Choosing the right dental elevator for your dental practice is key to minimizing trauma, easing workflows, reducing fatigue and making extractions efficient. However, with so many designs and functions, selecting the best-suited instruments for your practice can be challenging.
Learn about different dental elevators in dental procedures, their role in tooth extraction, maintenance considerations and picking the right options.
Elevator Types and Categories
Dental elevators are categorized by the shape of their shafts and blades. The main types include:
Straight: Straight dental elevators have a slender shaft and a flat, slightly curved tip. The blade runs in line with the handle, giving the user a direct, intuitive feel. Clinicians use them to break the periodontal ligament and create space before introducing forceps in dental extractions.
Pick: Pick elevators are used for root retrieval. Their fine, pointed end allows them to engage tiny fragments in the socket. Pick elevators are ideal for maxillary molars and where roots have fractured during extraction. These instruments are valuable in preserving the surrounding bone and minimizing trauma.
Triangular: Triangular elevators, also known as East-West elevators, lift root fragments. They have a triangular blade at a right angle to the shank, allowing access between the roots. They come in left and right pairs and are useful in mandibular molars.
Types of Dental Elevators and Uses
Within the broader category of elevators, specific instrument types offer more tailored functionality. Below are common dental elevator types and uses.
Chisel
Chisel elevators have a bent tip and can split or separate the periodontal ligament from the root surface. They’re used in both anterior and posterior teeth and are ideal for loosening roots before applying extraction forceps.
Models like 77 and 77R Chisel elevators are commonly used and available in forward or backward-bend options. These instruments rely on careful wedging, making them helpful for preserving surrounding structures.
Cryer
Cryer elevators remove broken or retained roots. Their sharp, angular design fits into interradicular spaces and rotates the root out using the wheel-and-axle technique. Available in left and right versions, they’re used after a tooth has been sectioned or fractured, allowing clinicians to lift each root.
Spade
Spade elevators have a broad blade that leads to a point for accessing the periodontal ligament space. Instruments like the forward and backward bend spade allow for controlled movement. Dentists can use them for maxillary and mandibular teeth. The gentle wedging capabilities make it ideal for preserving the bone around the tooth.
Root Tip Picks
Root tip picks retrieve root fragments where the rest of the tooth is already extracted or missing. These tools have narrow, sharp tips ideal for maxillary molars and posterior regions.
Common models include the 79/80 and Heidbrink 2/3, each offering variations in tip width.
Apical and Apexo
Apical and Apexo elevators help remove teeth by working at the apex of a tooth. They have narrow blades that taper to a fine point or straight tips, making them ideal for use in all parts of the mouth. Some variations include cross-bar handles for greater leverage.
Instruments like the 73 and 74 Miller Apexo allow for different entry angles. Practitioners can use them to preserve bone and soft tissue.
Gouge
Gouge elevators have a straight, curved, spade-like or rounded tip design. Their shape is effective in posterior regions or when working around third molars. Most of these instruments focus on narrow, curved surfaces, so they require precision and a steady, measured approach.
Seldin
Seldin elevators have a straight or fine-tapered design. They minimize the risk of bone fracture during elevation and allow for soft tissue retraction. They are ideal for the upper and lower molar roots.
Some variations, like the 1L and 1R Seldin Cryer pair, combine the lifting strength of a Cryer with the contours of a Seldin.
Heidbrink
Heidbrink elevators have a narrow, tapered blade that can access sockets without causing trauma to the surrounding bone. They are ideal for the upper and lower anterior.
Different from Heidbrink root tip picks, the Heidbrink elevators come in straight tip designs with grooved working ends to fit more efficiently around the tooth structure.
How Dental Elevators Work in Tooth Extraction
When used well, dental elevators create a safer, more efficient extraction process that preserves tissue and minimizes trauma.
Here’s how these instruments work.
Principles and Techniques
Elevators function by applying pressure to break the periodontal ligament and gently dislodge the tooth or root from the socket. Clinicians choose each technique based on the tooth’s location, root anatomy and the condition of the surrounding structures.
Here are the principles and techniques used in tooth extraction:
Leverage: The clinician inserts the blade between the root and the socket wall and applies force perpendicular to the tooth’s long axis while the surrounding tooth acts as a fulcrum.
