Download - Module 19- Area Specific Curets
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Module 19—Area-Specific Curets
Section 1Area-Specific Curets
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Area-Specific Curets
Design Characteristics
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Area-Specific Curet
-A periodontal instrument used to remove light calculus deposits from the crowns and roots of teeth
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Design Characteristics
-Have long, complex functional shanks-Especially suited for instrumentation of root surfaces
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Design Characteristics (cont.)
Like universal curets these instruments have a:-Rounded back-Rounded toe-Semicircular cross section
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Unique Design Characteristics
-Cutting edges are curved-Different from a universal curet that has parallel cutting edges
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ComparisonUniversal Area specific
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Relationship of Face to Lower Shank
Makes an area-specific curet VERY special!
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-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
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The tilted face of an area-specific curet is very different than the design characteristics of sickle scalers and universal curets.
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Lower Cutting Edge
Only the lower cutting edge is used for calculus removal.
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Working Cutting Edge
Because the lower cutting edge is used, it is called the working cutting edge.
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Nonworking Cutting Edge
The other cutting edge—that is not used—is called the nonworking cutting edge.
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Angulation
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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
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Angulation
The lower cutting edge is automatically at a 70-degree angle to the tooth surface when the lower shank is parallel.
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Identifying the Lower Cutting Edge
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In order to sharpen an area-specific curet, you need to be able to identify the lower cutting edge on each working-end.
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Procedure for Identification
1. Hold the instrument so that you are looking directly at the toe.
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Procedure for Identification (cont.)
2. Raise or lower the instrument handle until the lower shank is perpendicular to the floor.
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Procedure for Identification (cont.)
3. Look closely at the working-end. One cutting edge is lower, closer to the floor.
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Procedure for Identification (cont.)
4. The lower cutting edge is used for instrumentation.
5. Only the lower cutting edge needs to be sharpened.
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Recap
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
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Module 19—Area-Specific Curets
Section 3Use of Area-Specific Curets on Anterior
Teeth
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Anterior Teeth
Use of an Area-Specific Curet
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Topics
-Choosing the correct working-end-Step-by-step use of an area-specific curet on the anterior teeth
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Choosing the Correct Working-End
Anterior Teeth
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Visual Clue: Correct
-Instrument face tilts toward the tooth surface-Face is partially hidden from view
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Visual Clue: Incorrect
-Instrument face tilts slightly away from the tooth surface-Entire face is clearly visible
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Memory Aid: Anterior Teeth
Think: “face tilts slightly toward the anterior tooth”
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Application of Cutting Edges
Area-Specific Curet on Anterior Teeth
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Working-End Application
Two lower cutting edges used
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Step-by-Step Technique
Area-Specific Curet on Anterior Teeth
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Always One Step at a Time
Remember: “Me, My patient, My light, My mirror, My grasp, My finger rest, My adaptation.”
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Application to Anterior Surfaces
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Step 1
-Select the correct working-end-Place the working-end in the Get Ready Zone-Toe aims toward the distal surface
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Step 2
-Insert with face hugging the tooth surface-Adapt the toe-third-Lock toe-third against root surface
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Step 3
-Adapt toe-third to the midline-Work across the facial surface toward the distofacial line angle
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Step 4
Roll the instrument handle as you approach the distofacial line angle to maintain adaptation.
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Step 5
-Work at least halfway across the distal surface-Other half instrumented from lingual aspect
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Sequence for Sextant
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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.
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Module 19—Area-Specific Curets
Section 4Use of Area-Specific Curets on Posterior
Teeth
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Posterior Sextants
Use of Area-Specific Curet
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Topics
-Choosing the correct working-end-Application of cutting edges-Step-by-step use of an area-specific curet on posterior sextants
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Visual Clue: Correct
-Lower shank is parallel to the proximal surface-Functional shank goes “up and over” the tooth
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Visual Clue: Incorrect
-Lower shank is not parallel-Functional shank is “down and around” the tooth
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Memory Aids
Think: Posterior = ParallelFunctional shank up and over
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Application of Traditional Pairings
Gracey 11/12Gracey 13/14
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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.
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Possible Gracey Combinations
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Application of Cutting Edges
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Application of Gracey Cutting Edges
Cutting Edges Applied to Mandibular Posterior Surfaces
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Facial Aspect: Traditional Pairing
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Lingual Aspect: Traditional Pairing
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Modified Pairing
Gracey 11/14Gracey 12/13
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Application of Modified Pairing
Only one double-ended Gracey curet is needed to complete the FACIAL aspect of a sextant.
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Facial Aspect: Modified Pairing
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Lingual Aspect: Modified Pairing
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Advantages of Modified Pairing
The entire aspect of a sextant can be completed without changing instruments.
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Step-by-Step Technique
Area-Specific CuretsPosterior Sextants
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Always One Step at a Time
Remember: “Me, My patient, My light, My mirror, My grasp, My finger rest, My adaptation.”
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Distal Surfaces
Gracey 13 and Gracey 14Gracey 17 and Gracey 18
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Sequence for Tooth
Complete the distal surface first with an area-specific curet.
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Step 1
Place the working-end in the Get Ready Zone near the distofacial line angle.-Toe aiming toward back of mouth
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Step 2
Lower the instrument handle.Hug the face against the tooth surface.Insert beneath the gingival margin.
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Technique Check
If the lower shank is parallel to the tooth surface, then the face-to-tooth surface angulation will be at 70 degrees.
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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.
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Facial and Mesial Surfaces
Gracey 11 and Gracey 12Gracey 15 and 16
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Sequence for a Tooth
Begin at the distofacial line angle and work forward to the mesial.
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Step 3
-Place mesial curet in the Get Ready Zone-Toe aiming toward mesial surface
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Step 4
-Lower instrument handle
-Insert to base of pocket
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Step 5
Make a series of short, precise strokes across facial surface
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Step 6
Roll the handle as you approach the mesiofacial line angle to maintain adaptation.
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Step 7
Work at least halfway across the mesial surface from the facial aspect.Other half of mesial instrumented from lingual aspect
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Sequence
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Step-by-Step Technique
Maxillary Posterior Sextants
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Maxillary Posteriors
Follow the same sequence as used for mandibular posterior sextants.Select the correct working-end of an area-specific curet.
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Step 1
-Turn toe toward the distal surface-Establish a 0-degree angulation-Insert below gingival margin
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Step 2
Instrument from the distofacial line angle to the midline of the distal surface.
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Step 3
-Select a mesial curet and begin instrumentation of facial surface starting at distofacial line angle-Work across facial surface
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Step 4
As you approach the mesiofacial line angle, roll the handle to maintain adaptation.
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Step 5
-Work across mesial surface-Instrument at least halfway across mesial surface from facial aspect
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Recap
Select the correct working-end for posterior sextants using visual clues: -Lower shank parallel to distal surface -Functional shank goes up and over