module 19- area specific curets

Module 19—Area-Specific Curets

Section 1Area-Specific Curets

Area-Specific Curets

Design Characteristics

Area-Specific Curet

-A periodontal instrument used to remove light calculus deposits from the crowns and roots of teeth

Design Characteristics

-Have long, complex functional shanks-Especially suited for instrumentation of root surfaces

Design Characteristics (cont.)

Like universal curets these instruments have a:-Rounded back-Rounded toe-Semicircular cross section

Unique Design Characteristics

-Cutting edges are curved-Different from a universal curet that has parallel cutting edges

ComparisonUniversal Area specific

Relationship of Face to Lower Shank

Makes an area-specific curet VERY special!

-Face is tilted in relation to the lower shank-Causes one cutting edge to be lower than the other on each working-end

Tilted Face

The tilted face of an area-specific curet is very different than the design characteristics of sickle scalers and universal curets.

Lower Cutting Edge

Only the lower cutting edge is used for calculus removal.

Working Cutting Edge

Because the lower cutting edge is used, it is called the working cutting edge.

Nonworking Cutting Edge

The other cutting edge—that is not used—is called the nonworking cutting edge.

Angulation

Nonworking Cutting Edge

The nonworking cutting edge is angled away from the soft tissue wall of the pocket.-Great design feature, helps to protect the tissue

Angulation

The lower cutting edge is automatically at a 70-degree angle to the tooth surface when the lower shank is parallel.

Identifying the Lower Cutting Edge

In order to sharpen an area-specific curet, you need to be able to identify the lower cutting edge on each working-end.

Procedure for Identification

1. Hold the instrument so that you are looking directly at the toe.

Procedure for Identification (cont.)

2. Raise or lower the instrument handle until the lower shank is perpendicular to the floor.

3. Look closely at the working-end. One cutting edge is lower, closer to the floor.

4. The lower cutting edge is used for instrumentation.

5. Only the lower cutting edge needs to be sharpened.

Area-specific curets have several special unique design features:-Long complex lower shanks-Face that is tilted in relationship to the lower shank-Only one working cutting edge per working-end

Section 3Use of Area-Specific Curets on Anterior

Anterior Teeth

Use of an Area-Specific Curet

Topics

-Choosing the correct working-end-Step-by-step use of an area-specific curet on the anterior teeth

Choosing the Correct Working-End

Anterior Teeth

Visual Clue: Correct

-Instrument face tilts toward the tooth surface-Face is partially hidden from view

Visual Clue: Incorrect

-Instrument face tilts slightly away from the tooth surface-Entire face is clearly visible

Memory Aid: Anterior Teeth

Think: “face tilts slightly toward the anterior tooth”

Application of Cutting Edges

Area-Specific Curet on Anterior Teeth

Working-End Application

Two lower cutting edges used

Step-by-Step Technique

Area-Specific Curet on Anterior Teeth

Always One Step at a Time

Remember: “Me, My patient, My light, My mirror, My grasp, My finger rest, My adaptation.”

Application to Anterior Surfaces

Step 1

-Select the correct working-end-Place the working-end in the Get Ready Zone-Toe aims toward the distal surface

Step 2

-Insert with face hugging the tooth surface-Adapt the toe-third-Lock toe-third against root surface

Step 3

-Adapt toe-third to the midline-Work across the facial surface toward the distofacial line angle

Step 4

Roll the instrument handle as you approach the distofacial line angle to maintain adaptation.

Step 5

-Work at least halfway across the distal surface-Other half instrumented from lingual aspect

Sequence for Sextant

RecapThe correct working-end is selected for an anterior tooth if the instrument face tilts toward the tooth surface and is partially hidden.Only one cutting edge per working-end of an area-specific curet is used for instrumentation.

Section 4Use of Area-Specific Curets on Posterior

Posterior Sextants

Use of Area-Specific Curet

Topics

-Choosing the correct working-end-Application of cutting edges-Step-by-step use of an area-specific curet on posterior sextants

Visual Clue: Correct

-Lower shank is parallel to the proximal surface-Functional shank goes “up and over” the tooth

Visual Clue: Incorrect

-Lower shank is not parallel-Functional shank is “down and around” the tooth

Memory Aids

Think: Posterior = ParallelFunctional shank up and over

Application of Traditional Pairings

Gracey 11/12Gracey 13/14

Traditional Pairing

At least two double-ended Gracey curets are needed to complete the FACIAL aspect of a posterior sextant.Clinicians might select different combinations of Gracey curets to instrument posterior teeth.

Possible Gracey Combinations

Application of Cutting Edges

Application of Gracey Cutting Edges

Cutting Edges Applied to Mandibular Posterior Surfaces

Facial Aspect: Traditional Pairing

Lingual Aspect: Traditional Pairing

Modified Pairing

Gracey 11/14Gracey 12/13

Application of Modified Pairing

Only one double-ended Gracey curet is needed to complete the FACIAL aspect of a sextant.

Facial Aspect: Modified Pairing

Lingual Aspect: Modified Pairing

Advantages of Modified Pairing

The entire aspect of a sextant can be completed without changing instruments.

Area-Specific CuretsPosterior Sextants

Always One Step at a Time

Remember: “Me, My patient, My light, My mirror, My grasp, My finger rest, My adaptation.”

Distal Surfaces

Gracey 13 and Gracey 14Gracey 17 and Gracey 18

Sequence for Tooth

Complete the distal surface first with an area-specific curet.

Step 1

Place the working-end in the Get Ready Zone near the distofacial line angle.-Toe aiming toward back of mouth

Step 2

Lower the instrument handle.Hug the face against the tooth surface.Insert beneath the gingival margin.

Technique Check

If the lower shank is parallel to the tooth surface, then the face-to-tooth surface angulation will be at 70 degrees.

Sequence for Sextant

It is easier to begin with the posterior-most tooth and move forward because of the pressure exerted by the patient’s cheek against your hand.

Facial and Mesial Surfaces

Gracey 11 and Gracey 12Gracey 15 and 16

Sequence for a Tooth

Begin at the distofacial line angle and work forward to the mesial.

Step 3

-Place mesial curet in the Get Ready Zone-Toe aiming toward mesial surface

Step 4

-Lower instrument handle

-Insert to base of pocket

Step 5

Make a series of short, precise strokes across facial surface

Step 6

Roll the handle as you approach the mesiofacial line angle to maintain adaptation.

Step 7

Work at least halfway across the mesial surface from the facial aspect.Other half of mesial instrumented from lingual aspect

Sequence

Maxillary Posterior Sextants

Maxillary Posteriors

Follow the same sequence as used for mandibular posterior sextants.Select the correct working-end of an area-specific curet.

Step 1

-Turn toe toward the distal surface-Establish a 0-degree angulation-Insert below gingival margin

Step 2

Instrument from the distofacial line angle to the midline of the distal surface.

Step 3

-Select a mesial curet and begin instrumentation of facial surface starting at distofacial line angle-Work across facial surface

Step 4

As you approach the mesiofacial line angle, roll the handle to maintain adaptation.

Step 5

-Work across mesial surface-Instrument at least halfway across mesial surface from facial aspect

Select the correct working-end for posterior sextants using visual clues: -Lower shank parallel to distal surface -Functional shank goes up and over

module 19- area specific curets

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