Bumpers - Protection for the Physics forceps made of flexible plastic.
|Medizinisches Gerät||Class I|
|Hersteller||Directa Dental Group (USA)|
|Déclaration de conformité||CE|
With Physics Forceps, you can
- Achieve atraumatic extractions in seconds, not minutes.
- Extract most teeth (except lower third molars), in generally any condition.
- Offer patients a breakthrough in the standard-of-care for exodontia
- Reduce post-operative discomfort and patient healing time
- Convert a refer-out procedure to a highly efficient in-house procedure.
- Retain more patients, and eliminate surgical extractions
- Effectively preserves the avelor ridge in preparation for immediate-load implants
- Improve patient care
- Improve patient acceptance
What is it?
The Physics Forceps® are an atraumatic extraction system that provides a simple, predictable and unconventional method of extracting teeth regardless of a practitioner’s extraction experience, or the condition of the tooth, while providing a positive patient experience.
When to use?
The Physics Forceps® are effective in most cases, including badly decayed or broken down teeth, endodontically treated teeth, fractured or fragile teeth, curved or long rooted molars and cuspids, or any tooth that would historically be challenging with conventional instrumentation. The Physics Forceps® are ideal for implantologist that wants to preserve the surrounding bone and tissue in preparation for dental implants.
How does it work?
The Physics Forceps® operate as an elevator, rather than forceps, using first-class lever mechanics. One handle is connected to a "bumper," which acts as the fulcrum, that is placed deep in the vestibule. The other handle is connected to the "beak," which is positioned most often on the lingual or palatal root of the tooth into the gingival sulcus. No aspect of the instrument grasps the crown and there is no advanced elevation needed. Once the instrument is properly placed, the handles are rotated a few degrees with only wrist movement in a slow, steady and controlled manner — no squeezing
Why it works?
The Physics Forceps® place a constant and steady load on the tooth, allowing "creep" to build, releasing hyaluronic acid, resulting in the break down of the periodontal ligaments. Studies have proven this breakdown occurs in a much faster time period than conventional methods that employ intermittent, rocking or brute strength types of forces.
Separate the gingival attachment from the tooth. All upper teeth, including molars can be extracted without any sectioning. Lowers molars occasionally need to be sectioned (lingual buccal) to insure a more predictable extraction, by significantly reducing resistance to extracting forces.
For "upper" 2nd and 3rd molars only, use a elevator to separate the distal bone (including the tuberosity) from the tooth to ensure a successful extraction.
Note: When performing lower 2nd and 3rd molars, this step does not apply.
With the handles wide open, set the beak into the depth of the lingual or palatal sulcus on solid root surface. A secure purchase point on solid root surface is critical to successfully rolling out the tooth. When necessary, create a small trench with a small flame shaped diamond burr to engage the beak more securely on solid root surface
Set the bumper perpendicular to the tooth at about the level of the mucogingival junction. Holding that position securely, Freeze & Don't Squeeze the handles.
Note 1: The greater the distance between the beak and the bumper, the greater the arc of rotation, consequently achieving vertical lift.
Note 2: When extracting lower molars, the beak is placed before the bumper.
Note 3: When dealing with molars with the posterior instruments (EZ1 or EZ2), you can also place the plastic bumper on the lingual aspect of the tooth and use the instrument the opposite maner. (see animation at the bottom of this page)
WITHOUT SQUEEZING THE HANDLES OR MOVING YOUR ARM, begin to apply a steady, very slow rotational force in the direction of the bumper. Patiently, continue to apply this steady force for 30 to 40 seconds. This force or creep will continue to build, allowing time for the periodontal ligament to release, the bone to slowly expand and the tooth to disengage.
The buccal rotation of the tooth and vertical lift is successful by rotating your wrist only. This wrist action is very similar to using a bottle opener. You will soon feel the tooth move and slightly elevate occlusally from the socket. Stop rotating at this point.
Initially, you may want to avoid unnecessary damage to the buccal plate by not proceeding with the Physics Forceps beyond the first sign of the tooth 'popping' loose. If the tooth has not elevated sufficiently to grasp it with your fingers, consider using a hemostat, rongeurs or conventional forceps to lift it out
Biochemistry Of Tooth Extractions
Thomas C. