Periodontal curettage is a method that is applied in all stages of periodontitis. It is the removal of the gum lining which has grown in the area of the melted alveolar bone (cleaning of the periodontal pocket). It is done using a special tool called a curette. The whole operation is performed under anaesthesia and is completely painless. There are two types of curettage – open and closed curettage.
In closed curettage, the curette is inserted between the tooth root and the gum and, the tartar and the gum in the bottom of the periodontal pocket are removed blindly. This method is used only in shallow pockets because it is labour intensive and results in deep pockets are uncertain.
The open curettage is a more complex procedure, but it has more certain effect. It begins with opening of the mucosal flap (the gum is separated from the tooth root and bone) and the bottom of the periodontal pocket is exposed. The tartar and the granulation (gum) that remain at the bottom of the pocket are removed using a curette and the bone is exposed. The bone has sharp edges and groves, resulting from the melting during the inflammatory process. Using special burs, the edges are smoothened by filing the surface layer of the bone to produce a healthy and smooth base. In shallower pockets without loose teeth, the dental procedure ends here and the flap is sutured onto the cleansed bone. In deep pockets a bone void filler is necessary to restore the level of the bone. After suturing a temporary periodontal dressing can be placed that promotes healing and protects the surgical site. After the healing process is complete the roots of the teeth could become slightly exposed, but the gums are not inflamed and the development of periodontitis is halted.