Post on 07-May-2015
description
CurettesClinical Application Guide
Curettes
• In this tutorial you will learn:– Types of curettes– Curette blade designs– Curette instrumentation– Clinical uses of curettes
Types of Curettes
• A curette is a type of scaler that is designed for moderate calculus removal on supragingival and subgingival surfaces.
• Types of Curettes:– Universal– Area Specific (Gracey)
• All curettes share the same common elements:– Rounded back– Rounded toe– Semi-circular cross section
Curettes
Universal Curettes
Universal Curettes
• Universal curettes are designed for easy adaptation on all tooth surfaces (thus the name “universal”).
Universal CurettesThe blade of a universal curette has a round toe and back, and two cutting edges for scaling, making it an efficient design for scaling the entire mouth.
Toe
Face
CuttingEdge
LateralSide
Back
90°
Universal Instrumentation• The blade is correctly adapted when the toe is directed
interproximally and the terminal shank is parallel to the tooth.
• To remove deposits, the cutting edge is applied to the tooth surface and the facial surface of the blade is tilted toward the tooth to achieve a 70-85° angle between the tooth and the blade.
• Apply lateral pressure against the tooth and pull upward while maintaining contact with the tooth.
Pull StrokeLateral Pressure
70-85°
Anterior Universal• To scale the facial surfaces, place the toe of the blade
toward the proximal surface with the handle parallel to the tooth.
• Apply strokes to remove deposits from the midline of the tooth to the proximal surface.
• Work from canine to canine.
• Switch working ends and repeat for surfaces away from you.
• Repeat all of the above for the lingual surfaces.
SBH5/67
Universal Curettes
Anterior Universal Instrumentation Sequence
Posterior Universal
• Begin at the distal line angle of the most posterior tooth.
• Direct the toe of the blade toward the distal with the terminal shank angled slightly toward the tooth.
• Apply strokes from the line angle to the contact area.
• Next, turn the toe toward the mesial to scale the buccal and mesial surfaces.
• Continue this sequence to complete the posterior region.
• Switch ends and repeat from the lingual aspect.
Posterior Universal
Posterior Universal Instrumentation Sequence
SC4R/4L6
Curettes
Area Specific (Gracey) Curettes
Gracey Curettes
• In the early 1940’s, Dr. Clayton Gracey and Hu-Friedy introduced a set of instruments designed to be used on specific tooth surfaces that improve adaptation and deposit removal.
• The Gracey “area specific” designs have laid the groundwork for the new instruments of today.
• Today, the Gracey Curette family of instruments give clinicians many options for their treatment needs.
Gracey Curettes
• The Gracey blade design is offset from the terminal shank at 70°.
• This creates one cutting edge which is referred to as the lower edge.
Back
Face
Toe
Cutting Edge
Lateral Side
°
Gracey Instrumentation
• The blade of a Gracey Curette is correctly adapted when the lower cutting edge is against the tooth and the terminal shank is parallel to the tooth surface being scaled.
• Apply lateral pressure against the tooth (root) and pull upward, maintaining the parallel shank.
Pull StrokeLateral Pressure
70°
Gracey Curettes
The shank design is different for each Gracey pattern.
Gracey Curettes
Gracey Curettes are available in:• Standard • Rigid • After Five • Mini Five
The following slides will explain each of these in more detail.
Standard Gracey Curettes
• Gracey Curettes are area specific to allow for deep scaling, root planing and periodontal debridement.
• The offset blade provides a perfect working angulation for the tooth surface.
• Gracey Curettes are used in a set to completely scale the dentition.
Shank Design and Diameter
Blade Length
Blade Width
Available Patterns & Areas of Use(Chart on next slide)
Standard (Finishing)
SG#/#
Standard Standard Standard 1/2, 3/4, 5/6, 7/8, 9/10, 11/12, 15/16, 13/14, 17/18*
Rigid
SGR#/#R
Standard design, increased shank diameter
Standard Standard 1/2, 3/4, 5/6, 7/8, 9/10, 11/12, 15/16, 13/14, 17/18*
After Five
SRPG#/#
Longer terminal shank, standard diameter
Standard Decreased by 10%
1/2, 3/4, 5/6, 7/8, 11/12, 15/16, 13/14
Rigid
After Five
SRPG#/#R
Longer terminal shank, increased diameter
Standard Decreased by 10%
1/2, 3/4, 5/6, 7/8, 11/12, 15/16, 13/14
Mini Five
SAS#/#
Longer terminal shank, standard diameter
Decreased by 50%
Decreased by 10%
1/2, 3/4, 5/6, 7/8, 11/12, 15/16, 13/14
Rigid
Mini Five
SAS#/#R
Longer terminal shank, increased diameter
Decreased by 50%
Decreased by 10%
1/2, 3/4, 5/6, 7/8, 11/12, 15/16, 13/14
Gracey Design Comparisons
* The 17/18 is a unique pattern, having a longer terminal shank and slightly shorter blade, so no AF or MF are available.
Gracey Chart
Standard Gracey Curettes
7/8 11/12
15/16 17/18
Rigid Gracey Curettes
• All Gracey designs are available with a wider taper – rigid shank.
• The rigid shank may be preferred for heavier calculus removal.
• Although the shank is wider, the blade width is the same as the standard Gracey.
Standard Rigid
After Five® Gracey Curettes
• Designed for instrumentation in deeper periodontal pockets.
• The terminal shank is elongated 3mm to provide better clearance around crowns, and superior access to root contours and pockets 5mm or more in depth.
• Blade thinned by 10% to ease gingival insertion and reduce tissue distention.
3mm
Gracey After Five Curettes
The change in the location of the shank bend permits deeper insertion into periodontal pockets. The thinned blade allows for easier insertion.
SRPG11/12
Mini Five® Curettes
• Designed with the same elongated terminal shank and thinned blades as the After Five Gracey Curettes.
• 50% shorter blade for access to smaller roots, narrow pockets, furcations, and developmental grooves.
StandardAfter FiveMini Five
3mm
Gracey Mini Five Curettes
Mini Five reaching into a deep pocket on a narrow root.
SAS1/2
Hu-Friedy Curettes
• Hu-Friedy offers an array of curettes.
• Many designs are available with different handle options and in Hu-Friedy’s EverEdge Technology.
• Please refer to the Hu-Friedy catalog at www.hu-friedy.com for more information on all the curettes available.
Qualifying Question
• Thank you for taking the time to learn more about the clinical applications of curettes.
• To earn your Hu-Points towards a product evaluation, please exit and answer the following question on the Member Resources Page:
The After Five Gracey Curette has a terminal shank ___ longer and a blade thinned____ than a Standard Gracey Curette.
a) 3mm, 10%b) 3mm, 15%c) 4mm, 10%d) 4mm, 15%e) 5mm, 15%