CoChat
Sign Up
Cited by 155Oral microbiology and periodontitis researchBacterial biofilms and quorum sensingPeriodontal Regeneration and Treatments

Dental calculus: the calcified biofilm and its role in disease development

Open access
Akcalı, Aliye, Lang, Niklaus P.·2018·Periodontology 2000
DOI 10.1111/prd.12151
Open this paper in CoChat — free accountOpen PDF

Abstract

Dental calculus represents the first fossilized record of bacterial communities as a testimony of evolutionary biology. The development of dental calculus is a dynamic process that starts with a nonmineralized biofilm which eventually calcifies. Nonmineralized dental biofilm entraps particles from the oral cavity, including large amounts of oral bacteria, human proteins, viruses and food remnants, and preserves their DNA. The process of mineralization involves metabolic activities of the bacterial colonies and strengthens the attachment of nonmineralized biofilms to the tooth surface. From a clinical point of view, dental calculus always harbors a living, nonmineralized biofilm, jeopardizing the integrity of the dento-gingival or implanto-mucosal unit. This narrative review presents a brief historical overview of dental calculus formation and its clinical relevance in modern periodontal practice.

AI snapshot

Written from the paper’s full text.

TL;DR

This review describes dental calculus as a mineralized biofilm that is always covered by viable, nonmineralized plaque and acts mainly as a secondary plaque-retaining factor in periodontal disease. It concludes that periodontal therapy should prioritize removal of bacterial biofilms, with calculus removal as part of that goal rather than as the sole target.

Key findings

  • Nonmineralized oral biofilms contain more than 800 taxa; calculus forms when these biofilms mineralize with calcium phosphate salts, and it can develop both above and below the gingival margin.
  • Mineralization is described as complete within 12 days, with about half occurring in the first 2 days; daily calculus deposition in calculus formers is reported at roughly 0.10–0.15% dry weight.
  • Supragingival calculus has an average mineral content of 37% (range 16–51%, with exceptional layers up to 80%), while subgingival calculus is denser and more homogeneous, averaging 58% (range 32–78%, with maximal values of 60–80%).
  • Although calculus is associated with periodontitis and gingivitis, the review states that no cause–effect relationship has been established; calculus is always covered by living biofilm, and biofilm is considered more irritating to tissues than the calcified deposit itself.

Methods

  • Narrative review synthesizing literature on the development, structure, formation rate, and clinical relevance of dental calculus.
  • Evidence discussed includes archaeological and ancient-DNA studies, microscopic and crystallographic analyses, experimental animal work, epidemiologic observations, and clinical periodontal studies.
  • No primary data collection or systematic review methodology is reported.

Limitations

  • The paper states that little is known about the rate of calculus formation across life and whether calculus can be dissolved.
  • The paper notes ongoing debate about whether calculus exerts harmful effects through surface roughness alone and that it is difficult to separate the effects of calculus from those of the biofilm covering it.
  • Evident from the text: as a narrative review, it does not describe a systematic search strategy, inclusion criteria, or formal quality assessment, and several key claims rely on older or animal-based studies.

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.1111/prd.12151

Cites

53 of 53 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Claims the paper makes

5 of 69 cited sources checked · 3 supported · 0 flagged · accuracy not yet measured

  • Premisecitation
    § Dental calculus: the calcified biofilm and its role in disease development

    Viral and fungal taxa, as well as disease-associated microorganisms of the respiratory tract, have been identified both in ancient biofilms and in more recently mineralized biofilms.

