DENTAL ELEVATORS

DENTAL ELEVATORS
I.

Luxate teeth from the surrounding bone

Makes extractions easier
II. Expands alveolar bone:
Buccocervical plate of bone- tooth with limited
& obstructed path of removal
III. Remove broken/ surgically sectioned roots
IV. Remove interradicular bone
V. Split teeth once a bur groove has been placed
DENTAL ELEVATORS
PARTS
 DENTAL ELEVATORS

HANDLE: 2 DESIGNS
• HEAVY PEAR-SHAPED
• CROSSBAR: RIGHT ANGLES TO THE SHANK
GENERAL RULES:
 ADJACENT TOOTH- NOT THE FULCRUM; UNLESS TO BE
EXTRACTED
 CREST OF THE ALVEOLAR BONE: FULCRUM
 CONTROLLED FORCE- CORRECT DIRECTION-
ADEQUATE SUPPORT TO THE ADJACENT TOOTH
 FINGER GUARD: SUPPORT ADJACENT TISSUES
 DENTAL ELEVATORS

BASIC GRIPS:
• PALM GRIP: HEAVY FORCES; HANDLE RESTS AGAINST HEEL OF
PALM

• FINGER GRIP: DELICATE APPLICATIONS

 DENTAL ELEVATORS

HANDLE:
• GENEROUS SIZE: COMFORTABLY HELD
• SUBSTANTIAL, CONTROLLED FORCE
• CROSS-BAR/ T-BAR HANDLES: CAUTION
SHANK:
• CONNECTS HANDLE TO THE WORKING END
• SUBSTANTIAL SIZE; STRONG ENOUGH TO TRANSMIT FORCE
BLADE:
• WORKING TIP
• TRANSMIT THE FORCE TO THE TOOTH, BONE OR BOTH
 DENTAL ELEVATORS

TYPES
I. BASED ON THE SHAPE & SIZE:
1. STRAIGHT
2. TRIANGLE/ PENNANT-SHAPE
3. PICK

II. BASED ON THEIR FORM:

4. STRAIGHT
5. ANGULAR
6. CROSSBAR
 DENTAL ELEVATORS

III. BASED ON THEIR USE:

1. REMOVE ENTIRE TOOTH
2. REMOVE ROOTS BROKEN AT THE GINGIVAL LINE
3. REMOVE ROOTS BROKEN HALF WAY TO THE APEX
4. REMOVE THE APICAL THIRD OF THE ROOT
5. REFLECT MUCOPERIOSTEUM
 DENTAL ELEVATORS

STRAIGHT
• MOST COMMONLY USED
• BLADE: CONCAVE SURFACE ON ONE SIDE-THE TOOTH TO BE
ELEVATED
• SMALL- NO.301:BEGINNING THE LUXATION OF AN ERUPTED
TOOTH
 DENTAL ELEVATORS

• LARGE:NO.34S (COMMON),NO.46,NO.77R
-DISPLACE ROOTS FROM THE SOCKETS
-LUXATE MORE WIDELY SPACED TEETH
-SMALLER SIZED ELEVATOR: LESS EFFECTIVE
• ANGLED STRAIGHT ELEVATOR: POSTERIOR ASPECT
• EG : MILLER ELEVATOR, POTTS ELEVATOR
 DENTAL ELEVATORS

STRAIGHT ELEVATOR: COUPLAND’S

• LARGE, PEAR-SHAPED HANDLE
• STRAIGHT SHANK
• BLADE: CONCAVE/ CONVEX SURFACE & AN INCLINED PLANE
• CONCAVE GROOVE ON ONE SIDE
• SHARP & STRAIGHT TIP
 DENTAL ELEVATORS

• IMPACTED/ MALALIGNED TEETH

• WEDGE & 1ST ORDER LEVER PRINCIPLE
• 450 TO LONG AXIS: CONCAVITY FACING THE TOOTH
• CREST OF THE INTERSEPTAL BONE: FULCRUM
• APPLIED TO THE LONG AXIS: WEDGED INTO THE PDL SPACE-
LUXATE THE TOOTH
 DENTAL ELEVATORS

STRAIGHT ELEVATOR: HOSPITAL

• BLADE, HANDLE & SHANK: SAME PLANE
• HANDLE: FLAT & TRIANGULAR- DEEP CRISS-CROSS GROOVES
• BLADE: FLAT WITH VERTICAL SERRATIONS; OTHER SIDE-
CONVEX WITH POINTED TIP
• SERRATED FLAT SIDE: FACES THE TOOTH TO BE EXTRACTED
• 450 TO THE LONG AXIS/ WEDGED INTO THE PDL SPACE:
VERTICALLY ALONG THE LONG AXIS
• WEDGE & 1ST ORDER LEVER
 DENTAL ELEVATORS

