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




Cryers 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

Winters 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 tip 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

Maxillary 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)
Maxillary 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