    “Viral and fungal taxa, as well as disease-associated microorganisms of the respiratory tract, have been identified both in ancient biofilms and in more recently mineralized biofilms (56).”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites [56] 56. Warinner C, Rodrigues JF, Vyas R, Trachsel C, Shved N, Grossmann J, Radini A, Hancock Y, Tito RY, Fiddyment S, Speller C, Hendy J, Charlton S, Luder HU, Salazar-Garc ıa DC, Eppler E, Seiler R, Hansen LH, Castruita JA, Barkow- Oesterreicher S, Teoh KY, Kelstrup CD, Olsen JV, Nanni P, Kawai T, Willerslev E, von Mering C, Lewis CM Jr, Collins MJ, Gilbert MT, R€ uhli F, Cappellini E. Pathogens and host immunity in the ancient human oral cavity. Nat Genet 2014: 46: 336-344. source

      The Ancient Oral Microbiome section reports viral and fungal DNA in ancient dental calculus, and Carriage of Specific Pathogens identifies organisms implicated in respiratory illness there. The paper compares ancient calculus with modern controls, but the cited passages do not establish that all three groups were identified in more recently mineralized biofilms. (LLM, conf=0.86)

      Experimental — accuracy not yet measured
  • Premisecitation

    Complete removal of calculus on root surfaces is difficult in daily practice.

    “However, such complete removal of calculus on root surfaces is difficult in daily practice (35).”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites [35] 35. Rabbani GM, Ash MM Jr, Caffesse RG. The effectiveness of subgingival scaling and root planing in calculus removal. J Periodontol 1981: 52: 119-123. source
  • Premisecitation

    Dental calculus provides a surface onto which newly developing biofilm is deposited with various compositions.

    “Nevertheless, it now provides a surface onto which newly developing biofilm is deposited with various compositions (41).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [41] 41. Schroeder HE. Formation and inhibition of dental calculus. Berne: Hans Huber, 1969. source
  • Premisecitation

    These mineralized biofilms form both supragingivally and subgingivally.

    “These mineralized biofilms form both supragingivally and subgingivally (41) (Fig. 1A,B).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [41] 41. Schroeder HE. Formation and inhibition of dental calculus. Berne: Hans Huber, 1969. source
  • Premisecitation

    A difference in the microbial profile of supragingival and subgingival calculus was revealed.

    “A difference in the microbial profile of supragingival and subgingival calculus was revealed (9).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [9] 9. Friskopp J, Hammarstr€ om L. An enzyme histochemical study of dental plaque and calculus. Acta Odontol Scand 1982: 40: 459-466. source
  • Classified as probably not a substantial claim. 7
  • May combine two claims. 20

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation
    § Dental calculus: the calcified biofilm and its role in disease development

    Nonmineralized biofilms consist of over 800 different taxa.

    “It is widely accepted that nonmineralized biofilms consist of over 800 different taxa (20).”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites [20] 20. Liu B, Faller LL, Klitgord N, Mazumdar V, Ghodsi M, Som- mer DD, Gibbons TR, Treangen TJ, Chang YC, Li S, Stine OC, Hasturk H, Kasif S, Segr e D, Pop M, Amar S. Deep sequencing of the oral microbiome reveals signatures of periodontal disease. PLoS One 2012: 7: e37919. source

      The Introduction reports about 10,000 microbial phylotypes in dental plaque pooled from 98 healthy adults, supporting the broad point that oral plaque is highly diverse. It does not establish that nonmineralized biofilms generally contain over 800 taxa; the reported count is for pooled plaque, not individual biofilms. (LLM, conf=0.82)

      Experimental — accuracy not yet measured

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    The presence of tubular holes in dental calculus was reported.

    “Moreover, the presence of tubular holes was reported (44).”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites [44] 44. Shirato M, Kamishikiryo K, Itoh A, Kado H, Maeda Y, Seki- guchi T, Fukui K, Takezawa T. Observations of the surface of dental calculus using scanning electron microscopy. J Nihon Univ Sch Dent 1981: 23: 179-187. source

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation
    § Dental calculus: the calcified biofilm and its role in disease development

    Different metagenomic sequencing strategies have recently been applied to ancient dental calculus and described immense possibilities for dental calculus to reform ancient biomedical research.

