Periodontal curette (Gracey Curette)

Posted by admin 01/08/2018 0 Comment(s) Dental Instruments,

Gracey Curettes – the right tools for the job

Many hygienists were introduced to the Gracey curette range while training, and although some find the full range extends way beyond their everyday needs, it does include real gems which help out in tricky situations. There are nine Gracey curettes in BTI range, including two which are less familiar in the World Wide. Generally speaking, the higher the curette tip number, the further back in the mouth it is used. Mini Gracey curettes are also available from BTI, most with shanks about 25% longer and tips 30% finer, but with similar tip geometry.

 

The Gracey 1/2 is designed for use on all aspects of anterior teeth (including canines). The instrument has a small contra-angle and a return angle resulting in an instrument toe which is close to the mid-line of the instrument handle for better stability. The shank is particularly long on Gracey 1/2s to permit access to lower anteriors with the patient in a supine position.

 

The Gracey 3/4 is also designed for use on all aspects of anteriors, but this time as far back as the second bicuspids.

 

Gracey 5/6s are best used interproximally on most teeth up to and including the second molars, and distally and lingually up to the second bicuspid. However, the instrument’s angulation means access to difficult areas and posteriors is limited.

 

A Gracey 7/8 is arguably the most versatile in the range and can be used on the buccal and lingual surfaces of bicuspids and molars. The instrument has a large contra-angle with only a medium return angle and a shorter shank than the previous described curettes. The tip terminates in a hooked toe standing off-line to the instrument to allow for any tendency to twist during use to be countered by the angle of insertion. The remainder of the Gracey range is designed to root plane the posterior teeth, with a bias towards the molars. These patterns are specifically adapted to the complex root anatomy found in this region.

 

TheGracey 9/10 is predominantly used on the buccal and lingual molar aspects, especially around the bifurcation, where access can be difficult. Its wide contra-angle, wide return angle and short shank make for a distinctive instrument. The toe is very nearly in line with the instrument handle, making this pattern especially suited to the least accessible root surfaces, while still allowing good control.

 

The 11/12 and the 13/14 Graceys act as a pair, permitting access to the mesial and buccal root surfaces respectively. These Graceys are suited for use on both bicuspids and molars. The small contra angle and return angle are complemented by a third angle to offset the blade, which forms a smooth bladed toe.

 

This third angle is exaggerated on the 13/14 to curl the toe round further. These curettes’ tips are notably long, permitting access to the posterior teeth while keeping the clinician’s hand comfortably out of the mouth.

 

Table 1. The Series of Gracey Curettes and Their Area of Application

Gracey Curette Tooth Surfaces and Area of Mouth
1 and 2 All tooth surfaces: anterior
3 and 4 All tooth surfaces: anterior
5 and 6 All tooth surfaces: anterior and premolar

Facial, lingual, mesial surfaces: molars

7 and 8 All tooth surfaces: anterior
9 and 10 All tooth surfaces: premolars

Facial and lingual surfaces: posterior

11 and 12 Mesial and distal surfaces: anterior

Facial, lingual and mesial surfaces: posterior

13 and 14 Mesial and distal surfaces: anterior

Distal surfaces: posterior

15 and 16 Facial, lingual and mesial surfaces: posterior
17 and 18 Distal surfaces: posterior

The last pair of Graceys, the 15/16 and 17/18, are likely to be new to many UK and Irish practitioners.BTI introduced these to the BTeck range to solve problems hygienists had reported with access into particularly awkward spaces. They allow improved access mesially (the 15/16) and distally (the 17/18) to areas which even the complex curvature of the 11/12 and 13/14 has proved unable to reach satisfactorily. The 15/16 has the same exaggerated terminal shank design as the 13/14, but the blade is finished like an 11/12. This exaggerated angle helps correct positioning on harder to reach mesial molar surfaces. The 17/18 also has the same extreme angle, but also a longer terminal shank and reduced blade length to improve access to the distal surfaces of posterior teeth. With such a comprehensive choice available, many clinicians will favour a small selection for everyday use with the remainder of the range on “stand-by” to deal with more unusual cases. It’s reassuring to know there are tools in the cabinet to comfortably manage every type of clinical situation. 

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