One of the most important instruments used in the extraction procedure is the dental elevator

Elevators come in different designs, shapes and sizes

The three major components of the elevator are the handle,shank, and blade

Used to elevate and loosen the tooth from the periodontal ligament.

Elevation is done to create space and prevent trauma to adjacent teeth and tissues.

Available in sizes 1, 2 and 3 – working end gets larger with increase in size number.

The handle of the elevator is pear shaped

In some situations, crossbar or T-bar handles are used.

The shank of the elevator simply connects the handle to the working end, or blade, of the elevator.

The blade of the elevator is the working tip of the

The blade has two surfaces: a convex and a concave one.

Types of elevators Straight elevator it is used to luxate the teeth The blade of the straight elevator has a concave surface on one side

Come in different sizes

Cryer’s elevator – they come in pairs

The triangleshaped elevator is most useful when a broken root remains in the tooth socket and the adjacent socket is empty ( Commonly used in the mandibular arch)

In experts hands they can be used in the maxilla to luxate maxillary teeth or roots

Winter’s cross-bar elevator

Warwick-James elevator – this is a delicate elevator

Available as straight and curved (paired)

It is used to luxate the teeth in the maxilla

Since the handle is flat , the amount of the force aginat the bone will decrease ( reduce the incidence of the fracture)

Crane pick elevator Crane pick elevator is a heavy instrument used to elevate the whole

roots or even teeth

This elevator possess a sharp and thick , curved working that can be used for removing root

Root t ip pick, or apexo elevator– this is a delicate instrument

The instrument is wedged between the root and the bone

It is not used to push the roots

Double-angled elevators (also refered as Apexo elevator)

They are mainly used to remove root tips in both jaws

Their handle is similar to that of the straight elevator.

The shank has a double angle

The blade has a sharp point which can easily remove small broken root tips

Function

Removal of tooth from alveolar bone

Designed in various styles and configurations to adapt to variety of teeth for which they are used

Components

Components of a dental extraction forceps consists of:

- handle

- hinge

- beaks

1. Handle

They are made of adequate size

They are serrated

For the maxillary teeth, the forceps are held with palm under the forceps

For the mandibular teeth, the palm is kept on top of the forceps

Handles can be straight or curved

This provides the operator with a sense of "better fit"

2. Hinge

Like the shank of an elevator

The hinge transfers and concentrates the forces applied to the beaks.

The American type of forceps has a hinge that is directed in a horizontal direction with the handles of the forcep

While The English type of forceps has a hinge that is directed vertically to the handles of the forecep

3. Beaks

The beaks of the forcep are concave on their inner aspect and shaped to fit around the root of the tooth

The beak is designed to adapt to the tooth root at the junction of the crown and root

Upper anterior forceps

Used for extracting upper incisors & canines

Beaks are symmetrical & are placed in the same line as the handles

beaks are concave and not pointed

Beaks are shorter than the handles, so that load arm is shorter than the working arm

Upper Univeral forcep Used for removing premolars teeth

Beaks are symmetrical , concave, not pointed

The forcep have a slightly curved shape and look like an “S.”

Holding the forceps in the hand, the concave part of the curved handle faces the palm,while the concave part of the beaks is turned upwards

Maxillary molar forceps

There are two maxillary molar forceps: one for the left and one for the right side

Forceps have a slightly curved shape

The have asymmetrical beaks : sharply pointed buccal beak and rounded palatal beak

Beaks are broader than anterior forceps

Maxil lary Third Molar Forceps. It is the longest forceps, due to the posterior position of the third molar

The beaks are offset from the handle in a bayonet fashion

The beaks of forceps are concave and smooth (without pointed ends)

The forceps can be used for extraction of both the left and right maxillry third molar and maxillary second molar (conical roots)

Maxil lary cowhorn forceps .

They are particularly useful for maxillary molars whose crowns are severely decayed.

The sharply pointed beaks may reach deeper into the trifurcation

The major disadvantage is that they crush alveolar bone, and when used on intact teeth without due caution, fracture of large amounts of buccal alveolar bone may occur.

Maxillary cow horn forceps has a bayonet design, and are commonly used to extract the maxillary third molar , as well as , it can be used to extraxt the maxillary first and secnd molar

Maxillary cow horn forceps have unidentical beaks, one has pointed tip and the other has bifid pointed beaks

With experinced hands, the surgeon can extract the maxillary third molar by engaging the furcation area between the buccal roots by one pointed tip of the bifid beak so that other tips engane the trifurcation area from the distal area and from the palatal sides

Or , as it recommened by the manufacture, the dentist can usually extract the third molar by engaging the single pointed beak on the furcation area between the buccal roots and the other bifid pointed tip engages the palatal root

If Maxillary cow horn forceps is used to extract the maxillary first and second molar, the dentist should engage the single pointed beak on the furcation area between the buccal roots and the other bifid pointed beak should engages the palatal root ( strong apical force is important to engage the cervical portion of the root , not the crown (other wise it will crush the crown)

Upper root forceps

Designed for removing maxillary roots

The handles of the root tip forceps are straight, while the beaks are narrow and offset from the handle in a bayonet fashion

Beaks closely approximate each other and they meat at the ends

Beaks are narrow to fit to the circumference of the root & provide firm grip

Lower anterior forceps

Lower anterior forceps have identical , short closed beaks

Beaks are narrower than lower molar forceps, similar to upper root forceps

Beaks are at right angles to the handles

They can also be used as lower root forceps

The mandibular premolar forcep have identical long and broad open beaks

The mandibular premolar forcep and can be use to extract the mandibular canine

Lower molar forceps

Beaks are at right angles to the handles

Beaks are symmetrically pointed & the sharp pointed tips engage the bifurcation at the buccal & lingual surfaces

Beaks are more broader & stout

Mandibular Third Molar Forceps. These have straight handles, while the beaks, are curved at a right angle compared to the handles.

The beaks are a little longer compared to the previous forceps

Because this tooth varies in the shape and size and because there is usually no root bifurcation, the ends of the beaks of the forceps are concave without a pointed design.( most useful for the third molar with have fused conical roots)

Other types of the lower third forcep, have bilateral pointed tips in the center to adapt into the bifuraction area if it is present between the roots

Lower cowhorns forceps

They have two heavy beaks with a very sharp tips that can fit into the root bifurcation

These forceps are often used when the crown of the tooth is badly broken down.

They often cause the tooth to split in two the roots can be removed separately with elevators

Mandibular Root Tip Forceps.

The handles of the root tip forceps are straight,while the beaks are curved at a right angle.

Their ends are very narrow and meet at the tip when the forceps are closed