Periodontitis Aetiology — NDEB AFK MCQ
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Correct answer: C — Subgingival bacterial biofilm
While dental calculus acts as a retentive factor for plaque, it is the subgingival bacterial biofilm (dental plaque) that is the primary aetiological factor in chronic periodontitis. The biofilm contains pathogenic organisms (red complex: P. gingivalis, T. forsythia, T. denticola) that trigger host inflammatory and immune responses leading to periodontal tissue destruction. Calculus removal is important because it facilitates biofilm accumulation.
Reference: Newman – Newman and Carranza's Clinical Periodontology, 13th ed., 2019