Published on March 20, 2014
Gingival Curettage Wilkins, chapter
Learning Objectives • Distinguish between gingival and subgingival curettage • Identify the indications & contraindications for gingival curettage • Describe the procedure • Describe the healing that takes place following curettage
Introduction • Refers to the scraping of the pocket wall • Separates diseased soft tissue • Inadvertent curettage occurs with periodontal debridement
Definitions • Gingival Curettage: – Removal of inflamed soft tissue • Removes diseased sulcular & junctional epithelium – Indications: pseudopockets, shallow true pockets – Objective: gingival shrinkage
Definitions • Subgingival Curettage: – Performed apical to epithelial attachment • Removes connective tissue attachment down to alveolar crest – Indications: deep pockets – Objectives: reattachment
Rationale • Removes granulation tissue – Within granulation tissue we find: • Areas of chronic inflammation • Bacteria, calculus – Epithelial tissue lines granulation tissue • May pose barrier to new fiber attachment
Rationale • However, – Granulation tissue slowly resorbs following debridement – Bacteria eliminated – Tissue heals • Questionable: – Whether curettage significantly improves health of tissue beyond what is seen with periodontal debridement
Indications • Generally limited: – Moderately deep infrabony pockets where new attachment attempted • Closed surgery advised • Technically difficult procedure • Inadequate accessibility – When surgical techniques not advised • Due to age, systemic problems • Goal of pocket elimination compromised
Indications • Maintenance therapy – In areas of chronic inflammation, especially if client has had pocket reduction surgery
Basic Technique • Periodontal debridement performed prior to curettage • Tissues anaesthesized • Appropriate selection of instruments – Curettes, universal curette • Curette blade placed against tissue – Horizontal stroke
Basic Technique • Irrigate tissues to flush out debris • Gentle finger pressure applied to adapt tissues • Separated interdental papillae may require sutures • Surgical dressing may be indicated
Other Techniques • Excisional New Attachment Procedure • Ultrasonic Curettage • Chemical Curettage • Laser Fiber Curettage • Students can do their own research on the above techniques
Healing Following Debridement & Curettage • Uneventful healing • Formation of long junctional epithelium • No significant differences when compared to debridement therapy alone
Curettage using Laser Fiber Fiber tip slowly inserted into pocket & kept parallel to tooth Usually painless Moved apically until pocket base reached Vaporizing of pocket epithelium, subgingival plaque & some granulation tissue occurs
Curettage using Laser Fiber Fiber, held in contact with root surface, is slowly moved coronally & withdrawn This vaporizes microbial debris on root surface Any remaining deposits can be removed with a curette
Results of Curettage - Laser Fiber Before treatment – pockets measure 7-8 mm
Results of Curettage - Laser Fiber Just after treatment 3 months after treatment – 3 mm pockets
Abstract. Abstract The purpose of the present study was to evaluate biometrically the periodontal response to gingival curettage. 15 subjects having ...
Curettage, in medical procedures, is the use of a curette (French, meaning scoop) to remove tissue by scraping or scooping. Curettages are also a declining ...
Gingival Curettage Wilkins, chapter Learning Objectives Distinguish between gingival and subgingival curettage Identify the indications & contraindications ...
Sub gingival curettage: ... After 1 week: gingival appears reduced in height owing to apical shift in the position of gingival margin.
Summary In the journal article, Gingival Curettage: Study Comparing a Laser Treatment to Hand Instruments, a study was conducted to compare differences in ...
1.1mm Gingival Curettage K12 $3.45 Grit: Thank you for visiting A&M Instruments, Inc. Diamond Dental Burs. You will be pleased with the high quality ...
Shows several methods of Subgingival Curettage on patients with Periodontal Pockets. This is part of the Open.Michigan collection at: http ...
Effects of gingival curettage when performed 1 month after root instrumentation. A biometric evaluation. Echeverria JJ, Caffesse RG.