Ultrastructural study of calculus-enamel and calculus-root interfaces.
UNLABELLED: The attachment of dental calculus to the tooth (enamel or cementum) surface affects the ease or difficulty of its removal. Understanding the ultrastructural features of the calculus-tooth interface will help in the development of efficient strategies for efficient removal of dental calculus. OBJECTIVE: The aim of this study was to determine the ultrastructural characteristics of the calculus-tooth interface in relation to the occurrence of calculus fracture. DESIGN: Investigation of the ultrastructural characteristics of the calculus-tooth interface was made on eight human molars with mature supragingival and subgingival calculus using scanning electron microscopy (SEM), transmission electron microscopy (TEM) and fourier transform infra-red (FT-IR) spectroscopy. RESULTS: Fractures were shown by SEM to consistently occur within the calculus itself, but not at the calculus-tooth interface. Higher magnification revealed that the enamel apatite crystals (in the case of supragingival calculus) or the cementum apatite crystals (in the case of subgingival calculus) appeared intimately connected with the calculus crystals at the calculus-enamel or calculus-cementum interface. TEM micrographs confirmed this intimate direct connection or fusion (epitaxial growth) of calculus crystals with enamel and cementum apatite crystals. FT-IR showed lower concentrations of organic phase attributed to microorganisms and higher concentrations of collagen at the calculus-cementum interface compared to that in the calculus away from the interface. CONCLUSION: Difficulty in complete calculus removal from tooth surfaces (especially from cementum or dentin) may be due in part to the intimate contact between the calculus and the tooth, due to the chemical bonding between the calculus crystals and the tooth apatite crystals and occasional fusion (i.e., epitaxial growth) of the calculus calcium phosphate crystals with the enamel, dentin or apatite crystals. This cohesive bonding results in fracture planes occurring within the calculus instead of at the calculus-tooth interface.