Dental Tribune United Kingdom Edition

The third force to be over- come is that of atmospheric pressure. Withdrawing a tooth from its socket will create a void or vacuum at the apex of the socket, and until this void is filled with blood or the in- gress of air, then atmospheric pressure will effectively push on the tooth to keep it in posi- tion. Anyone who can remem- ber back to the Magdeburg Hemisphere experiment in school physics will know that simple atmospheric pressure resisted the force of two teams of horses pulling in opposite directions. Little wonder then that simply using a combination of forceps and brute force can lead to unnecessary loss of al- veolar bone, root fracture, and a subsequently more stress- ful experience for both pa- tient and dentist. Dealing with the fracture of a maxillary tuberosity can certainly ruin your day! The careful and considered use of a Luxator helps the dentist to divide and conquer the forces retaining a tooth, making the extraction process an infinitely more predictable and stress-free process. The appropriate size of Luxator is chosen to match the diameter of the root, and the angle of the blade is chosen to give the best access. The tip of the Luxator is gently inserted into the gingival margin, with the blade angled slightly to- wards the root surface. This ensures the Luxator enters the periodontal ligament be- tween the crestal bone and the root. Once in the perio- dontal ligament the Luxator is worked down the length of the root with a side to side rock- ing motion and steady axial pressure (Fig 2). This motion firstly severs the periodontal fibres, then as the blade is in- troduced further, the socket is dilated to allow an easier path of removal. Finally, as the per- iodontal ligament is severed and the socket dilated, bleed- ing and air ingress overcome the vacuum that resists tooth removal. The Luxator should be in- serted around as much of the circumference of the root as possible to evenly dilate the socket. Once this has been achieved, then the final deliv- ery of the tooth may be per- formed with forceps, although this is often not required with single-rooted teeth. When using a Luxator, the uniquely designed handle should sit neatly in the palm of your hand, cradled by your fingers and thumb, with the index finger extended towards the tip of the instrument (Fig 3). This allows for precise control of the tip and prevents the risk of slipping. Excessive force should be avoided; the Luxator is a surgical instru- ment, and should be used as such, not as an elevator. To complement their range of Luxators, Directa now pro- duce an elevator called the Luxator Forte. Having dilated the socket using a Luxator, if it is felt that greater dilating and elevation forces are re- quired then the stronger Lux- ator Forte should be used. The Forte is easily recognisable by its black handle (Fig 4). This sequence of luxation followed by elevation generally means that forceps are only ever used for the final easy delivery of the tooth. The Swedish dental com- pany Directa not only invent- ed the name ‘Luxator’, but have developed this range of instruments to perfection. The use of high-grade surgi- cal steel blades and a two-part moulding technique for the uniquely ergonomic polymer handle combine to provide a high-quality instrument that will give years of reliable ser- vice, and endure countless cycles of dishwasher disinfec- tion and autoclaving. Having used Luxators for more than 20 years, I can- not imagine undertaking the extraction of any tooth with- out first severing the peri- odontal fibres with my trusty friend. It would be the equiva- lent of struggling to remove my boots without first undoing the laces. DT About the author Dr. Simon P. Jones is a lead- ing UK dentist with a prac- tice in Mid- dlesbrough, north east of England. He qualified in 1985 and has worked mainly in the British NHS since then. For the past six years he also served as a Vocational Train- er for the Northern deanery of Newcastle University Den- tal School. Fig 3 Correct handling of Luxator Periotome Fig 4 Luxator Periotome vs. Luxator Forte Fig 5 An atraumatic extraction is per- formed ‘The careful and considered use of a Luxa- tor helps the dentists to divide and conquer the forces retaining a tooth’ April 23-29, 2012United Kingdom Edition Luxator Extraction Instruments are now the preferred method of performing extractions 3512-11201©DirectaAB Distributed in the UK by Trycare Tel. 01274-88 10 44 Luxator Extraction Instruments were invented by a Swedish dentist to make extractions as trauma free as possible. He developed subtleties in the design only a practising dentist would appreciate with an acclaimed and ergonomic handle design. For this reason our Luxator instruments are discernably different.