APEXO ELEVATORS
• ‘OFFSET’/ ANGULATED ELEVATOR
• BLADE AT AN ANGLE – SHANK
• BLADE ENDS- SHARP POINTED TIP
• LARGE PEAR-SHAPED HANDLE
• PAIRS- RIGHT & LEFT
• REMOVE ROOT FRAGMENTS
• WEDGE PRINCIPLE
 DENTAL ELEVATORS

TRIANGULAR
• SECOND MOST COMMONLY USED
• PAIRS: LEFT AND RIGHT
• BROKEN ROOTS IN THE TOOTH SOCKETS + ADJACENT EMPTY
SOCKET
• FRACTURED LOWER 6:DISTAL ROOT LEFT IN THE SOCKET-
ELEVATOR TIP IN THE SOCKET; SHANK ON THE BUCCAL PLATE-
WHEEL AND AXLE ROTATION
• EG : CRYER
 DENTAL ELEVATORS

CRYERS
• ‘OFFSET’ BLADE: AT AN ANGLE TO THE SHANK
• CURVED & TRIANGULAR BLADE
• HEAVY PEAR SHAPED HANDLE
• PAIRS
 DENTAL ELEVATORS

• IMPACTED MOLARS: BUCCAL FURCATION & LUXATED

• FRACTURED ROOT TIPS: MAXILLARY MOLARS
• ERUPTED MAXILLARY MOLARS
• BUR HOLE- DRILLED ONTO THE TOOTH & TIP ENGAGED-
PURCHASE POINT
 DENTAL ELEVATORS

CROSSBAR ELEVATOR
• OFFSET BLADE- SIMILAR TO CRYERS
• HANDLE PERPENDICULAR TO SHANK
• MAXIMUM MECHANICAL ADVANTAGE DUE TO CROSSBAR
HANDLE & OFFSET BLADE
 DENTAL ELEVATORS

• ROTATIONAL FORCES: WHEEL & AXLE PRINCIPLE

• IMPACTED MANDIBULAR TEETH
• CAUTION: IMPACTED MANDIBULAR 8- #ANGLE MANDIBLE
• REMOVAL OF MANDIBULAR ROOT FRAGMENTS
• NOT USED IN MAXILLARY ARCH
 DENTAL ELEVATORS
PICK
REMOVE ROOTS
1. CRANE PICK: HEAVY VERSION-LEVER TO ELEVATE THE
BROKEN ROOTS
• PURCHASE POINT: 3MM DEEP INTO THE ROOT, USING BUR
• TIP OF THE PICK INSERTED- BUCCAL PLATE OF THE BONE AS
FULCRUM
 DENTAL ELEVATORS

2.ROOT TIP PICK/APEX

• DELICATE
• TEASE SMALL ROOT TIPS
• DON’T USE: WHEEL- AND- AXLE/LEVER
• VERY SMALL ROOT END : INSERT THE TIP INTO THE PDL SPACE-
ROOT TIP & SOCKET WALL
 PRINCIPLES OF ELEVATORS

• LEVER PRINCIPLE
• WEDGE PRINCIPLE
• WHEEL AND AXLE PRINCIPLE
 LEVER PRINCIPLE
• 3 BASIC COMPONENTS-
- AN EFFORT ARM WHICH IS THE HANDLE,FULCRUM WHICH IS
THE CREST OF THE ALVEOLAR BONE AND RESISTANCE ARM
WHICH EXERTS PRESSURE ON THE TOOTH.
- MAXIMUM MECHANICAL ADVANTAGE IS GAINED BY KEEPING
THE EFFORT ARM LONGER THAN THE RESISTANCE ARM.
 WEDGE PRINCIPLE
ACCORDING TO THIS PRINCIPLE A WEDGE
CAN BE USED TO SPLIT, EXPAND OR
DISPLACE THE PORTION OF THE
SUBSTANCE THAT RECEIVES IT.
 IS DONE BY WEDGING THE ELEVATOR OR
BEAKS OF FORCEPS BETWEEN THE
TOOTH AND THE SOCKET IN THE
PERIODONTAL LIGAMENT SPACE.THIS
DISPLACES THE TOOTH OCCLUSALLY
AND THE INSTRUMENT CAN FURTHER BE
PUSHED INTO THE SOCKET TO DISPLACE
THE TOOTH FURTHER TILL IT CAN BE
REMOVED COMPLETELY
 WHEEL AND AXLE PRINCIPLE

• RESEMBLES THE WHEEL OF A

VEHICLE ATTACHED TO A AXLE
AROUND WHICH THE WHEEL MOVE
• THE HANDLE SERVES AS THE
WHEEL AND BLADE ENGAGES THE
TOOTH.
• WHEN THE HANDLE IS ROTATED
THE FORCE CREATED ON THE
BLADE OF THE ELEVATOR IS
MULTIPLIED CREATING A GREATER
MECHANICAL ADVANTAGE TO
ELEVATE TOOTH OUT OF ITS
SOCKET