Periodontal Periodontal Scaling Scaling

InstrumentsInstruments

Gracey CurettesGracey Curettes

Periodontal scaling is the Periodontal scaling is the therapeutic procedure performed therapeutic procedure performed by a dentist or dental hygienist by a dentist or dental hygienist to remove all mineralized, to remove all mineralized, hardened deposits from the hardened deposits from the tooth's surfaces. It is performed tooth's surfaces. It is performed supra and subgingivally and can supra and subgingivally and can be done using a non surgical be done using a non surgical (closed) or a surgical (open) (closed) or a surgical (open) approach. approach.

Based on instrument design, Based on instrument design, how they are used, where how they are used, where they are used and how they they are used and how they work, the following work, the following classification of periodontal classification of periodontal scaling instruments is used. scaling instruments is used.

Periodontal Scaling Periodontal Scaling InstrumentsInstruments

Sickle scalers Sickle scalers Universal Curettes Universal Curettes Area Specific Curettes Area Specific Curettes Files Files Ultrasonic/Sonic Instruments Ultrasonic/Sonic Instruments

Comparison of a universal curette to an area-specific curette. 1, The angle formed by the terminal shank and the face of a universal curette is 90 degrees. 2, The angle formed by the terminal shank and the face of an area-specific curette is 60c to 700

A, Terminal shank. B, Toe. C, Heel. D, Tip. E, Cutting edge

Periodontal Scaling Periodontal Scaling InstrumentsInstruments

In the category of In the category of area specific area specific curettes a sub classification exists. curettes a sub classification exists.

Area Specific CurettesArea Specific Curettes Gracey Curettes Gracey Curettes Vision Curettes Vision Curettes Modifications to Gracey Design Modifications to Gracey Design Furcation series Furcation series

After five After five (extended (extended series)series)

Mini series Mini series Langer seriesLanger series Rigid seriesRigid series

Gracey Curettes Gracey Curettes

The original Gracey series The original Gracey series was developed in the was developed in the 1930's by Dr. Clayton 1930's by Dr. Clayton Gracey, a periodontist at Gracey, a periodontist at the University of Michigan. the University of Michigan.

They were designed to They were designed to provide better access to provide better access to root surfaces in deep root surfaces in deep pockets. pockets.

They feature long shanks They feature long shanks and unique blades, some and unique blades, some with bends improving with bends improving access to complex root access to complex root surface morphology. surface morphology.

Gracey CurettesGracey Curettes

The original series contained 7 double ended instruments The original series contained 7 double ended instruments

1/2; 3/4; 5/6; 7/8; 9/10; 11/12; 13/141/2; 3/4; 5/6; 7/8; 9/10; 11/12; 13/14

G F E D C B AG F E D C B A In the 1980's, 2 modified instruments were added to the In the 1980's, 2 modified instruments were added to the

collection collection 15/16; 17/18 15/16; 17/18

Gracey CurettesGracey Curettes

Gracey curettes 1/2, 3/4, and 5/6 are used Gracey curettes 1/2, 3/4, and 5/6 are used to scale all tooth surfaces in the anterior to scale all tooth surfaces in the anterior sextants.sextants.

7/8 and 9/10 are used for scaling the 7/8 and 9/10 are used for scaling the buccal and lingual aspects of teeth in the buccal and lingual aspects of teeth in the posterior sextants. posterior sextants.

11/12 and the 15/16 are used to scale the 11/12 and the 15/16 are used to scale the mesial aspects of the teeth in the mesial aspects of the teeth in the posterior sextant. posterior sextant.

13/14 and 17/18 are used to scale the 13/14 and 17/18 are used to scale the distal aspects distal aspects

Design CharacteristicsDesign Characteristics

Standard or Finishing (non-rigids)Standard or Finishing (non-rigids) Rigid Rigid Extra RigidExtra Rigid Extended ShanksExtended Shanks Different Blade sizesDifferent Blade sizes

RegularRegular MiniMini

Design CharacteristicsDesign Characteristics Area specificArea specific

Adapt to a specific area or tooth surfaceAdapt to a specific area or tooth surface Two curved edges with a bladeTwo curved edges with a blade

Only one cutting edge is used for calculus Only one cutting edge is used for calculus removalremoval

Lateral surface

Face

Back

Cutting edge

Lateral surface

Cutting edge

Design CharacteristicsDesign Characteristics Working end is tilted in relationship to the terminal shank (offset Working end is tilted in relationship to the terminal shank (offset

by 70°)by 70°) Makes one cutting edge lower than the otherMakes one cutting edge lower than the other This lower end is the one that is used for instrumentationThis lower end is the one that is used for instrumentation

Gracey CurettesGracey Curettes

Gracey curettes are available in Gracey curettes are available in stainless steel or in carbon steel. stainless steel or in carbon steel. Carbon steel requires more care as it Carbon steel requires more care as it rusts very easily and also wears away rusts very easily and also wears away more quickly. more quickly.

