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The periodontal curette is a type of hand-activated instrument used in dentistry and dental hygiene for the purpose of scaling and root planing<ref name=":0">Darby ML, Walsh MM, editors. ''Dental Hygiene: Theory and Practice.'' 4<sup>th</sup> ed. St. Louis: Saunders/Elsevier; 2015. </ref>. The periodontal curette is considered a treatment instrument and is classified into two main categories: universal curettes and Gracey curettes.<ref name=":0" /> Periodontal curettes have one face, one or two cutting edges and a rounded back and rounded toe.<ref name=":0" /> They are typically the instrument of choice for subgingival calculus removal.<ref name=":0" />
Universal and Gracey curettes are typically used during nonsurgical periodontal therapy of a patient’s dental hygiene care.<ref name=":1">Gehrig JS, Willmann DE. ''Foundations of Periodontics for the Dental Hygienist.'' 4<sup>th</sup> ed. Philadelphia: Wolters Kluwer; 2016. </ref> The goal of nonsurgical periodontal therapy is to eliminate inflammation and return the patient’s periodontium back to health.<ref name=":2">Newman MG, Takei HH, Klokkevold PR, Carranza FA. ''Carranza’s Clinical Periodontology.'' 12th ed. St. Louis: Saunders/Elsevier; 2015. </ref> One of the ways this can be achieved is by minimizing the bacterial challenge to the patient.<ref name=":1" /> To control the bacterial levels in the mouth, oral health education is provided to the patient to control calculus and plaque buildup.<ref name=":1" /> An important component of removal and management of bacterial levels in the mouth is the use of hand instruments, such as Gracey curettes and universal curettes, that remove calculus deposits contaminating the tooth surface supragingivally and subgingivally.<ref name=":1" /> This is vital to nonsurgical periodontal therapy because scaling and root planing reduces bacterial biofilms in the mouth that are associated with inflammation.<ref name=":1" /> A research study suggests that periodontal root debridement is a key factor that influences the success of gaining periodontal attachment on previously infected root surfaces.<ref>Obeid PR, D'Hoore W, Bercy P. Comparative clinical responses related to the use of various periodontal instrumentation. ''J Clin Periodontol''. 2004;31(3):193-9.</ref>
== Universal Curette ==
[[Image:Columbia currettes.JPG|150px|thumb|right|'''Universal curettes''' have sharp cutting edges on both sides of their blades. Therefore, only two instruments are necessary -- anterior (pink ring) and posterior (purple ring).<ref name=":3" />]]
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=== Indication of use and function ===
Gracey curettes are area-specific periodontal curettes made from stainless steel used to remove supra and subgingival calculus.<ref name=":2" /><ref name=":3" /> Along with universal curettes, Gracey curettes are one of the main instruments used for scaling and root planing. Gracey curettes are especially ideal for subgingival calculus removal because the design of the instrument allows for better adaptation to the anatomy of the roots.<ref name=":2" />
[[Image:Currettes diagram.jpg|150px|thumb|left|While the blade of the universal curette is situated perpendicular to the edge of the terminal shank, the blade of the Gracey curette is only offset by 70 degrees, giving the blade a lower cutting edge and an upper non-cutting edge.]]
=== Design characteristics ===
These curettes are area-specific due to the design of the face of the instrument in relation to the terminal shank.<ref name=":0" /> Because the face is at a 70-degree angle from the terminal shank, one of the cutting edges is lower than the other, and this is the cutting edge that is used during periodontal debridement.<ref name=":3" /> Similar to the universal curette, the Gracey curette features a rounded back and toe with a semicircular cross section, which prevents damaging the gingival tissue.<ref name=":2" />
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=== Technique ===
Similarly to a universal curette, the Gracey curette is used with a modified-pen grasp and fulcrum finger for support, with the toe third of the instrument being adapted to the crown or root surface.<ref name=":3" /> When using a Gracey curette, the terminal shank should be parallel to the tooth surface that is being worked on. This is to ensure that the cutting edge is at the correct angulation.<ref name=":3" /> In order to select the correct working end of an anterior Gracey curette, the face of the instrument must tilt towards the tooth. It is important to select the right end, as tissue trauma may occur if the wrong end is selected.<ref name=":3" /> To select the correct working end of a posterior Gracey curette, the terminal shank must be parallel to the surface being instrumented, and the functional shank goes up and over the tooth rather than down and around the tooth.<ref name=":3" />
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