    “Different metagenomic sequencing strategies have recently been applied to ancient dental calculus and described immense possibilities for dental calculus to reform ancient biomedical research (56).”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites [56] 56. Warinner C, Rodrigues JF, Vyas R, Trachsel C, Shved N, Grossmann J, Radini A, Hancock Y, Tito RY, Fiddyment S, Speller C, Hendy J, Charlton S, Luder HU, Salazar-Garc ıa DC, Eppler E, Seiler R, Hansen LH, Castruita JA, Barkow- Oesterreicher S, Teoh KY, Kelstrup CD, Olsen JV, Nanni P, Kawai T, Willerslev E, von Mering C, Lewis CM Jr, Collins MJ, Gilbert MT, R€ uhli F, Cappellini E. Pathogens and host immunity in the ancient human oral cavity. Nat Genet 2014: 46: 336-344. source

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation
    § Dental calculus: the calcified biofilm and its role in disease development

    Extraction and selected sequencing of ancient oral microbial DNA was reported in 2012.

    “and the extraction and selected sequencing of ancient oral microbial DNA was reported in 2012 (4).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [4] 4. De La Fuente C, Flores S, Moraga M. DNA from human ancient bacteria: a novel source of genetic evidence from archaeological dental calculus. Archaeometry 2012: 55: 767- 778. source

  • May combine two claims.

    Premisecitation
    § Dental calculus: the calcified biofilm and its role in disease development

    Scanning electron microscopy and the first observations and description of in situ calcified oral microbes revealed the broad presence of well-preserved calcified microorganisms in human calculus and allowed extrapolation into ancient oral microbiomes.

    “Scanning electron microscopy and the first observations and description of in situ calcified oral microbes (5) revealed the broad presence of well-preserved calcified microorganisms in human calculus and allowed the extrapolation into ancient oral microbiomes (6,10).”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites [5] 5. Dobney K, Brothwell D. A scanning electron microscope study of archaeological dental calculus. In: Olsen SL, edi- tors. Scanning electron microscopy in archaeology. British archaeological reports international series. Oxford: Archaeo- press, 1988: 372-385.

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

    • cites [6] 6. Dobney K. Study of the dental calculus. In: Lilley JM, Stroud G, Brothwell DR, Williamson MH, editors.The Jewish burial ground at Jewbury. York, UK: York Archaeological Trust, Council for British Archaeology, 1994: 507-521.

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

    • cites [10] 10. Hansen PH, Meldgaard J, Nordqvist J, editors. The Green- land mummies. Washington, DC: Smithsonian Institution Press, 1991. source

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation
    § Dental calculus: the calcified biofilm and its role in disease development

    Intact bacterial DNA within preserved calcified biofilm deposits was first demonstrated in 2011.

    “Intact bacterial DNA within preserved calcified biofilm deposits was first demonstrated in 2011 (34), and the extraction and selected sequencing of ancient oral microbial DNA was reported in 2012 (4).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [34] 34. Preus HR, Marvik OJ, Selvig KA, Bennike P. Ancient bacte- rial DNA (aDNA) in dental calculus from archaeological human remains. J Archaeol Sci 2011: 38: 1827-1831. source

  • May combine two claims.

    Premisecitation
    § Dental calculus: the calcified biofilm and its role in disease development

    Dental calculus represents the first fossilized record of bacterial communities associated with the human body and is an important source of information related to the evolution of the human microbiome.

    “As dental calculus represents the first fossilized record of bacterial communities associated with the human body (microbiome), it is an important source of information related to the evolution of the human microbiome (57).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [57] 57. Weyrich LS, Dobney K, Cooper A. Ancient DNA analysis of dental calculus. J Hum Evol 2015: 79: 119-124. source

  • May combine two claims.

    Premisecitation

    Dental biofilms always cover the surface of mineralized deposits, so dental calculus is always covered by an unmineralized layer of viable biofilm.

