 SURGICAL ELEVATORS Three types of surgical elevators

are used in oral surgery: the periosteal, root, and malar. Root picks
are classified as root elevators and will also be discussed.
Periosteal Elevators During surgery the dentist often needs to
separate a bone or tooth from the fibrous membrane, called
the periosteum that covers it. This is done with a periosteal
elevator. The dentist may also use it to gain access to retained
roots and surrounding bone. Two periosteal elevators are the
Molt #9 and Seldin #23 shown in figure 5-18. The Molt #9
is used exclusively as a periosteal elevator. The Seldin #23,
because of its wide working ends, is also used as a retractor. Root
Elevators Root elevators come in many sizes and shapes. At least
one (and sometimes more) is used in every tooth extraction.
Which elevator or elevators that are used will depend upon
the desire of the dentist. A root elevator has three functions:
To loosen the teeth in their sockets. To remove parts of teeth
(broken root tips or retained roots). To remove a complete
tooth. Figure 5-18.—Periosteal elevators. 5-10

Figure 5-23.—Cogswell A and B root elevators. Miller #73 and

#74 elevators, shown in figure 5-24, have curved, thin working
ends with smooth, rounded tips. These elevators are designed to
elevate a tooth or large root fragment. The Seldins #1L and #1R,
shown in figure 5-25, have sharp-tipped working ends with an
abrupt 90-degree angle. The Seldins, sometime referred to as
East- West elevators, are designed for use on molar roots. The
Cryer #25 and #26 are similar to the #1L and #1R Seldins;
however, the working ends are angled at angles greater than 90
degrees (fig. 5-26). APICAL ROOT TIP PICK
ELEVATORS— This group of elevators are used to remove
fractured root tips lodged deep in the root socket. These
elevators are often called root picks. Elevators that make up
this group are the #5 and #6 West, and the #9 apical, #9L, and
 #9R. The working ends on these elevators are very thin,
sharply pointed, and small. The Figure 5-24.—Miller root
elevators. Figure 5-25.—East-West (Seldin) root elevators.
Figure 5-26.—Cryer root elevators. #5 and #6 West, shown in
figure 5-27, have much shorter shanks and are designed to
remove extremely small apical fragments. The #9L and #9R are set
at left and right angles to the handles (fig. 5-28). The handles are
also small in diameter but longer than those on other
elevators discussed earlier. Malar Elevator The facial bone that
forms the cheek is called the zygoma or malar bone. An injury
to this bone often causes a depressed fracture. If this occurs, the
dentist will use a malar elevator to raise the bone to its normal
position. Figure 5-27.—Apical root tip picks (#5 and #6 west).
5-12
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In the last case, the tooth is usually an underdeveloped third

molar. The elevators are actually levers. The fu lcrum
(support point) for the elevator is usually the bone supporting
the tooth. STRAIGHT ROOT ELEVATORS.—The elevators
composing the straight working end group are the #301 and the
#34S (figs. 5-19 and 5-20). The Figure 5-19.—Root elevator
#301. Figure 5-20.—Root elevator #34S. working ends are in
line with the handle and have a concave surface. The #301
has the smallest working end and is used when roots are
deeply seated. The #34S has the largest end and is
commonly used for anterior roots. The #92, shown in figure 5-
21, also has a straight working end; however, it is serrated and the
shanks are angled rather than straight as in the #301 and #34S.
SPADE/WEDGE-TYPE ROOT ELEVA- TORS.—Another
style of elevator has spade or wedge-type working ends.
The Stout #11 (fig. 5-22) and the Cogswell A (fig. 5-23) are
examples of this style. The Cogswell B, also shown in figure 5-
23, is a pick-shaped root elevator that has a working end
shaped similar to a rounded toothpick tip. ANGLED-TYPE
 ROOT ELEVATORS.—In several sets of elevators, the
handles are in line with the shank, but the working ends are set at
an angle. The Figure 5-21.—Serrated root elevator #92. Figure
5-22.—Stout #11 root elevator. 5-11

an elevator. Forceps will have two handles and look almost like a pair of pliers,
with a "beak" that closes. An elevator is a single shaft, thicker than examination
tools, with one or two ends. It could also be a thick shaft with one thin end,
known as a root pick.