Instruments can come in the form of a Instruments can come in the form of a solid one piece instrument (usually solid one piece instrument (usually stainless steel) or as a cone socket stainless steel) or as a cone socket instrument (usually carbon steel). With instrument (usually carbon steel). With the cone socket instrument, shank and the cone socket instrument, shank and blade can be unscrewed and replaced. blade can be unscrewed and replaced.

Gracey Gracey CurettesCurettes

Gracey CurettesGracey Curettes

The design of the The design of the Gracey curettes is Gracey curettes is unique in that each unique in that each end had only one end had only one cutting edge cutting edge

It can adapt closely It can adapt closely to the specific tooth to the specific tooth surface for which it surface for which it is intended. is intended.

Gracey CurettesGracey Curettes The cutting or useable edge The cutting or useable edge

of the blade is the lower of the blade is the lower outer aspect of the blade. outer aspect of the blade.

It can be identified by It can be identified by holding the terminal shank holding the terminal shank of the end in question, blade of the end in question, blade side lower, in a vertical side lower, in a vertical position and viewing the position and viewing the blade portion head on. blade portion head on.

The blade of the curette is The blade of the curette is machined at a 70 degree machined at a 70 degree angle and the cutting edge angle and the cutting edge exhibits a curve, which is exhibits a curve, which is longer or convex in relation longer or convex in relation to the "non-working" edge. to the "non-working" edge.

Design characteristics of Design characteristics of the curettethe curette

A, Semicircular cross section of the curette B, Tip, last third of the working endC, Toe, which is roundedD, FaceE, Cutting edgeF, BackG, Lateral surface

Gracey CurettesGracey Curettes

When adapting the Gracey When adapting the Gracey instruments to the teeth to perform instruments to the teeth to perform scaling, the cutting edge must first scaling, the cutting edge must first be identified and placed against the be identified and placed against the surface to be scaled and the terminal surface to be scaled and the terminal shank should be parallel to that shank should be parallel to that surface. surface.

In this position, the ideal working In this position, the ideal working angulation for calculus removal is angulation for calculus removal is achieved. achieved.

Place shank perpendicular to floorPlace shank perpendicular to floor Lower blade is the cutting edgeLower blade is the cutting edge Lower shank will be parallel to surface being Lower shank will be parallel to surface being

scaledscaled

Identification of the Identification of the Cutting EdgeCutting Edge

Adapting the Curet BladeAdapting the Curet Blade

insertion0° <45°

Healthy tissuePlaque removal

45-90°Ideal CalculusRemoval

> 90°Tissue Trauma

Gracey CurettesGracey Curettes

Gracey Gracey CurettCurett

eses

Gracey curettes Universal curettes

Area of use Many curettes for each sextant and dental surface

A single curette for all dental surfaces and sextants

Working-end One cutting edge Two cutting edges

Bending Working-end has two bendings towards upper and lateral

Working-end has one bending orientated upperly

Cutting edge angulation

Working-end makes a 600 angle with the terminal shank

Working-end makes a 900 angle with the terminal shank

Rigid seriesRigid series- a number of four double-ended instruments 1 /2 , 3 / 4, 5 / 6, 7 /8 - the shank is shorter and more rigid- used for removing supragingival calculus (maintanance)- Are also called prophylactic Gracey’s curettes- also called - also called Mini FiveMini Five / / Mini Mini BladedBladed- are derived from the Gracey’s curettes- the working-end is half than a standard Gracey’s curette (50% less)

- this allows an easier insertion and adaptation in deep narrow pockets, furcations, developmental grooves- are seven modified Gracey curettes1/2, 3/4, 5/6, 7/8, 11/12 , 13/14 , 15/16 - the shank is elongated with 3mm- the workig-end is mini-bladed- Removing calculus from: crowded teeth, pockets deeper than 5 mm, furcation areas

Mini seriesMini series

After five After five (extended (extended design)design)

Modifications of an instrument

Each of the three instruments is a Gracey 1/2

A, The working end is shortened by half the regular length, whereas the working end - Mini Five

C, The working end has been lengthened for supragingival calculus removal – Rigid Gracey

B, Conventional design. Gracey Standard