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The Gracey Curette is a periodontal tool specially designed to
be utilized primarily for scaling and root planing. It comes with a region-specific design to remove plaque and calculus in the
subgingival region and result in minimal trauma to the soft tissue. The Gracey
Curette was developed by Dr. Clayton Gracey and Hu-Friedy in the 1940s and
revolutionized the therapy of non-surgical periodontal treatment because it was possible to utilize it more accurately than universal
curettes.
In this comprehensive article, we will review the history, design, applications, technique of manipulation, variations, benefits, drawbacks, maintenance, and development of the Gracey Curette.
Before the Gracey Curette was invented, dental operators
used universal curettes and scalers. They were mirror images in shape and lacked
precision in the process of deep cleaning.
Periodontist Dr. Clayton Gracey realized the necessity for
area-specific curettes that would provide better adaptation to different tooth
surfaces. He worked in association with Hu-Friedy, a world-famous dental
instrument company, and created the Gracey Curette set, a series of curettes
for working on different tooth surfaces.
Important Milestones in Gracey Curettes Development
• 1940s – Dr. Gracey creates the first area-specific
curette.
• 1950s – Gracey Curettes become more and more popular in
periodontics.
• 1980s – Extended shank Gracey Curettes to be used in deep
pockets.
• 1990s – Blade thickness was made heavier to prolong the lifespan.
• 2000s-To date – Ergonomic handles and mini-bladed designs
for ease of use.
Gracey Curette remains a tried and tested standard in modern periodontology, with ongoing innovation prolonging its use as well as the ease with which it's used, mini-bladed designs for ease of use. Gracey Curette remains a tried and tested standard in modern periodontology, with ongoing innovation prolonging its use as well as the ease with which it's used.
The Gracey Curette was designed specifically to function
well and reduce risk with successful minimally invasive scaling.
•70 degrees offset from the terminal shank.
•Offset angulation for optimal adaptation to the root
surface.
•Inferior cutting edge and area-specific debridement is
anticipated.
Compared to the two working cutting edges of universal
curettes, Gracey Curette has a single functional cutting edge and hence, is
more selective in scaling.
• The spiral and longer lower shank provide enhanced access to
lower periodontal pockets.
•Mini-bladed and long varieties for diverse periodontal
cases.
•Light and tactile handles for enhanced grip are now also on Gracey Curettes.
•Ergonomically designed handles spare the hands from fatigue, so that enhanced precision and comfort can be offered by the operators.
Gracey Curettes are classified on the basis of length, size
of blade, and angle.
• Used in routine periodontal debridement.
• In the situation where the depth of the pocket is
moderate.
• Gives a longer terminal shank for deep furcations with
periodontal pockets (≥5mm).
• Provides more control in furcations and even in root
concavities.
• 50% shorter blade with enhanced access for narrow, tight
spaces.
• Useful in furcations, developmental grooves, and deep
pockets.
• 20% thinner than the mini-bladed ones.
• Designed to do very fine scaling in very narrow
interproximal areas.
• Thicker and stiffer shank for the removal of excess calculus deposits.
• Especially to use in cases where the regular curette is deflected due to excessive pressure.
• Instrument of choice for scaling and root planing (SRP).
• Kills subgingival plaque, calculus, and bacterial
endotoxins.
• Utilized in the treatment of chronic periodontitis.
• Plastic or titanium-tipped Modified Gracey Curettes are
utilized in implant surface debridement.
• Utilized in fixed orthodontic brackets and retainers for debridement against plaque deposits.
• Used in open flap debridement and periodontal plastic
surgery.
• Used in cases with friable oral tissues where heavy instrumentation is contraindicated.
Effective and safe scaling is enhanced by effective holding
of a Gracey Curette.
• Utilize a pen modified hold to have maximum control.
• Utilize a light hold to avoid fatigue.
• Utilize short controlled strokes with lateral pressure.
• Utilize light strokes for root planing and firm strokes
for debridement of calculus.
• Keep the lower cutting edge on the tooth at all times.
• Position the 70-degree blade to the root surface angle.
Selective Scaling – Isolated shape per area allows selective
debridement.
Less Tissue Damage – Offset blade reduces unnecessary soft
tissue damage.
Access to Deep Pockets – Long shapes allow efficient
subgingival debridement.
Flexibility – Suitable for many periodontal pathologies.
Longevity – Better quality stainless steel gives longer sharpness.
Use of Multiple Instruments – Different curettes are used
for different surfaces.
Learning Curve – Must be properly trained before learning
and angling appropriately.
Not for Heavy Calculus – Softer types must be employed for tenacious deposits.
Proper cleaning is the secret to performance and durability.
• Ultrasonic cleaning for the removal of debris.
• Autoclave instruments in a 121°C cycle for 15 minutes.
• Straight angulation on a fixed stone.
• Sharpen at 70 degrees.
Titanium-Coated Curettes – Improved toughness and precision.
Laser-Assisted Curettes – Designed to provide biostimulation
of periodontal tissues.
3D-Printed Curettes – Patient-individualized periodontal therapy.
Gracey Curette remains the ultimate benchmark for periodontal
therapy, allowing for precise, efficient, and minimally invasive debridement. In
spite of the ultrasonic scalers' discovery, Gracey Curettes are an inevitable
tool in modern dentistry.
For those practitioners who want to be competent in periodontal instrumentation, it will be well worth their time to learn about technique, practice skill, and care of instruments, which will significantly enhance treatment results.
Written by: Beauty Teck
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