Wedge principle: Practitioners wedge the blade into the periodontal space, which creates a split between the root and bone. This separation helps loosen the tooth.
Wheel and axle motion: The handle serves as the axle while the blade, engaged in the socket, acts as the wheel. Rotating the handle lifts the root segment out. Cryer elevators rely on this principle.
Safe Handling and Best Practices
Elevators deliver mechanical force. Without proper control, they can lead to complications. Practices to ensure safe and effective use include the following:
Avoid overuse: If an elevator isn’t progressing, consider switching to a different instrument with better angulation or a finer tip.
Use a secure grip: Depending on the instrument, hold the elevator with a palm grip or modified pen grasp to improve control.
Direct force thoughtfully: Apply pressure gradually and in the correct direction to avoid damaging the socket.
Establish a clear fulcrum point: For mechanical advantage, always rest the instrument’s shaft or handle against a stable bony surface NOT on the adjacent tooth.
Dental Elevators vs. Luxating Elevators
While they may look similar, there are differences between dental elevators and luxating elevators.
Dental elevators lift the tooth out of the socket once it has been loosened. They break down ligaments with a combination of apical pressure and leverage and may be used in tandem with luxating elevators to expand the alveolar socket for clean extraction.
Luxating elevators cut through the periodontal ligament. Clinicians use them before extraction to loosen the tooth.
Explore how these instruments differ in design:
Handle options: Both elevators are offered in the standard stainless steel handle with an ergonomic thumb-rest, but luxating elevators have the options of the short and silicon handles, which help in precision-based operations.
Blade thickness: Dental elevators are thicker and robust. Their blades apply leverage and deliver controlled force, which is useful in loosening for lifting teeth and root fragments. Luxating elevators have thinner, sharper blades. They slide into the periodontal ligament space to separate the tooth from its socket with minimal trauma.
Clinicians can use a dental elevator when:
They need to apply leverage to loosen a tooth before using forceps.
The tooth is broken or sectioned and needs elevation.
Roots are retained and require controlled elevation from the socket.
Luxating elevators work well for finesse. Use this type of elevator when:
You are working in crowded anteriors.
The tooth is fragile, and you want to avoid applying too much pressure.
Working with patients with thinner bone.
Benefits of Using Dental Elevators
Dental elevators can make the extraction experience smoother, faster and less traumatic for the patient and clinicians. Here are the perks of using them in your procedures:
Reduces force: Elevators reduce the amount of force you need to apply with forceps. These instruments let you extract teeth with less resistance, leading to patient comfort.
Expands socket access: Elevators expand the alveolar socket, creating a larger exit path for the tooth and reducing the need for more invasive procedures.
Lowers the risk of root or crown fracture: By pre-loosening the periodontal ligament, elevators reduce the likelihood of snapping the root tip or cracking the crown when using forceps.
Reduces postoperative pain: When used correctly, elevators can minimize bleeding, swelling and postoperative pain, helping speed up recovery.
Considerations When Using Dental Elevators
Like any dental tool, elevators carry risks. Here are some limitations to be aware of for responsible use:
Blade fracture: Elevator tips can fracture when used with excessive force or for the wrong application. Avoid using delicate picks for leveraging, and opt for sturdier blades when dealing with dense bones or stubborn roots.
Damage to surrounding tissue: The instrument can cause trauma to adjacent teeth, soft tissues or the sinus floor in upper posterior regions when used incorrectly. Always control the fulcrum point. Use a finger rest, stabilize your hand and apply steady pressure.
Potential for complications: Over-rotation when using the wheel and axle principle can displace the wrong structure or cause complications. Use this technique under supervision.
Risk of alveolar bone fracture: Using too much force can fracture the alveolar bone. Select elevators with appropriate tip width and angulation.
Commonly Used Dental Elevators
Dental professionals have personal preferences for elevator selection, and a few models stand out for their utility and performance.
Forward and backward bend spade: Forward and backward bend spade elevators provide access for reaching posterior areas that are difficult to approach with straight instruments.
Factors Influencing Choice
Selecting the right dental elevator is based on multiple variables. Some of these include:
Type of extraction: Simple extractions with minimal trauma may involve finer tools that gently loosen the periodontal ligament. Surgical extractions may require a full range of tools.
