Elevators (also known as luxators) are instruments used in dental extractions. They may be used to loosen teeth prior to forcep extraction, to remove roots or impacted teeth, when teeth are compromised and susceptible to fracture or when they are malpositioned and cannot be reached with forceps. [1]
Elevators work on the principle of leverage to dislodge a tooth from its socket. The fulcrum is usually the crest of the socket bone; however, adjacent teeth can be used if they are also to be extracted. The contact point on the tooth or root surface where force is delivered is described as the purchase point, and the position of this can be idealised by cutting bone or sectioning teeth. With root picks especially, a slot or notch may be cut into the root surface to obtain a purchase point. [2]
Instruments can be broadly classed as elevators or luxators. Conventional elevators are bulkier and are designed to withstand leverage and torquing forces. Luxating elevators are thinner and sharper, for more delicate use in severing and wedging the ligament.
There are three main types of elevator. Straight elevators e.g. Coupland's or Warwick James' have one concave and one convex aspect to the tip and are used for wedging. Triangular elevators e.g. Cryer's or Winter's have a lateral point and are used to deliver class I leverage. Especially when combined with a T-bar, these can deliver large forces and risk jaw fracture. Pick elevators are used to engage root tips. [3]
Dental surgery is any of a number of medical procedures that involve artificially modifying dentition; in other words, surgery of the teeth, gums and jaw bones.
Endodontics is the dental specialty concerned with the study and treatment of the dental pulp.
Toothache, also known as dental pain, is pain in the teeth or their supporting structures, caused by dental diseases or pain referred to the teeth by non-dental diseases. When severe it may impact sleep, eating, and other daily activities.
A dental implant is a prosthesis that interfaces with the bone of the jaw or skull to support a dental prosthesis such as a crown, bridge, denture, or facial prosthesis or to act as an orthodontic anchor. The basis for modern dental implants is a biological process called osseointegration, in which materials such as titanium or zirconia form an intimate bond to the bone. The implant fixture is first placed so that it is likely to osseointegrate, then a dental prosthetic is added. A variable amount of healing time is required for osseointegration before either the dental prosthetic is attached to the implant or an abutment is placed which will hold a dental prosthetic/crown.
Alveolar osteitis, also known as dry socket, is inflammation of the alveolar bone. Classically, this occurs as a postoperative complication of tooth extraction.
Dental alveoli are sockets in the jaws in which the roots of teeth are held in the alveolar process with the periodontal ligament. The lay term for dental alveoli is tooth sockets. A joint that connects the roots of the teeth and the alveolus is called gomphosis. Alveolar bone is the bone that surrounds the roots of the teeth forming bone sockets.
A dental extraction is the removal of teeth from the dental alveolus (socket) in the alveolar bone. Extractions are performed for a wide variety of reasons, but most commonly to remove teeth which have become unrestorable through tooth decay, periodontal disease, or dental trauma, especially when they are associated with toothache. Sometimes impacted wisdom teeth cause recurrent infections of the gum (pericoronitis), and may be removed when other conservative treatments have failed. In orthodontics, if the teeth are crowded, healthy teeth may be extracted to create space so the rest of the teeth can be straightened.
The alveolar process or alveolar bone is the thickened ridge of bone that contains the tooth sockets on the jaw bones. The structures are covered by gums as part of the oral cavity.
A dental emergency is an issue involving the teeth and supporting tissues that are of high importance to be treated by the relevant professional. Dental emergencies do not always involve pain, although this is a common signal that something needs to be looked at. Pain can originate from the tooth, surrounding tissues or can have the sensation of originating in the teeth but be caused by an independent source. Depending on the type of pain experienced an experienced clinician can determine the likely cause and can treat the issue as each tissue type gives different messages in a dental emergency.
Veterinary dentistry is the field of dentistry applied to the care of animals. It is the art and science of prevention, diagnosis, and treatment of conditions, diseases, and disorders of the oral cavity, the maxillofacial region, and its associated structures as it relates to animals.
Dental instruments are tools that dental professionals use to provide dental treatment. They include tools to examine, manipulate, treat, restore, and remove teeth and surrounding oral structures.
Root canal treatment is a treatment sequence for the infected pulp of a tooth which is intended to result in the elimination of infection and the protection of the decontaminated tooth from future microbial invasion. Root canals, and their associated pulp chamber, are the physical hollows within a tooth that are naturally inhabited by nerve tissue, blood vessels and other cellular entities. Together, these items constitute the dental pulp.
When extracting lower wisdom teeth, coronectomy is a treatment option involving removing the crown of the lower wisdom tooth, whilst keeping the roots in place in healthy patients. This option is given to patients as an alternative to extraction when the wisdom teeth are in close association with the inferior alveolar nerve, and so used to prevent damage to the nerve which may occur during extraction.
Socket preservation or alveolar ridge preservation is a procedure to reduce bone loss after tooth extraction. After tooth extraction, the jaw bone has a natural tendency to become narrow, and lose its original shape because the bone quickly resorbs, resulting in 30–60% loss in bone volume in the first six months. Bone loss, can compromise the ability to place a dental implant, or its aesthetics and functional ability.
Dental trauma refers to trauma (injury) to the teeth and/or periodontium, and nearby soft tissues such as the lips, tongue, etc. The study of dental trauma is called dental traumatology.
Dental avulsion is the complete displacement of a tooth from its socket in alveolar bone owing to trauma. Normally, a tooth is connected to the socket by the periodontal ligament. When a tooth is knocked out, the ligament is torn.
Impacted wisdom teeth is a condition where the third molars are prevented from erupting into the mouth. This can be caused by a physical barrier, such as other teeth, or when the tooth is angled away from a vertical position. Completely unerupted wisdom teeth usually result in no symptoms, although they can sometimes develop cysts or neoplasms. Partially erupted wisdom teeth can develop cavities or pericoronitis. Removal of impacted wisdom teeth is advised in the case of certain pathologies, such as nonrestorable caries or cysts.
Tooth mobility is the horizontal or vertical displacement of a tooth beyond its normal physiological boundaries around the gingival area, i.e. the medical term for a loose tooth.
Tooth ankylosis is the pathological fusion between alveolar bone and the cementum of teeth, which is a rare phenomenon in the deciduous dentition and even more uncommon in permanent teeth. Ankylosis occurs when partial root resorption is followed by repair with either cementum or dentine that unites the tooth root with the alveolar bone, usually after trauma. However, root resorption does not necessarily lead to tooth ankylosis and the causes of tooth ankylosis remain uncertain to a large extent. However, it is evident that the incident rate of ankylosis in deciduous teeth is much higher than that of permanent teeth.
A root-analog dental implant (RAI) – also known as a truly anatomic dental implant, or an anatomical/custom implant – is a medical device to replace one or more roots of a single tooth immediately after extraction. In contrast to common titanium screw type implants, these implants are custom-made to exactly match the extraction socket of the specific patient. Thus there is usually no need for surgery.