Curettage in dentistry is of two types
1.Gingival curettage consists of removal of inflamed soft tissue lateral to the pocket wall.
2.Subgingival curettage refers to the procedure that is performed apical to the epithelial attachment, severing the connective tissue attachment to the osseous crest.
Inadverent curettage- it is the curettage which is done un intentionally during scaling and root planning procedure.
The objective of curettage is to remove chronically inflamed granulation tissue, dislodged calculus, bacterial colonies. Removal of these elements will fasten the healing process and promote healing and reduction in periodontal pocket depth.
How is curettage done
- Curettage cannot eliminate the complete cause of periodontal infection so it is always preceded by scaling and root planning.
- A mild local anesthesia will be needed before curettage.
- There is a small hand held instrument called as curette is selected for the procedure.
- There are different curette for right side and left side.
- Gracey curette is used for this purpose.
|Cross sectional view of gum pocket and curette in fucntion|
- Head of the curette is inserted into the pocket upto the base.
- The cutting edge of the instrument is toward the epithelium of the periodontal pocket.
- The pocket wall can be supported with finger pressure from the outside and a light stroke is given So that the inflamed epithelium can come out of the pocket.
- The process is repeated where ever indicated.
- Scooping motion of the curette will remove all the inflammed tissue, which is then followed by flushing of the pocket.
- At last gingiva is adapted to the tooth with gental fingre pressure.
- In some cases suturing of the gums in interdental region is required or a periopack is given.
- Analgesic and antibiotic may be prescribed where ever needed.
When is Curettage indicated in Dentistry
- As a whole it is used in periodontitis- inflammation and infection of gums.
- Can be used in conjugation with periodontal surgeries.
- Can be used in case of recurrent periodontal infection.