Clinical Tips: Luxator

The Luxator extraction instrument product range enhances the outstanding selection of high quality extraction instruments from Directa. Modern techniques as implants requires instruments and equipment offering possibilities to achieve fast healing and placement of direct implants after extraction.

The difference between Luxator Periotome and Luxator Forte Elevator

Luxator Periotome is a surgical instrument specially designed for extraction by vertical luxation, correctly used an indispensable instrument in every dental clinic. The tip of the instrument is very thin and sharp to be inserted into the periodontal space between bone and tooth, cut off the ligaments and at the same time compress the alveolar bone. To bend, chip or otherwise damage the tip strong elevation forces are required that may not occur by regular vertical luxation. Should such forces be applied there will be damages to the cheekbone before damage to the tip is made. Luxator Periotomes are not intended for use as elevators! Any kind of use for leverage will result in damages to the tip. The surgical tip is made of hardened stainless special steel specifically developed for surgical instruments thus making a very strong instrument despite the precision thin tip. The hardening process also gives excellent durability in the sharpness of the instrument. In order to meet the demand for elevating technique Directa developed Luxator Forte which is specially designed for tooth elevation.

Luxator Periotome

Luxator Periotomes are used to cut the periodontal ligaments. The thin cutting metal blade is designed to cut off the periodontal ligaments and widen the space between the alveolar bone and the root. Luxator Periotome comes in light handles (grey, pale blue or pale yellow). The tips of Luxator Periotome are extremely sharp and can be damaged if excessive force is used. These tips are not designed for strong forces.

Luxator Forte

Luxator Forte comes with a black handle and shall be used as an elevator to extract a root that has been released by Luxator Periotome. Luxator Forte Elevators are made with a cornered, rigid tip that enables elevation of roots without risk of damaging the instrument. The unique cornered tip design grasps dentine or root cementum for controlled and safer tooth elevation. 

Luxator, size and shape – when to use?

It is always a matter of personal choice and experience. Below you can find a few examples of use.

Long / short - Using the regular or the short periotome is a matter of control and access. The 10mm shorter blade on Luxator Short Peritome enables an optimal working position for smaller hands. 
Contra - Good access from the lingual and/or distal side.
Inverted - About the same but less. General, Lingual and/or Distal
Curved - General use or starter. Good from the buccal side 
Straight - Apical and/or interproximal
L3A - Distal of the third molar
Dual Edge - Start of difficult, well hidden, root extraction, extract fractured tips. Safer stepped insertion reduces the risk of slipping. Ideal for deeply fractured teeth and decayed roots. 
Forte -For elevation

Preserves bone integrity

The placement of implants is a relatively simple and straightforward surgical procedure of modern dentistry, if there is sufficient bone available. However, if there is massive loss of bone due to periapical or periodontal pathosis, implants can only be placed with bone augmentation. In some cases it is the extraction procedure itself that causes the loss of mostly the buccal wall of the alveolar socket. This also makes it very difficult to place the implant. A careful removal of the tooth from the alveolar socket however will leave the bony walls intact. Even without augmentation materials there will be good wound healing resulting in good bone height and width at the level of the alveolar ridge. Luxators are ideal instruments for such a careful tooth removal. The action of the Luxators is based on the possibility of bone expansion. The Luxator is introduced in a rotating fashion parallel to the long axis down the periodontal ligament. The shape of its blade allows the instrument to be advanced to the apical third of the root. This will lead to an enlargement of the alveolar socket so the tooth can be easily removed with a slight rotational movement with a forceps. Concial roots will sometimes literally “jump” out of the socket.

Even though Luxators look like classical elevators, the mode of action of these instruments has nothing in common. Luxators are much more delicate than any elevator. You should not use the Luxator as an elevator because this will cause the instrument to bend.
Your patients will be thankful for the atraumatic extraction even if you don’t place an implant. They will experience less discomfort operatively and postopertively.

Author: Dr. Michael Liebler, D.D.S (Univ. Iowa, USA)