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before doing curettage, S/RP shd be done thoroughly
insert the inst so as to engage the inner lining of the pocket wall & is carried along the soft tissue usually in a horizontal stroke . The pocket wall may be supported by gentle finger pressure on external surface.
subgingival curettage– ts attached b/w the bottom of the pocket & alv crest are removed with a scooping motion of the instrument to the tooth surface
Ultrasonic curettage- using ultrasonic devices ultrasonic vibrations disrupt ts continuity & lift off the epithelium results in a narrow band of necrotic ts ed infl n & less removal of C.T These inst’s are not as effective as hand inst’s in removing c.t. & leaving a smooth pocket wall Chemical curettage- using caustic drugs sodium sulfide alk sodium hypochlorite phenol These were discarded after studies showed their ineffectiveness The extent of ts destruction cannot be controlled They may rather than reduce the amount of ts to be removed by enzymes & phagocytes
HEALING: immediately after curettage, a bld clot fills the pocket area ( this is organized into granul n ts) haemorrhage in ts (dilated cap’s) & PMNL’s on wound surface rapid proliferation of granul n ts ts maturation ( smal bld vs) epithelization of sulcus takes 2-7 days CLINICAL APPEARANCE: immediately after curettage, gingiva appears hemorrhagic & bright red after 1 wk, gingiva is slightly redder than normal apical shift in position of marginal gingiva after 2wk, normal color, contour, consistency, s.t. gingival margin well adapted