Instrument used in exodontia (updated)

1. 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

3. 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.

4. The handle of the elevator is pear shaped
In some situations, crossbar or T-bar handles are used.

5. 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.

6. 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

7. 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

8. 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)

9. 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

10. 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

11. 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

12. 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

13. 1. Handle
They are made of adequate size
They are serrated
For the maxillary teeth, the forceps are held with palm under the
forceps

14. 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"

15. 2. Hinge
Like the shank of an elevator
The hinge transfers and concentrates the forces applied
to the beaks.

16. 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

17. 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

18. 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

19. 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

20. 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

21. 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)

22. 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.

23. 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)

26. 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

27. 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

28. The mandibular premolar forcep have identical long and broad open beaks
The mandibular premolar forcep and can be use to extract the mandibular
canine

29. 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

30. 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

31. 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

32. 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