Insufficient Removal of Calculus Boosts Risk of Periodontal Inflammation

According to findings published in Dentistry Journal, the inadequate removal of calculus plays a critical role in the frequent failure of non-surgical periodontal therapy to eradicate inflammation.

The authors indicated that in 2018 the American Academy of Periodontology (AAP) and the European Federation of Periodontists (EFP) concurrently published a new classification of periodontal disease.

Authors conducted a narrative review of the literature discussing the impact of calculus on inflammation and the effects of inadequate removal of calculus during periodontal therapy were also examined in light of the 2018 classification of periodontal disease, the decision points of periodontal therapy, and the guidelines of periodontal therapy.

Results revealed that the published literature supports that calculus is a major risk factor for periodontal inflammation. The authors also noted that recent studies indicate that the pathologic risk of calculus goes further than the preservation of biofilm and may represent a different pathophysiologic pathway for periodontal disease separate from the direct action of biofilm and that inadequate removal of calculus is a factor in the failure of periodontal therapy.

The authors noted that this narrative review was intended to inform the reader of recent publications establishing clinical decision points and guidelines for periodontal therapy and was not meant to be a definitive literature review such as would be presented in a systematic review.

The authors concluded, “The inadequate removal of calculus plays an important role in the frequent failure of non-surgical periodontal therapy to eliminate inflammation.”

“If the response to a performed treatment has been inadequate to render periodontal health, it is ethically mandatory that the patient be informed that the treatment results have not been completely successful, and that further treatment is available,” wrote the authors, “ Not informing the patient of continued inflammation and disease progression is ethically unacceptable.”

Reference

Harrel SK, Cobb CM, Sheldon LN, Rethman MP, Sottosanti JS. Calculus as a Risk Factor for Periodontal Disease: Narrative Review on Treatment Indications When the Response to Scaling and Root Planing Is Inadequate. Dent J (Basel). 2022 Oct 20;10(10):195. doi: 10.3390/dj10100195. PMID: 36286005; PMCID: PMC9600378.