bacteriology 185 (18): 5591–5601. 2003. doi:10.1128/jb.185.18.5591-5601.2003. PMC 193775. PMID 12949112.
^ "Diet and the aetiology of dental calculus". Int. J. Osteoarchaeol. 9 (4): 219–232. 1999. doi:10.1002/(SICI)1099-1212(199907/08)9:4<219::AID-OA475>3.0.CO;2-V.
^ "Processes contributing to the formation of dental calculus". Biofouling 4 (1–3): 209–218. 1991. doi:10.1080/08927019109378211.
^ "Dental calculus: recent insights into occurrence, formation, prevention, removal and oral health effects of supragingival and subgingival deposits". Eur J Oral Sci 105 (5): 508–522. 1997. doi:10.1111/j.1600-0722.1997.tb00238.x. PMID 9395117.
^ "Detection of oral bacteria in cardiovascular specimens". Oral Microbiology and Immunology 24 (1): 64–68. 2009. doi:10.1111/j.1399-302x.2008.00479.x. PMID 19121072.
^ "Periodontal disease—the emergence of a risk for systemic conditions: pre-term low birth weight". Ann Acad Med Singap 34 (1): 111–116. 2005. PMID 15726229.
^ "Parameter on Systemic Conditions Affected by Periodontal Diseases" (PDF). J Periodontol 71 (5 Suppl): 880–883. 2000. doi:10.1902/jop.2000.71.5-S.880. PMID 10875699. Retrieved 2007-07-30.
^ "Effects of a zinc citrate mouthwash on dental plaque and salivary bacteria". J. Clin. Periodontol. 7 (4): 309–15. August 1980. doi:10.1111/j.1600-051x.1980.tb01973.x. PMID 7007451.
^ http://jn.nutrition.org/content/128/12/2712S.full.pdf
^ Hilson S (2005). Teeth. Cambridge University Press. ISBN 9780521545495.
^ "The developmental biology of cementum". International Journal of Developmental Biology 45 (5/6): 695–706. 2001. PMID 11669371.
^ "Ancient human oral plaque preserves a wealth of biological data". Nature Genetics 46 (4): 321–323. 2014. doi:10.1038/ng.2930. PMID 24675519. Retrieved 2014-11-11.
^ A. Molokhia and G. S. Nixon, "Studies on the composition of human dental calculus. Determination of some major and trace elements by instrumental neutron activation analysis", Journal Journal of Radioanalytical and Nuclear Chemistry, Volume 83, Number 2, August, 1984, p. 273-281. (abstract)

UpToDate Contents

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1. 成人における歯肉炎および歯周炎：分類と歯科治療gingivitis and periodontitis in adults classification and dental treatment [show details]
…increase inflammation and may lead to loss of both clinical attachment and alveolar . Calculus ("tartar") is essentially mineralized plaque. Calculus promotes the retention of bacterial biofilm and must …
2. 歯性感染症の疫学、病因、および臨床症状epidemiology pathogenesis and clinical manifestations of odontogenic infections [show details]
…observe until it has reached a certain thickness and becomes discolored or is calcified (calculus or tartar). Calculus is prevalent among all age groups, ranging from 74 to over 90 percent . The frequency…
3. 歯性感染症の合併症、診断、および治療complications diagnosis and treatment of odontogenic infections [show details]
4. 口腔扁平苔癬：マネージメントおよび予後oral lichen planus management and prognosis [show details]
5. 小児や青年の歯肉炎と歯周炎gingivitis and periodontitis in children and adolescents [show details]

English Journal

Kinetics of canine dental calculus crystallization: An in vitro study on the influence of inorganic components of canine saliva.

Borah BM1, Halter TJ1, Xie B1, Henneman ZJ1, Siudzinski TR1, Harris S2, Elliott M3, Nancollas GH4.Author information 1Department of Chemistry, University at Buffalo, The State University of New York, Buffalo, NY 14260, USA.2Waltham Centre for Pet Nutrition, Leicestershire LE14 4RT, UK.3Mars Care & Treats Europe, Oakwell Way, Birstall WF17 9LU, UK.4Department of Chemistry, University at Buffalo, The State University of New York, Buffalo, NY 14260, USA. Electronic address: ghn@buffalo.edu.AbstractThis work identifies carbonated hydroxyapatite (CAP) as the primary component of canine dental calculus, and corrects the long held belief that canine dental calculus is primarily CaCO3 (calcite). CAP is known to be the principal crystalline component of human dental calculus, suggesting that there are previously unknown similarities in the calcification that occurs in these two unique oral environments. In vitro kinetic experiments mimicking the inorganic components of canine saliva have examined the mechanisms of dental calculus formation. The solutions were prepared so as to mimic the inorganic components of canine saliva; phosphate, carbonate, and magnesium ion concentrations were varied individually to investigate the roll of these ions in controlling the nature of the phases that is nucleated. To date, the inorganic components of the canine oral systems have not been investigated at concentrations that mimic those in vivo. The mineral composition of the synthetic calculi grown under these conditions closely resembled samples excised from canines. This finding adds new information about calculus formation in humans and canines, and their sensitivity to chemicals used to treat these conditions.
Journal of colloid and interface science.J Colloid Interface Sci.2014 Jul 1;425:20-6. doi: 10.1016/j.jcis.2014.03.029. Epub 2014 Mar 21.
This work identifies carbonated hydroxyapatite (CAP) as the primary component of canine dental calculus, and corrects the long held belief that canine dental calculus is primarily CaCO3 (calcite). CAP is known to be the principal crystalline component of human dental calculus, suggesting that there
PMID 24776659

Factors related to unmet oral health needs in older adults living in Chile.