Tooth type and location: Anterior teeth require fine, more controlled elevators, such as small apical elevators. Molars may require stronger instruments, such as Cryer or East-West pairs, to effectively section and elevate roots. The maxilla has a softer, more porous bone that allows for easier elevations, while the mandible has a dense structure that requires instruments with greater leverage.
Radiographic appearance: Bone density influences how much pressure is required and which tools are safe during extraction. The presence or absence of periodontal disease informs whether conservative elevation is possible or if surgical instrumentation is required.
Practitioner’s experience and preference: Some practitioners favor a progression from fine to robust tools. Others rely on familiar elevator designs they’ve mastered. Personal comfort guides what feels safer and most effective in the clinician’s hands.
How to Choose the Right Dental Elevator for Your Practice
Choosing the right elevator entails understanding your operations and the extraction types you perform. Here’s how to make choices based on your needs.
Considerations for Dentists, Students and Assistants
Dental elevator needs vary depending on your career phase and hands-on experience with certain surgical tools. Here are practical considerations professionals should weigh:
Safety: Elevator tips should be strong enough to resist flex or fracture but thin enough to access tight spaces without damaging adjacent structures. A well-designed blade makes extractions less invasive.
Budget: Choose quality over quantity. Start with a versatile core set and expand strategically.
Ergonomics: Look for elevators with nonslip, contoured handles and balanced weight. For new users, lighter instruments can provide better control, while seasoned professionals may prefer more heft for additional leverage.
Supplier support: Partner with suppliers who offer warranties, customer service and accessible reordering or re-sharpening options.
5 Tips From ProDentUSA Experts
ProDentUSA produces high-quality, surgeon-approved elevators and surgical tools. If you’re in the market for your next set, here are five expert tips to get you started:
Pick core models: Start with a few essentials, such as the Apical, Chisel and Spade sets. They cover general and surgical needs.
Select the right design: Try different handle styles and pay attention to grip. The right tool should feel comfortable in the hand.
Choose durable materials: Pick instruments made with reliable, long-lasting stainless steel to reduce the risk of breakage, premature dulling and surgical complications.
Match the blade to the tooth: For tight posteriors, use a backward-bending spade. For narrow anterior roots, a more narrow apical style offers better access and control.
Seek support: If you’re unsure which model is best, our team can help match instruments to your needs and budget.
Best Practices for Caring for Dental Elevators
Caring for dental elevators helps ensure long-term performance and safety. Explore four proper care and upkeep techniques below.
1. Cleaning
Rinse elevators under distilled water immediately after use to remove blood, debris and tissue. Soak the instruments in a neutral disinfectant for 10 to 15 minutes, then rinse again. Scrub gently with a stiff nylon brush to prevent damaging the blade surface and clean serrated areas. After scrubbing, rinse well using distilled water and dry thoroughly.
2. Sterilization
Dry instruments completely before sterilization. Pack elevators in sterilization pouches with steam indicators. Avoid overloading or stacking instruments. Ensure the tips are also not in contact with other instruments.
Autoclaving is the best way to sterilize tools, but not all tools are suited for the technique. Always follow the manufacturer’s instructions for cycle temperature, pressures and drying.
3. Storage
Here’s how to properly store your instruments:
Store instruments in a clean, dry cabinet or drawer.
Use cassettes or trays that hold instruments securely and prevent metal-on-metal contact.
Avoid environments with high humidity or temperature swings to prevent corrosion.
Never store damp or warm instruments inside closed containers.
Label and organize tools clearly for proper handling.
4. Longevity and Performance
Longevity depends on how elevators are cleaned, used and maintained. Here’s how to protect the performance of your tools:
Ensure proper drying: Dry instruments thoroughly using lint-free cloths and allow them to cool.
Seek professional servicing: Schedule regular assessments before performance declines. Some manufacturers provide professional services to restore blade function.
Conduct regular inspections: Check for signs of damage and avoid reusing compromised tools.
Wear personal protective equipment: Wear gloves, eye shields and gowns during handling, cleaning and sterilization.
Explore ProDentUSA’s Dental Elevators
ProDentUSA offers different types of dental elevators. We manufacture instruments from quality Surgical Stainless steel and back each one with our ProDent Promise — designed to last, guaranteed to satisfy. If your elevator fails within the first year, we’ll replace it.
Our team offers free standard domestic shipping on orders over $100 or a flat rate for supply orders. Browse our collection today.
