Understanding Periodontal Elevators: Types, Uses and Importance in Therapy

Understanding Periodontal Elevators

Periodontal elevators are specialized dental instruments used by dentists and dental hygienists during periodontal surgery and root scaling procedures. They assist in effectively accessing and elevating tissue, tooth roots, and bone to facilitate debridement and examination. Let's explore what periodontal elevators are, the types available, and how they are used in periodontal therapy.

What are Periodontal Elevators?

Periodontal elevators, also known as perio elevators, are small hand instruments shaped like chisels or hoes. They are manufactured from high-grade stainless steel for durability and feature thin, beveled, double-ended blades with handles. The working ends are uniquely designed for conservative elevation and separation of gingiva, periodontal flap, tooth roots, and alveolar bone during surgery.

These specialized dental tools help dentists gain access and visibility to subgingival tooth surfaces, roots, and surrounding tissues. They can delicately elevate tissue and disrupt fibrous attachments around teeth, assisting with debridement, examination, and procedures. Periodontal elevators are available in various sizes and tip designs to suit different needs.

Types of Periodontal Elevators

There are many varieties of perio elevators, with the most common types being:

• Periosteal elevators - For elevation of mucoperiosteal flaps and periosteum.
• Molt periosteal elevators - Featuring broader blades for flap elevation.
• Tissue elevators - For collar elevation and interproximal tissue work.
• Apical elevators - For finer elevation and accessing apical areas.
• Coupland elevators - For incremental elevation and fracturing procedures.

The blades may be curved, straight, or angled, with some featuring round edges to minimize tissue trauma. Mini periodontal elevators are also available for finer manipulation in tight areas.

Uses of Periodontal Elevators

Periodontal elevators serve multiple important uses during common procedures like:

• Periodontal flap surgery - Elevating gingival tissue and periosteum to access roots and alveolar bone.
• Crown lengthening - Gently lifting gum tissue away from teeth.
• Operculectomy - Removing inflamed operculum tissue.
• Osseous surgery - Incrementally fracturing and elevating bone.
• Root planing and scaling - Adjunct for root and subgingival debridement.
• Tooth extractions - Elevating teeth, bone and surrounding tissue.
• Implant site development - Lifting soft tissue from underlying bone.
• Biopsies - Safely obtaining tissue samples.
• Sinus lifts - Cautious elevation of schneiderian membrane from sinus cavity.
• Guided tissue regeneration - Placing and securing regenerative membranes.

Proper Use of Periodontal Elevators

Good instrumentation skills are required to properly utilize periodontal elevators. Dentists should adhere to some core principles and techniques for safe, effective use:

• Carefully select the most appropriate elevator size and design.
• Establish a firm finger rest position on adjacent teeth.
• Insert the blade interproximally, engaging just the periosteum initially.
• Apply light, controlled strokes to elevate tissue incrementally.
• Support and protect flap using finger, mirror or retractor.
• Use mini elevators in restricted areas.
• Keep blade parallel against bone to minimize trauma.
• Avoid excessive, forceful leverage motions.
• Take great care around thin bony plates and anatomical structures.
• Utilize copious irrigation to maintain visibility.

With careful, controlled use, periodontal elevators allow dentists to gently separate and lift tissues. This provides the access and visibility needed for procedures, while minimizing collateral trauma and damage to important anatomical structures. Ongoing practice is key to developing proficiency with these specialized instrumentation tools.

Maintaining Periodontal Elevators

Like all dental instruments, proper care and maintenance of periodontal elevators is vital for longevity, functionality and infection control:

• Rinse elevators after each use to remove debris.
• Clean thoroughly with brush, ultrasound or autoclave as per manufacturer guidelines.
• Inspect for damage and defects before sterilization.
• Lubricate joints periodically with recommended lubricants.
• Store in a secure, organized manner to prevent damage.
• Replace worn elevators - do not use dull, compromised instruments.
• Adhere to all sterilization standards and protocols.

Well-maintained elevators with sharp, undamaged blades will perform reliably during procedures. Diligent instrument care procedures also prevent cross-contamination between patients and staff.

The Role of Periodontal Elevators in Periodontal Therapy

Periodontal elevators play an integral role during many common periodontal procedures. Their specialized designs allow conservative elevation of flaps, tissues, roots and bone to facilitate access, debridement, examination and surgery.

In the hands of a skilled clinician, these precise instruments enable procedures to be performed more efficiently and with reduced trauma. Periodontal elevators serve an important function in periodontal therapy by supporting thorough debridement and surgery to help restore periodontal health.

With proper use and care, periodontal elevators serve as invaluable additions to the periodontal armamentarium. Their unique ability to gently elevate various structures expands treatment possibilities and improves outcomes.

FAQs

What are periodontal elevators used for?

Periodontal elevators are used during dental procedures to gently lift and separate tissue, tooth roots, and bone. This allows for access and visibility to perform tasks like debridement, biopsy, crown lengthening, implants, and more.

What precautions should be taken when using perio elevators?

Use controlled, light pressure, keep the blade parallel to bone, support tissue with fingers/tools, use copious irrigation, select the right size and type, and avoid excessive force. Take great care around thin bone and anatomical structures.

What are some types of periodontal elevators?

Common varieties include periosteal, Molt, tissue, apical, and Coupland elevators. They come in different sizes with unique blade designs for different needs and treatment sites.

How should you maintain periodontal elevators?

Rinse after use, sterilize properly, inspect for defects, lubricate joints, store carefully to prevent damage, replace worn instruments, and adhere to all infection control protocols.

Why are periodontal elevators important?

Periodontal elevators allow procedures to be performed more efficiently and with less trauma. They enable gentle tissue manipulation and access to facilitate therapy. Proper use helps improve outcomes and periodontal health.