By Dr. Michael Liebler, D.D.S.

If there is sufficient bone available, the placement of implants is a relatively simple and straightforward surgical procedure of modern dentistry. However, if there is massive loss of bone due to periapical or periodontal pathosis, implants can only be placed with bone augmentation. The augmentation can be done prior to implantation or simultaneously.

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. Careful removal of the tooth from the alveolar socket however will leave the bony walls intact (Fig.1). Even without augmentation materials (e.g. beta tricalcium phosphate) there will be good wound healing resulting in good bone height and width about at the level of the alveolar ridge. Directa Luxators are ideal instruments for such a careful tooth removal.

luxator-diagramThe action of the Luxator 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 (Fig.2, 3). The shape of its blade allows the instrument to be advanced to the apical third of the root (Fig.4). This is not a forceful movement and 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.

Luxator instruments come in wide variety of shapes (e.g. contrangle, inverted curved, different size blades) so it is always possible to work parallel to the long axis of the root. One can even expand the bone
from the distal of the root.

Even though Luxator instruments look a lot like classical elevators, the mode of action of these two instruments have nothing in common (Fig.6). Luxator instruments are much more delicate than any elevator. You should not use the Luxator as an elevator because this may cause the instrument to bend. Directa has recently introduced a special Luxator for extraction purposes only called “Luxator Forte”.

Luxators have large and ergonomically formed plastic handles that help make the instrument comfortable and efficient to use.

Your patients will be thankful for the atraumatic extraction even if you don’t place an implant at a later time. They will experience less discomfort operatively and postopertively. u

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