    “It thus maintains close proximity to the gingival tissues, as dental biofilms always cover the surface of the mineralized deposits (11) (Fig. 4).”
    • Also stated in: § Clinical relevance of dental calculus · boosted
      “Although strong associations between calculus deposits and periodontitis have been demonstrated in experimental (54,55) and epidemiologic (22) studies, it should be noted that calculus is always covered by an unmineralized layer of viable biofilm.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [11] 11. Hazen SP. Supragingival dental calculus. Periodontol 2000 1995: 58: 125-136. source

  • May combine two claims.

    Premisecitation
    § Dental calculus: the calcified biofilm and its role in disease development

    Mineralized biofilms, penetrated by crystals of various calcium phosphates, develop above or below the free gingival margin as moderately hard white/yellowish deposits and are superficially covered with vital, nonmineralized biofilms.

    “Mineralized biofilms, penetrated by crystals of various calcium phosphates, develop above or below the free gingival margin as moderately hard deposits that are white/yellowish in color.They are superficially covered with vital, nonmineralized biofilms (41).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [41] 41. Schroeder HE. Formation and inhibition of dental calculus. Berne: Hans Huber, 1969. source

  • May combine two claims.

    Premisecitation

    Histologically, supragingival and subgingival calculus are similar in appearance and in the sequence of events of formation of the supragingival and subgingival deposits.

    “Histologically, supragingival and subgingival calculus are similar in terms of appearance and in the sequence of events of the formation of the supragingival and subgingival deposits, respectively (32).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [32] 32. Oshrain H, Salkind A, Mandel ID. An histologic comparison of supra and subgingival plaque and calculus. J Periodontol 1971: 42: 31-33. source

  • May combine two claims.

    Interpretationreasoning

    Dental calculus always harbors a living, nonmineralized biofilm, which jeopardizes the integrity of the dentogingival unit.

    “From a clinical point of view, it must be noted that dental calculus always harbors a living, nonmineralized biofilm (depicted as the blue mass of biofilm in Fig. 4), which jeopardizes the integrity of the dentogingival unit.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Premisecitation

    Filamentous organisms dominated supragingival calculus and were oriented at right angles to the surface of the teeth, whereas subgingival calculus was covered by cocci, rods and filaments with no distinct pattern of orientation.

    “Filamentous organisms dominated supragingival calculus and were oriented at right angles to the surface of the teeth, whereas subgingival calculus was covered by cocci, rods and filaments with no distinct pattern of orientation.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [9] 9. Friskopp J, Hammarstr€ om L. An enzyme histochemical study of dental plaque and calculus. Acta Odontol Scand 1982: 40: 459-466. source

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation
    § Dental calculus: the calcified biofilm and its role in disease development

    The calcification process follows various mechanisms of mineralization.

    “The calcification process follows various mechanisms of mineralization (58).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [58] 58. White DJ. Dental calculus: recent insights into occurrence, formation, prevention, removal and oral health effects of supragingival and subgingival deposits. Eur J Oral Sci 1997: 105: 508-522. source

  • May combine two claims.

    Premisecitation

    Nonmineralized dental biofilm entraps particles from the oral cavity, including large amounts of oral bacteria, human proteins, viruses and food remnants, and preserves their DNA.

    “Nonmineralized dental biofilm entraps particles from the oral cavity, including large amounts of oral bacteria, human proteins, viruses and food remnants, and preserves their DNA (15) (Fig. 2).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [15] 15. Jin Y, Yip HK. Supragingival calculus: formation and control. Crit Rev Oral Biol Med 2002: 13: 426-441.

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • May combine two claims.

    Premisecitation

    The presence of calculus may limit the ability to perform optimal oral hygiene practices and hence may increase the rate of biofilm deposition.

    “The presence of calculus may limit the ability to perform optimal oral hygiene practices (33) and hence may increase the rate of biofilm deposition.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [33] 33. Pradeep AR, Agarwal E, Arjun Raju P, Rao MS, Faizuddin M. Study of orthophosphate, pyrophosphate, and pyrophos- phatase in saliva with reference to calculus formation and inhibition. J Periodontol 2011: 82: 445-451. source

  • May combine two claims.