 2

Examine the instrument you chose. Notice everything you can about it. Does the
beak close completely, or is the tip of the elevator curved or straight, narrow or
wide? Find the number that should be printed on it toward the bottom of the shaft
or handles. These numbers are used to identify the type and size of instruments
used by dentists in the extraction process.

Read more: How to Identify Dental Extraction Instruments | eHow.com

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instruments.html#ixzz0xc18nQhp

Surgical Elevators
Elevators are multipurpose bone tools
used to elevate, dissect, or scrape bones.
Certain elevators are used for tissues and
elevators.

Periosteal Elevators
They are used to strip portions of the
membrane (periosteum) covering the exterior
surface of a bone. Periosteal Elevators are used
for trauma, spinal and other bone and soft
tissue procedures. They are well balanced
equipment with enough hardness to maintain
the sharp edges. In the oral surgery, they are
used to separate the tooth or the bone from
the fibrous surroundings. Periosteal Elevator is
also used to access the root and may also be
used as a retractor.

Root Elevators
Root elevators are essential for any dental
surgery. They act as levers in tooth extraction.
A root elevator loosens the teeth in their
sockets, removes parts of teeth and may be
used to remove a complete tooth. Root
elevators come in many sizes and shapes. The
straight root elevators have working ends in
line with the handle and a concave surface.

The spade/wedge-type root elevators have

spade or wedge-type working ends. In the
angled-type root elevators the handles are
in line with the shank, but the working ends are
set at an angle. These elevators are designed
to elevate a tooth or large root fragment.
Apical root tip pick elevators are used to
remove fractured root tips lodged deep in the
root socket.

Malar Elevator
The facial bone that forms the cheek is called
the zygoma or malar bone. An injury to this
bone often causes a depressed fracture. If this
occurs, the dentist will use a malar elevator to
raise the bone to its normal position.

FIG. 6-32 A, Transfer forceps are used to move

sterile instruments from one sterile area to another.
B, These forceps are sturdy enough to move
instruments without fear of loosing grip on them.
C, Transfer forceps can alsobe used to handle small
items, such as anesthetic cartridges.
The shank of the elevator simply connects the handle to
the working end, or blade, of the elevator. The shank is
generally of substantial size and is strong enough to transmit
the force from the handle to the blade. The blade of the
elevator is the working tip of the elevator and is used to
transmit the force to the tooth, bone, or both.
Types
The biggest variation in the type of elevator is in the shape and
size of the blade. The three basic types of ele- vators are (1) the
straight or gouge type; (2) the triangle or pennant-shape type;
and (3) the pick type. The straight or gouge type elevator is the
most commonly used eleva- tor to luxate teeth (Fig. 6-37,A ).
The blade of the straight elevator has a concave surface on one
side so that it can be used in the same fashion as a shoehorn
(Fig. 6-37,B andQ. The small straight elevator, no. 301, is
frequently used for beginning the luxation of an erupted tooth,
before application of the forceps (Fig. 6-38). The larger straight
elevator is used to displace roots from their sock- ets and is
also used to luxate teeth that are more widely spaced. The
most commonly used large straight elevator is the no. 34S, but
the no. 46 and no. 77R are also occa- sionally used.
FIG. 6-33 Towel clip is usedto hold drapes in position.
Sharp points
penetrate towels, andlocking handles maintain drape
in position.
Towel clamps with nonpenetrating action are also
available.
The shape of the biade of the straight elevator can be
angled from the shank, allowing this instrument to be used in
the more posterior aspects of the mouth. Two examples of
the angled-shank elevator with a blade simi- lar to the
straight elevator are the Miller elevator and the Potts
elevator.

