CURETTES: A Curette is a Surgical instrument used to remove deep subgingival calculus, root planning altered cementum and removing the soft tissue lining the periodontal pocket. The procedure of using a Curette is termed as Curettage which is the process of cleaning or scrapping the gingival wall of a Periodontal Pocket to remove infected or diseased tissue. The purpose of Curettage is to reduce the pocket depth and enhance new Connective tissue attachment.
Uses of Periodontal Curettes:
- Removal of deep Sub-Gingival Calculus
- Root Planning
- To remove soft tissue lining of Periodontal Pocket
- To clean Deep Infected pockets
- Removal of Altered Cementum from Sub-Gingival Root Surface
Types of Periodontal Curettes:
Universal Curettes
Area Specific Curettes
A Curette has two working ends, with each working end having a cutting edge on both sides of the blade and a rounded toe. Curette us finer than the sickle scalers and has only a cutting edge and no corners or sharp points. This is done to prevent any soft tissue damage during sub gingival cleaning in deep pockets.
Universal Curettes:
These are termed Universal as these can be used in any tooth to clean Sub-Gingivally. These instruments can be used in most teeth by just altering the finger rest position and adjusting your hand position depending on the Quadrant which you are cleaning and Mandibular or Maxillary jaw.
Universal curettes are designed in a way that they can be adapted to any tooth surface, with the face of the blade at a 90-degree angle which is perpendicular to the lower shank in cross-section from the tip. The blade of the head is curved to one side from the head of the blade to toe.
Names of Universal Curettes:
- Barnhart Curettes #1-2
- Barnhart curettes 5-6
- Columbia curettes #13-14,
- Columbia curettes 2R-2L
- Columbia curettes 4R-4L
- Younger-Good #7-8
- Mc Call’s #17-18
- University #17-18
Area Specific Curettes:
These are a set of Curettes which are specified to a particular area, they whole instrument is designed in such a manner which adapts to only a particular set of Dentition. These instruments provide the best adaptation for the dentition they are designed for, hence these are usually the ones preferred for deep gingival or Root level scaling.
Area Specific Curettes blades are at an angle of 60 to 70 degrees to the lower shank and not at 90 degree angle to the lower shank which is the major difference from Universal Curettes. The most popular Area Specific Curettes are Gracey Curettes,
Note: Double-ended Gracey are usually paired to be used in the Opposite arches
- Gracey #1-2 and 3-4: Anterior teeth
- Gracey #5-6: Anterior teeth and Premolars
- Gracey #7-8 and 9-10: Posterior teeth: facial and lingual
- Gracey #11-13: Posterior teeth: mesial aspect of tooth
- Gracey: #13-14: Posterior teeth: Distal aspect of tooth
- Gracey: #15-16: Modifications of Standard #11-12 for mesial surfaces of posterior teeth
- Gracey: #17-18: Modifications of #13-14 which has a terminal shank elongated by 3mm and a more accentuated angulation
We even get single ended Gracey Curettes which are available in a set of 14 instruments and are designed to be used in specific areas only. This makes the more efficient and requires less forces to be applied to clean effectively. The shank of Gracey Curettes are designed in to types – Rigid and Finishing types.
Rigid type shank in Gracey Curettes are longer, stronger and not flexible. This helps in removal of moderate to heavy calculus deposits as it can transmit more amount of force to the tooth surface.
Finishing type of Gracey Curettes have more flexible shanks which give more tactile sensation to the operator ad transmits less force to the root surface. It helps in Root planning where tactile sensation is more useful in cleaning less visible surfaces.
Differences between Universal Curettes and Area Specific (Gracey) Curettes:
The blade of Area-specific curettes are curved from head to toe and also along the side of the cutting edge. The Universal curettes are curved in one direction only.
Only Pull stroke can be used to clean surfaces in Area-Specific due to the way the blade is designed.
Uses:
- Area-specific: Only on working edge can be used and you can use only the outer edge
- Universal: Two working edges are present and both cutting edges can be used (outer and inner edge)
Blade Angle:
- Area-Specific: Face of blade is beveled at an angle of 60-70 degrees to the shank, it is an Offset blade.
- Universal: Face of blade is beveled at 90 degree angle and the blade is not offset.
Curvature:
- Area-Specific: Blade curves up and to the side with the blade curved in two planes
- Universal: Blade is curved to the Up and not to the side, it is curved only in one plane
Area of Use:
- Area-Specific: Multiple instruments designed to be used in a specific region
- Universal: Single instrument can be used in any area and on all surfaces
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