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Gingival Curettage: Understanding the Procedure and Benefits

Gingival curettage is a periodontal procedure removing inflamed soft tissue lining the periodontal pocket (sulcular epithelium, granulation tissue) to promote reattachment and reduce pocket depth. It is typically adjunctive to scaling and root planing (SRP).

Indications

  • Chronic periodontitis with persistent pockets ≥4–5 mm after SRP.
  • Gingival hyperplasia (drug-induced, hereditary).
  • Peri-implantitis (with caution).
  • Pre-prosthetic: reduce inflammation before impressions.

Procedure

  1. Local anesthesia (infiltration/block).
  2. SRP first: thorough calculus removal, root smoothing.
  3. Curettage: Gracey curette or ultrasonic tip inserted to base of pocket; gentle strokes remove inflamed epithelium/granulation tissue. Goal: bleeding, healthy connective tissue exposure.
  4. Irrigation (saline, chlorhexidine).
  5. Periodontal dressing (optional).
  6. Post-op: chlorhexidine 0.12% rinse × 2 weeks; soft diet; avoid brushing site 24–48h.

Benefits

  • Reduces pocket depth (1–2 mm average).
  • Decreases bleeding on probing (BOP), suppuration.
  • Promotes new attachment (long junctional epithelium or true regeneration).
  • Improves access for home care.
  • May reduce need for flap surgery in moderate cases.

Risks & Limitations

  • Transient sensitivity, gingival recession (minimal with technique).
  • Not a substitute for SRP; ineffective as monotherapy.
  • Does not regenerate lost periodontal ligament/cementum predictably.
  • Contraindicated: acute necrotizing ulcerative gingivitis (ANUG), uncontrolled diabetes, anticoagulation (relative).

Recovery

Mild soreness 2–3 days. Healing: epithelial closure 3–7 days; connective tissue maturation 4–6 weeks. Re-evaluate at 4–6 weeks.

Modern Context

With lasers (diode, Nd:YAG, Er:YAG), “laser curettage” offers hemostasis, bactericidal effect, less discomfort. Evidence similar to mechanical. Decision based on clinician expertise and case selection.

Gingival curettage is a valuable, minimally invasive tool in the periodontal armamentarium when used selectively after thorough SRP.

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