Artikel angående "Hävel enligt Bo Ericson" - endast engelska
Published in The Swedish dental journal
No 15-16 1984
Extraction by means of an elevator
by Dr. Bo Ericson
Dr Bo Ericson has been in private practice dentistry in Hedemora, Sweden since 1973.
Dr. Ericson is a graduate of UMEA University where he later served as assistant professor of the Gathology Department. He has also worked at a specialised national clinic for periodontology.
These are the goals for a set of dental elevators - which I have developed during my work as a dentist.
a quick and effective treatment
minimal pain and discomfort for the patient
significant savings for all concerned - the patient, the dentist and the community
At the swedish dental congress in Stockholm recently I had the opportunity of demonstrating the instruments and the method of application, and I was pleased at the very positive response.
The history of my innovation goes back as far as 1974, when I read an interesting article in the Swedish dental journal. The author was a colleague, Leonard Krekmanov, who described a technique for the extraction of teeth by means of elevators using a wedge effect. We are all aware how frequently problems and complications arise with the use of elevators for removal of teeth, because elevators such as the Bremer and Hylin types are used for leverage , that is, as a kind of crow-bar, with very uncertain results. How many roots have we fractured in our assiduous attempts to remove teeth? How many buccal plates of bones have we fractured? How many fillings and crowns with inadequate posts have we destroyed? I can answer only from my own experience, but I know that there have been far to many.
We all know what happens in a dental practice when we have problems with an extraction. We are soon running 30 minutes late, start glancing nervously at the clock, knowing that the waiting room is filling up. The wretched root we are to remove is lying loose in it's socket, we can move it freely to fro, but we cannot grasp it. In sheer desperation we place an H6-file in the canal and twist as hard as we can. We grasp the handle of the file and start to pull. Then the file gives away, and as it leaves the mouth at a furious speed causes a nasty tear to the corner of the patient's mouth. With a sigh we adjourn the day's exercises and decide - at last - to bring the patient back in a week's time for surgical removal. Seven days later we perform our surgery, remover the root and suture the wound. We make an appointment for suture removal the following week, but that appointment is soon a matter of history. On the third day of after our operation the patient telephones to complain of pain and an unpleasant taste in the mouth. Diagnosis: dry socket. We are now forced into five further appointments for irrigation and sedative dressings. The whole procedure has shaken our faith in ourselves, and we note yet again how often such problems occur in daily practice. And all because we don't have suitable instruments to allow the technique so well described by Leonard Krekmanov in his article in 1974.
During 1975, therefore, I began to reshape my elevators myself. I wanted them so fine that I could force them down into the periodontal space, widen this, and thus “luxate" the tooth so that I could then simply lift it out. I soon found, however, that the quality of steel in the elevators available did not satisfy the need of such precision instruments. We were, therefore, forced to begin our search for steel of a quality which would meet our demands. After six years of detective work, and finally with the help of metallurgists at Sandvik steel, we found our super steel - a though but hard steel which we have been able to grind to a very thin blade. After clinical testing of the material for 18 months - which implies extraction of 200 teeth without reshaping the elevator blade - we have had four types of elevators constructed. The plastic tolerates autoclaving and even hot air sterilising. The blades are respectively 3 and 5mm wide. There is a straight and a curved model in each width.
From our own experiences we can verify that the new luxators have made this routine procedure in dentistry both simpler and more undramatic. We now have well-adapted and clinically tested precision-surgical instruments which allows a widening of the periodontal space and thus quickly and simple achieves our goal: and extraction which for the patient is undramatic and fast.