Mariño R1, Giacaman RA2.Author information 1Oral Health Cooperative Research Centre, Melbourne Dental School, University of Melbourne, Australia. Electronic address: rmarino@unimelb.edu.au.2Cariology Unit, Department of Oral Rehabilitation and Interdisciplinary Excellence Research Program on Healthy Aging (PIEI-ES), University of Talca, Talca, Chile.AbstractTo assess the oral health status and treatment needs of an ambulant population of older adults, living in the Maule Region, Chile, and provide descriptive information on its distribution by selected socio-demographic characteristics. The source of primary data was the Regional Oral Health Survey. A stratified random sample of 438 older adults, aged 65-74 years, living independently in the community was orally examined, and underwent an oral health interview. The sample was largely a dentate one (74.9%); with a mean DMFT score of 25.7 (s.d. 6.5) and an average number of missing teeth of 22.4 (s.d. 5.8). Dentate participants had 41% of their restorative care needs unmet, and 68.4% needed oral hygiene instruction plus removal of calculus on their teeth. Almost 30.1% required complex periodontal therapy. 21% of those fully edentulous were in need of full dentures. Comparing these findings with existing data on the oral health of older adults in Chile, participants in this study appear to have lower missing teeth scores and less need for complex periodontal treatment. Inequities were apparent in the proportion of unmet restorative and prosthetics needs. Community-based preventive care programs specifically tailored to older adults are needed to address this challenge.
Archives of gerontology and geriatrics.Arch Gerontol Geriatr.2014 May-Jun;58(3):454-9. doi: 10.1016/j.archger.2014.01.003. Epub 2014 Jan 20.
To assess the oral health status and treatment needs of an ambulant population of older adults, living in the Maule Region, Chile, and provide descriptive information on its distribution by selected socio-demographic characteristics. The source of primary data was the Regional Oral Health Survey. A
PMID 24556393

Calcium Phosphate Particles Induce Interleukin-8 Expression in Human Gingival Epithelial Cell Line via Nuclear Factor-κB Signaling Pathway.

Sakai Y1, Nemoto E, Kanaya S, Shimonishi M, Shimauchi H.Author information 1Department of Periodontology and Endodontology, Tohoku University Graduate School of Dentistry, Sendai 980-8575, Japan.AbstractBackground: Dental calculus is calcified plaque composed primarily of calcium phosphate mineral salts, and there is a clear association between the presence of calculus and the initiation/progression of periodontitis. However, it is still inconclusive whether dental calculus can be a direct causative factor. We examined the effect of nano/micro-sized calcium phosphate particles, which may be generated in the process of early precipitation and/or dissolution of calcium phosphate mineral, on the expression of interleukin (IL)-8 in human gingival epithelial cells. Methods: Primary human gingival epithelial cells and/or a human gingival carcinoma cell line (Ca9-22) were stimulated with calcium phosphate particles. Gene and protein levels were assessed by real-time polymerase chain reaction analysis and enzyme-linked immunosorbent assay, respectively. The activity of nuclear factor-κB (NF-κB) signaling was measured by an immunofluorescence assay to evaluate NF-κB p65 nuclear translocation. Results: We showed that nano/micro-sized particles stimulated IL-8 expression in human gingival epithelial cells at gene and protein levels. The activity to induce IL-8 expression depended on the particle size, where particles with a diameter of 200 nm were more effective than those of 40 nm and 5 μm. Calcium phosphate particles (ø: 200 nm) stimulated NF-κB activity. Pretreatment with BMS-345541, an NF-κB signaling inhibitor, inhibited the particle-mediated IL-8 gene induction, suggesting a requirement for the NF-κB signaling pathway. Conclusion: These findings suggest that calcium phosphate particles, which may be related to calculus development, may act as a direct causative factor in the pathogenesis of gingival epithelium.
Journal of periodontology.J Periodontol.2014 Apr 23. [Epub ahead of print]
Background: Dental calculus is calcified plaque composed primarily of calcium phosphate mineral salts, and there is a clear association between the presence of calculus and the initiation/progression of periodontitis. However, it is still inconclusive whether dental calculus can be a direct causativ
PMID 24754833

Japanese Journal

尋常性天疱瘡に歯周病を併発した患者に歯周基本治療を行い良好な結果を得られた一症例

十川裕子,竹内康雄,片桐さやか,木村文香,難波佳子,小田茂,足達淑子,和泉雄一
日本歯周病学会会誌 56(4), 451-456, 2015
尋常性天疱瘡は皮膚や粘膜に上皮内水疱を形成する自己免疫疾患であり，歯肉を含む口腔粘膜にもその病変がしばしば認められる。本報では尋常性天疱瘡により著しい浮腫性の腫脹や剥離性のびらんが認められた患者に対し，徹底した口腔清掃指導を軸とした歯周基本治療により，非外科治療のみでも良好な臨床症状の改善を図ることができた一症例を示す。患者は 56 歳女性で，全顎的な歯肉の腫脹，ブラッシング時の出血，歯の動揺を主 …
NAID 130004842597