principles of elevator

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Information about principles of elevator
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Published on September 10, 2010

Author: swasti_tambi

Source: authorstream.com

Slide 1: Topic : Principles of Elevator By : Swasti Tambi Guided by : Dr. Shoaib Tipu Dr. Pradeep Singh Elevator : Elevator Instrument used in minor oral surgical procedure Its used to luxate the tooth from socket prior to the application of forceps and to expand bony socket there by aiding in tooth extraction. Uses To reflect mucoperiosteum To luxate tooth To luxate and remove tooth when forcep engagement is not possible To remove fractured or carious tooth To remove intra-radicular bone To remove fractured root Components of the Elevator : Components of the Elevator Rules for Application : Rules for Application Never use adjacent tooth as fulcrum Never use buccal or lingual plate as the fulcrum Direction of use should be correct Always use finger guards to protect the soft tissues Always apply controlled force Always elevate from the mesial side of the tooth The concave or flat surface of the elevator should face the tooth/root to be elevated Work principles of the elevator : Work principles of the elevator Lever principle Wedge principle Wheel & axel principle Lever Principle : Lever Principle Lever is a type of simple machine used to lift heavy object by exerting small amount of force. Its 3 basic component are : Fulcrum Effort Load Types of lever : First class lever Second class lever Third class lever First class lever : First class lever Fulcrum is located in between the input effort and the output load Resistance * Short Arm = Effort * Long Arm Long Arm = ¾ of total arm Short Arm = 1/4 of total arm R * ¼ = E * ¾ R = 3E MA= R/E =3 Example - Straight elevator (coupland elevator) Second class lever : Second class lever In a second class lever the input effort is located at one end of the bar. The fulcrum is located at the other end of the bar, opposite to the input, with the output load at a point between these two forces. Third class lever The input effort is higher than the output load, which is different from the first-class and second-class levers. The input effort moves through a shorter distance than the load. Wedge Principle : Wedge Principle Wedge is a simple machine & consists of two movable inclined planes which meet & form a sharp angle. R – Resistance E – Effort L – Length H - Height R Formula for wedge :- Effort * length = resistance* height E*L = R*h where L= 10 mm ; H = 4 mm M.A. = R/E = 10/4 = 2.5 E.g. : Apexo Elevator , Warwick James l E Wheel & Axle : Wheel & Axle A machine made up of two circular objects of different size. Effort applied to the wheel turns the axle or effort applied to the axle turns the wheel. Effort * radius of wheel = resistance * radius of axle E* Rw = R * ra where Rw = 42 ; ra = 9 MA = Rw/ra = 42/9 = 4.6 Example : Cross bar elevator , Cryer elevator Rw Ra Classification : Classification Straight or gouge type – Eg : Miller elevator, Pott’s elevator Triangular or Pennant type – Eg : Cryer Pick type : Eg : Crane pick type , Root pick type Straight - Coupland, London Pattern : Straight - Coupland, London Pattern Most commonly used Frequently used small straight elvator No 301 for luxation of erupted tooth Large straight Elvator used to displace roots from their socket and also to luxate teeth that are more widely spaced. Shape of blade can be angled from shank, allowing instrument to be used in the more posterior aspect of the mouth. Eg. : Miller elevator, Potts elevator Potts elevator Miller apexo elevator Straight – Coupland : London Pattern contd. : Insert perpendicular to the long axis of the tooth into interdental space after reflection of the interdental Papilla & elevator is turned in a particular way Strong, forceful turning of the handle moves the tooth in posterior direction result in expansion of alveolar bone and tearing of PDL. Useful if the patient does not have tooth posterior to the tooth being extracted. If tooth is intact and contact with table anterior and posterior to it, amount of movement achieved with straight elevator is minimum Excessive force luxation can cause damage or displace the teeth adjacent to tooth being extracted. Straight – Coupland : London Pattern contd. Triangular elevators : Triangular elevators Available in pairs - left & right Useful when a broken root remains in the tooth socket and the adjacent socket is empty Tip of the triangle /concave surface of elevator is placed into the socket with shank of the elevator resting on the buccal plate of bone. Then turned in a wheel and axle type of rotation. Commonly used elevator :- Cryer Pick type : Pick type Used to remove roots Two types a) Crane pick b) Root tip pick (apex elevator) Crane - Used as a lever to elevate broken roots from socket For this drill a hole with a bur, approx 3 mm deep into the root Tip of pick is inserted in hole with buccal plate as fulcrum Roots elevated from socket Root Tip Pick - Delicate instrument used to pick tease small root tips from their socket. Straight Elevator (Coupland Pattern) : Straight Elevator (Coupland Pattern) To retract gingiva Loosening of soft tissue attachment from teeth Eg : Howarth’s periosteal Elevator, Molt Periosteal Elevator Molt Periosteal Elevator Howarth’s Periosteal Elevator Periosteal Elevator Concave surface on one side Concave side faces tooth to be elevated Based on LEVER principle Slide 17: Pennant shaped elevator Working tip angulated with one convex and another flat surface Flat surface working side Available in pairs Based on Lever & Wedge principle. available in pairs Cryer’s Elevator Apexo Elevator Biangulated and sharp, straight working tips In pairs Based on LEVER & WEDGE principle Used to remove maxillary root stumps Slide 18: Shank at 90 degree to handle & working tip at an angle to shank Blade has convex and flat Surface In pairs Based on Wheel & Axle principle To luxate md. molars Winter’s Elevator (Cross Bar) Pick Type Elevator To remove roots & to elevate broken roots Based on Lever principle Warwick Elevator Straight Curved Slide 19: PICK TYPE To remove roots , to elevate broken roots Based on LEVER principle WARWICK JAMES Slide 20: Fracture of maxilla and mandible Fracture of alveolar bone Push tooth into sinus Push tooth in spaces Trauma to soft tissues Trauma to blood vessels Luxation of adjacent tooth Dangers associated with Elevators Slide 21: Thank You

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