    Premisecitation

    The predominant mineral in subgingival calculus is whitlockite, although hydroxyapatite has been found.

    “The predominant mineral is whitlockite, although hydroxyapatite has been found (47).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [47] 47. Sundberg JR, Friskopp J. Crystallography of supragingival and subgingival human dental calculus. Scand J Dent Res 1985: 93: 30-38. source

  • May combine two claims.

    Premisecitation

    On average, the density of subgingival calculus is 58%, ranging from 32% to 78%, with maximal values of 60-80% also identified.

    “On average, the density is 58%, ranging from 32% to 78%.Maximal values of 60-80% have also been identified (8,16).”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [8] 8. Friskopp J, Isacsson G. Mineral content of supragingival and subgingival dental calculus. A quantitative microradio- graphic study. Scand J Dent Res 1984: 92: 417-423. source
    • cites [16] 16. Kani T, Kani M, Moriwaki Y, Doi Y. Microbeam X-ray diffrac- tion analysis of dental calculus. J Dent Res 1983: 62: 92-95. source

  • May combine two claims.

    Interpretationreasoning

    Dental calculus is an ideal breeding environment for bacterial biofilm and growth and is accepted as an important secondary etiological factor in the development and progression of periodontitis.

    “Dental calculus is an ideal breeding environment for bacterial biofilm and growth and it is accepted as an important secondary etiological factor in the development and progression of periodontitis.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Premisecitation

    Supragingival and subgingival calculus progressing in an apical direction or laterally is directly responsible for pocket deepening and loss of attachment, as a metabolically active biofilm always covers subgingival calculus.

    “Supragingival and subgingival calculus progressing in an apical direction or laterally is directly responsible for the pocked deepening and loss of attachment (55), as a metabolically active biofilm always covers subgingival calculus (Fig. 5).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [55] 55. Wærhaug J. The gingival pocket. Odontol Tidskr 1952: 60: 1-186.

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • May combine two claims.

    Interpretationnone given

    Although dental calculus is always covered with viable bacterial biofilm, it is difficult to distinguish between the effects of calculus or biofilm per se on the periodontium.

    “Although dental calculus is always covered with viable bacterial biofilm, it is difficult to distinguish between the effects of calculus or biofilm per se on the periodontium.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Premisecitation

    On average, the mineral content of supragingival calculus is 37%, but ranges from 16% to 51%, with some exceptional layers having a maximal density of minerals of up to 80%.

    “On average, the mineral content is 37%, but ranges from 16% to 51%, with some exceptional layers having a maximal density of minerals of up to 80% (8,16).”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [8] 8. Friskopp J, Isacsson G. Mineral content of supragingival and subgingival dental calculus. A quantitative microradio- graphic study. Scand J Dent Res 1984: 92: 417-423. source
    • cites [16] 16. Kani T, Kani M, Moriwaki Y, Doi Y. Microbeam X-ray diffrac- tion analysis of dental calculus. J Dent Res 1983: 62: 92-95. source

  • May combine two claims.

    Premisecitation

    Heavy calculus formers have higher levels of calcium, three times higher levels of phosphorus and lower levels of potassium in saliva than light calculus formers.

    “higher levels of calcium, three times higher levels of phosphorus and lower levels of potassium in the saliva of heavy calculus formers than in the saliva of light calculus formers (24).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [24] 24. Mandel I. Biochemical aspects of calculus formation. J Peri- odontal Res 1969: 4: 7-8. source

  • May combine two claims.

    Premisecitation

    The mineralization process of the biofilm appears to be complete in 12 days, but half of the mineralization occurs in the first 2 days.

