INSTRUMENTS FOR ELEVATING MUCOPERIOSTEUM
After an incision through mucoperiosteum has been made the mucosa and periosteum should be reflected from the underlying bone in a single layer with a periosteal elevator.
The instrument that is most commonly used is the no. 9 Molt periosteal elevator (Fig. 6-5, A), This instrument has a sharp, pointed end and a broader flat end. The pointed end is used to reflect dental papillae from between teeth, and the broad end is used for elevating the tissue from the bone.Some surgeons prefer to use round-ended Molt periosteal elevators. This type of periosteal elevator can be single-ended (Fig. 6-5, m or double-ended (Fig. 6-5, C and D). The cutting edge of the Molt periosteal elevator is thin and sharp, resulting in a clean separation of the periosteum from the bone.
The periosteal elevator can be used to reflect soft tissue by three methods First, the pointed end can be used in a prying motion to elevate soft tissue. This is most commonly used when elevating a dental papilla. from between teeth. The second method is the push stroke, in which the broad end of the instrument is slid underneath the flap, separating the periosteum from the underlying bone. This is the most efficient stroke and results in the cleanest reflection of the periosteum. The third method is a pull, or scrape, stroke. This is occasionally usefull in some areas but tends to shred or tear the periosteum unless it is done carefully.
The periosteal elevator can also be used as a retractor.Once the periosteum has been elevated, the broad blade of the periosteal elevator is pressed against the bone, with the mucoperiosteal flap elevated into its reflected position.
When teeth are to be extracted, the soft tissue attachment around the tooth must be released from the tooth.The instrument most commonly used for this is the no.1 Woodson periosteal elevator (Fig., 6-6). This instrument is relatively small and delicate and can be used to loosen the soft tissue via the gingival sulcus. The pointed end of the no. 9 periosteal elevator can also be used for this purpose.