Luxator LX

Luxator surgical instruments - setting a new standard?

As a general dental practitioner one also performs teeth extractions on daily basis, since they are an integrated part of everyday general dentistry. However, we refer more complex cases to a specialist, an oral surgeon. Many dentists prefer to perform the majority of extractions by themselves. It is in both in dentist’s and patients’ best interest to preserve as much tissue as possible. In order to reach that goal, we now a modern dental extraction tool Luxator LX at our disposal.
The extraction, however, has to fulfil certain demands:
First of all it has to be painless, what we ensure with an adequate anaesthesia. An extraction has to be done quickly as possible and in a reasonable time. A modern demand is that a proper extraction should have a minimal biological cost, which means that it should preserve or at least not damage too much of the adjacent tissues, such as gingiva and even more importantly, the bone. A well preserved bone is of great importance to the field of implantology, where in order to avoid possibly unnecessary bone grafts and artificial bone augmentations, one must consider preserving the bone while extracting the natural tooth.

Moreover, preservation of the bone is of paramount importance regardless of what should follow the extraction. It cannot be stressed enough how crucial it is to have a preserved alveolar ridge to retain and stabilize a total or partial removable denture, or even achieve a favourable osseointegration of the implants, especially if implantation follows extractions in the same session.

To keep biological cost as low as possible one might find the Luxator surgical instruments more than helpful. The Swedish company Directa AB has been manufacturing Luxator manual instruments, such as Luxator forte lifters and Luxator periotomes for many years. Just recently the Luxator family released a new instrument, Luxator LX, which is a mechanical hand piece with different Luxator coated tips. The latest was presented at IDS 2013.

This far I have carried out a couple of procedures with the help of Luxator LX and it has to be indicated that this instrument is meant to be used in combination with other Luxator family instruments.

Here is the short summary of a typical extraction with Luxator LX.

1. A careful examination of the case is made, patient’s history is taken and the x-ray is assessed.
2. Local anaesthesia is applied.
3. The patient is explained what he or she should expect during the procedure.
4. Luxator LX is used up to the point of resistance with medium speed all around the circumference of the tooth to cut the periodontal fibres.
5. Luxator Forte instruments are used to loosen the tooth a bit more.
6. If the tooth crown is preserved, appropriate forceps are used, mainly for vertical lift of the tooth. If only a root remained special pincers RootPicker are used.
7. If needed, a proper excochleation and socket cleaning is performed.
8. Tamponade with gauze or equine collagen plug is inserted.
9. A follow up made in one week’s time.

Since the tips of Luxator LX are angulated at 90 degrees, one has a much better access to the teeth in the posterior region and can therefore more efficiently cut the periodontal fibres located between the alveolar bone and root surface. Furthermore, the vertical movement of the cutting tip is very limited, what ensures a very safe and controlled use even in very slippery environment.

Some of my patients reported a slight discomfort during cutting with Luxator LX. For this reason one might suggest the patients are explained what they should expect prior to the procedure. According to my experience the handling of Luxator LX is easy, the tip, however, sometimes does not follow the shape of the tooth so the direction of the tip needs to be modified manually. That is why one should always use sterile gloves, which come handy also while inserting the tip into the hand piece head before the procedure. This is how we can maintain the sterility of the cutting tip. In the future development of Luxator LX the incorporation of intralight into the hand piece would be much appreciated.

The outcome of the extractions I performed was very favourable since the wounds were clean, sharply cut and with little or no tissue damage. All of these advantages lead to quicker healing times and better bone preservation. I challenge and propose to the scientific community to carry out scientific trials, comparing extractions with traditional instruments to the ones using the mechanical Luxator LX instrument. Through research we have the possibility to confirm our ambitions – to set a new standard during every extraction and to reach our common goal of preserving as much tissue as possible. For this reason I propose the potential term of “biological extraction” to be used if our claims are to be scientifically confirmed.

If “biological extraction” is scientifically recognized, it is our duty to introduce Luxator LX instruments into everyday dentistry, and thus set a new standard of modern general dental practitioners, which would certainly also be recognized by our patients who expect service in our dental surgeries.