    “The mineralization process of the biofilm appears to be complete in 12 days, but half of the mineralization occurs in the first 2 days (28,40).”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [28] 28. M€ uhlemann H, Schroeder H. Dynamics of supragingival calculus formation. Adv Oral Biol 1964: 1: 175-203. source
    • cites [40] 40. Schroeder H. Inorganic content and histology of early den- tal calculus in man. Helv Odontol Acta 1963: 7: 17.

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Whitlockite contains small proportions (3%) of magnesium.

    “Whitlockite contains small proportions (3%) of magnesium (26).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [26] 26. McDougall WA. Analytical transmission electron micro- scopy of the distribution of elements in human supra-gingi- val dental calculus. Arch Oral Biol 1985: 30: 603-608. source

  • May combine two claims.

    Premisecitation

    The rate of calculus formation and the amount of calculus formed depends on multiple factors, including diet, especially alkaline foods and sugars, genetic variations in salivary content, and other factors such as age, race, gender, presence of disease and bacterial load.

    “The rate of calculus formation and the amount of calculus formed depends on multiple factors, including diet, especially alkaline foods (15,17) and sugars (39), genetic variations in the salivary content (29) and other factors, such as age, race, gender, presence of disease and the bacterial load of the subject (29,58).”
    Quote in the paperNot a substantial claim0 of 4 sources checked
    • cites [15] 15. Jin Y, Yip HK. Supragingival calculus: formation and control. Crit Rev Oral Biol Med 2002: 13: 426-441.

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

    • cites [17] 17. Lieverse AR. Diet and the aetiology of dental calculus. Int J Osteoarchaeol 1999: 9: 219-232. source
    • cites [39] 39. Scheie AA. Mechanisms of dental plaque formation. Adv Dent Res 1994: 8: 246-253. source
    • cites [29] 29. Nancollas GH, Johnsson MA. Calculus formation and inhi- bition. Adv Dent Res 1994: 8: 307-311. source

  • May combine two claims.

    Premisecitation

    The predominant mineral in exterior layers of supragingival calculus is octacalcium phosphate, while hydroxyapatite is dominant in the inner layers of old calculus.

    “The predominant mineral in exterior layers is octacalcium phosphate, while hydroxyapatite is dominant in the inner layers of old calculus.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [47] 47. Sundberg JR, Friskopp J. Crystallography of supragingival and subgingival human dental calculus. Scand J Dent Res 1985: 93: 30-38. source
26 of 26

  • The paper relies on this without support.

    The human microbiome plays a central role in health and chronic disease.

    “Modern investigations of the native human microbiota have demonstrated that the human microbiome plays a central role in health and chronic disease, raising questions about changes in microbial ecology, diversity and function throughout the course of human evolution.”

  • The paper relies on this without support.

    Biofilm is the cause of periodontal disease.

    “indirectly impairs sufficient removal of biofilm, the cause of periodontal disease.”
2 of 2

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • The most frequent calcium phosphate crystalline phases found in dental calculus are hydroxyapatite, octacalcium phosphate, and whitlockite.

    “The most frequent calcium phosphate crystalline phases found in dental calculus are hydroxyapatite, octacalcium phosphate, and whitlockite30.”

    From Recent advances in the pathogenesis and prevention strategies of dental calculus (2024) · cites this paper as [30]

  • Calculus-associated biofilms can sustain an inflammatory response, leading to continuous destruction of soft and hard tissues if not adequately managed.

    “Additionally, calculus-associated biofilms can sustain an inflammatory response, leading to continuous destruction of both soft and hard tissues if not adequately managed [3].”

    From In vitro biomimetic development of artificial dental calculus: a proof of concept study (2025) · cites this paper as [3]

  • As bacterial metabolism progresses, the biofilm transitions into calculus, strengthening its attachment to the tooth surface and capturing intraoral particles.

    “As bacterial metabolism progresses, the biofilm transitions into calculus, strengthening its attachment to the tooth surface and capturing intraoral particles [3].”