FIG. 6-32 A, Transfer forceps are used to move

sterile instruments from one sterile area to another.
B, These forceps are sturdy enough to move
instruments without fear of loosing grip on them.
C, Transfer forceps can alsobe used to handle small
items, such as anesthetic cartridges.
The shank of the elevator simply connects the handle to
the working end, or blade, of the elevator. The shank is
generally of substantial size and is strong enough to transmit
the force from the handle to the blade. The blade of the
elevator is the working tip of the elevator and is used to
transmit the force to the tooth, bone, or both.
Types
The biggest variation in the type of elevator is in the shape and
size of the blade. The three basic types of ele- vators are (1) the
straight or gouge type; (2) the triangle or pennant-shape type;
and (3) the pick type. The straight or gouge type elevator is the
most commonly used eleva- tor to luxate teeth (Fig. 6-37,A ).
The blade of the straight elevator has a concave surface on one
side so that it can be used in the same fashion as a shoehorn
(Fig. 6-37,B andQ. The small straight elevator, no. 301, is
frequently used for beginning the luxation of an erupted tooth,
before application of the forceps (Fig. 6-38). The larger straight
elevator is used to displace roots from their sock- ets and is
also used to luxate teeth that are more widely spaced. The
most commonly used large straight elevator is the no. 34S, but
the no. 46 and no. 77R are also occa- sionally used.
FIG. 6-33 Towel clip is usedto hold drapes in position.
Sharp points
penetrate towels, andlocking handles maintain drape
in position.
Towel clamps with nonpenetrating action are also
available.
The shape of the biade of the straight elevator can be
angled from the shank, allowing this instrument to be used in
the more posterior aspects of the mouth. Two examples of
the angled-shank elevator with a blade simi- lar to the
straight elevator are the Miller elevator and the Potts
elevator.

FIG. 6-34 A,Bulb or regular syringes may be used to

carry irrigation solution to operative site. B, The
self-ioaded syringe iss pring-loaded to allow filling
simplyb y releasing the plunger.
FIG. 6-35 The major components of an elevator are
the handle, shank, and blade.
The second most commonly used elevator is the trian-
gular or pennant-shaped elevator (Fig. 6-39). These eleva-
tors are provided in pairs: a left and a right. The triangle-
shaped elevator is most useful when a broken root remains
in the tooth socket and the adjacent socket is empty. A
typical example would be when a mandibular first molar is
fractured, leaving the distai root in the socket but the mesial
root removed with the crown. The tip of
the triangle-shaped elevator is placed into the socket, with
the shank of the elevator resting on the buccal plate of
bone. It is then turned in a wheel-and-axle type of rotation,
with the sharp tip of the elevator engaging the cementum of
the remaining distal root; the elevator is then turned and the
root delivered. Triangle-shaped ele- vators come in a
variety of types and angulations, but the Cryer is the most
common type.

FIG. 6-36Crossbar handle is used onc e r t ai n

elevators. This type of handle can generate large
amounts of force and therefore must be used with
caution.
FIG. 6-37A, Straight elevator is most commonly used
elevator. B and C, Blade of straight elevator is
concave on its working side.
The third type of elevator that is used with some fre-
quency is the pick-type elevator. This type of elevator is
used to remove roots. The heavy version of the pick is the
Crane pick (Fig. 6-40). This instrument is used as a lever to
elevate a broken root from the tooth socket. It is usu- ally
necessary to drill a hole with a bur, approximately 3 mm
deep into the root. The tip of the pick is then insert- ed into
the hole, and, with the buccal plate of bone as a fulcrum, the
root is elevated from the tooth socket. Occa- sionally the
sharp point can be used without preparing a purchase point
by engaging the cementum of the tooth.
The second type of pick is the root tip pick, or apex
ele-
vator (Fig. 6-41). The root tip pick is a delicate
instrument
thati s used to tease small root tips from their sockets. It
must be emphasized that thisi s a thini n s t r u me n t and
cannot be used as a wheel-and-axle or lever type of eleva-
tor like the Cryer elevator or theCr a ne pick. The root tip
pick is used to tease the very small root end of a tooth.
EXTRACTION FORCEPS
The instruments that come to mind when thinking of the
removal of a tooth are the extractionf o r c e p s . These
instruments are used for removing thet o o t h fromt h e
alveolar bone. Theya re designed in manys ty l e s andc o
n-
figurations to adapt to the variety of teethfo r
whicht h e y