Periosteal Elevator: An Essential Tool in Surgical Dentistry

The periosteal elevator is a fundamental surgical instrument widely used in dentistry, particularly in procedures that require access to the underlying bone structure

1. Periosteal Elevator: An Essential Tool in Surgical
Dentistry
The periosteal elevator is a fundamental surgical instrument widely used in dentistry, particularly in
procedures that require access to the underlying bone structure. Its primary function is to elevate or
separate the periosteum (the connective tissue that covers the surface of bones) from the bone during
surgery. This tool plays a critical role in ensuring a smooth, minimally invasive surgical experience,
especially in procedures such as tooth extractions, implant placements, and other oral surgeries that
require exposure of the bone or tooth root.

What is a Periosteal Elevator?
A Periosteal Elevator is a hand-held surgical tool designed to detach the periosteum from the underlying
bone in a controlled manner. The instrument is typically comprised of a handle and a blade or a working
end that is either straight or curved. The blade end is designed to gently lift the periosteum from the
bone without causing unnecessary damage to the tissue.

2. The periosteal elevator comes in various shapes and sizes to accommodate different surgical needs. Its
design allows for precise maneuvering and controlled force application, which is essential for
maintaining the integrity of the surrounding tissues and achieving optimal surgical outcomes.
Components of a Periosteal Elevator
1. Handle: The handle is typically made of stainless steel or another durable material, providing a
firm grip for the surgeon during the procedure. Some handles are ergonomically designed to
reduce hand fatigue during prolonged surgeries.
2. Blade/Working End: The working end of a periosteal elevator can be straight, angled, or curved,
depending on the specific requirements of the surgery. The blade is sharp enough to cut
through the periosteum while being delicate enough to avoid unnecessary trauma to the
underlying bone.
3. Tip: The tip of the instrument is often tapered or flat, designed to easily fit under the
periosteum and lift it away from the bone without causing excessive force or tearing of the
tissue.
Types of Periosteal Elevators
There are several types of periosteal elevators, each designed for specific applications in surgical
dentistry:
1. Straight Periosteal Elevator: This is the most basic form of the instrument, featuring a straight
blade. It is typically used for general periosteal separation and is ideal for procedures where the
bone needs to be exposed in a straightforward manner.
2. Curved Periosteal Elevator: The curved design of this elevator allows for better access to certain
areas of the oral cavity, particularly those with limited visibility or difficult angles. The curvature
helps the surgeon work in confined spaces without compromising precision.
3. Double-Ended Periosteal Elevator: This tool features two different types of blades on either
end, allowing the surgeon to switch between instruments without needing to change tools
during surgery. This design increases efficiency in the operating room.
4. Luxe Periosteal Elevator: Known for its very fine blade, this instrument is designed for delicate
surgeries where precision is paramount. It is often used in procedures such as periodontal
surgeries or for uncovering dental implants.
5. Patterson Periosteal Elevator: This instrument has a unique design with a more pronounced
curvature and is particularly effective for lifting periosteum in complex surgeries involving the
maxillary or mandibular regions.
Uses of a Periosteal Elevator
The periosteal elevator has a variety of important applications in surgical dentistry:
1. Tooth Extractions: During tooth extraction, the periosteal elevator is used to lift the periosteum
away from the bone surrounding the tooth, allowing the surgeon to access the root and remove

3. the tooth without damaging surrounding tissues. It is especially helpful in cases where the tooth
is impacted or requires significant surgical intervention.
2. Implant Placement: The periosteal elevator is essential for preparing the site for dental
implants. It helps expose the bone and separate the periosteum from the bone, creating the
necessary space for implant placement.
3. Bone Grafting: In bone grafting procedures, where additional bone material is added to the site
to facilitate healing or bone regeneration, the periosteal elevator is used to expose the bone
and create the required surgical access.
4. Periodontal Surgery: In procedures aimed at treating gum disease, such as flap surgeries, the
periosteal elevator helps elevate the gum tissue from the underlying bone, allowing the dentist
or periodontist to clean the roots or perform necessary repairs to the bone and tissue.
5. Orthodontic Surgery: In orthodontics, the periosteal elevator can be used to gain access to
areas of the jaw that require surgical modification to correct alignment or structure.
Proper Technique for Using a Periosteal Elevator
Using the periosteal elevator effectively requires both skill and precision. Here are some steps involved
in the correct technique:
1. Initial Incision: A surgical incision is typically made in the soft tissue to expose the bone. This
step prepares the area for the use of the periosteal elevator.
2. Inserting the Elevator: The blade of the periosteal elevator is gently inserted beneath the
periosteum, typically starting at the edge of the incision.
3. Elevating the Periosteum: The surgeon applies gentle pressure and uses a rocking motion to lift
the periosteum off the bone. Care is taken to avoid damaging the underlying bone or soft
tissues.
4. Maintaining Control: Throughout the procedure, the surgeon ensures that the periosteal
elevator is used with controlled force to prevent excessive trauma to the tissues.
5. Completing the Procedure: Once the periosteum is adequately lifted, the surgeon can proceed
with the main surgical intervention, whether it be tooth extraction, implant placement, or
another procedure.
Advantages of Using a Periosteal Elevator
 Minimal Tissue Damage: The periosteal elevator is designed to minimize trauma to surrounding
tissues, making it an ideal tool for delicate surgeries.
 Increased Precision: The fine design of the instrument allows for greater precision in lifting the
periosteum, which is critical in complex oral surgeries.
 Efficient Access: By effectively separating the periosteum, the elevator provides the surgeon
with unobstructed access to the underlying bone, improving the efficiency and success of the
procedure.

4.  Versatility: With various shapes, sizes, and configurations, the periosteal elevator can be used in
a wide range of dental procedures.
Conclusion
The periosteal elevator is an indispensable tool in the field of dental surgery. Whether in tooth
extractions, bone grafting, implant surgeries, or periodontal procedures, it serves a critical role in
achieving successful outcomes by enabling surgeons to access the bone and tissues while minimizing
damage to surrounding areas. Mastery of the periosteal elevator’s use is essential for dental
professionals to perform precise, effective surgeries, ultimately leading to better patient outcomes and
recovery times.