    From In vitro biomimetic development of artificial dental calculus: a proof of concept study (2025) · cites this paper as [3]

  • The formation of dental calculus is a dynamic process that begins with the calcification of non-mineralized biofilm-comprising oral bacteria, host proteins, and DNA-when saliva becomes supersaturated with calcium and phosphate ions.

    “Building on these findings, it is essential to recognize that the formation of dental calculus is a dynamic process that begins with the calcification of non-mineralized biofilm -comprising oral bacteria, host proteins, and DNA -when saliva becomes supersaturated with calcium and phosphate ions.”

    From In vitro biomimetic development of artificial dental calculus: a proof of concept study (2025) · cites this paper as [3]

  • Dental calculus serves as a passive retention site for biofilms and plays an active role in the progression of periodontal disease; its porous and rough surface facilitates bacterial adhesion and protects the microbial community from mechanical removal and host defense mechanisms.

    “Dental calculus not only serves as a passive retention site for biofilms but also plays an active role in the progression of periodontal disease.Its porous and rough surface facilitates bacterial adhesion and protects the microbial community from mechanical removal and host defense mechanisms.”

    From In vitro biomimetic development of artificial dental calculus: a proof of concept study (2025) · cites this paper as [3]

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Each contradiction between two passages listed here was confirmed by an independent check.

  • Causal role of calculus is both denied and asserted

    Minor

    The paper says no causal relationship between calculus and disease progression has been established, but later states that calculus is directly responsible for pocket deepening and attachment loss.

1 of 1

Cites

Flagged first, then by citations

Research works printed but not linked: 8

  1. Bosshardt DD, 2015, Clinical periodontology & implant dentistry, 183
  2. Dobney K, 1988, Scanning electron microscopy in archaeology. British archaeological reports international series, 372
  3. Dobney K, 1994, The Jewish burial ground at Jewbury, 507
  4. Jenkins GN, 1974, Metabolism and cariogenicity of dental plaque
  5. Mandel I, 1969, Biochemical aspects of calculus formation, J Periodontal Res, 4, 7
  6. Schroeder H, 1963, Inorganic content and histology of early dental calculus in man, Helv Odontol Acta, 7, 17
  7. Turesky S, 1962, Effects of changing the salivary environment on progress of calculus formation, J Periodontol, 33, 45
  8. Wærhaug J, 1952, The gingival pocket, Odontol Tidskr, 60, 1

Cited by

Sorted by citations

Related

Authors
Akcalı, A., & Lang, N. P.
ORCID
Venue
Periodontology 2000
Publisher
Wiley
Published
2017-12
Volume
76
Issue
1
Pages
109-115
ISSN
  • 0906-6713 (ISSN-L)
  • 1600-0757
DOI
10.1111/prd.12151
OpenAlex
W2774942396
Cited by
155
References
52
Citations by year
2026: 16 · 2025: 29 · 2024: 29 · 2023: 18 · 2022: 16 · 2021: 19 · 2020: 11 · 2019: 11 · 2018: 3 · 2017: 2
FWCI
1.03
Type
journal article
Language
en
Open access
Licence
onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations
  • Periodontology 2000 (publishedVersion)
  • PubMed (publishedVersion)
  • BORIS (University Library Bern) (submittedVersion)
Topics
  • Health Sciences › Dentistry › Periodontics › Oral microbiology and periodontitis research
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Bacterial biofilms and quorum sensing
  • Health Sciences › Medicine › Urology › Periodontal Regeneration and Treatments
Keywords
dental calculus, dental plaque, calcification, mineralization, oral bacteria, periodontal disease, biofilm attachment, oral microbiota
MeSH terms
Animals, Bacteria, Calcification, Physiologic, Dental Calculus, Biological Evolution, Gingiva, Humans, Mouth, Viruses, Biofilms, Disease Progression, Microbiota

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Claims read by deepseek-v4.1-flash under definition version 3 (extract-v3) on 2026-10-11.

Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-10-11.

Cited sources are checked by gpt-6-sol.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review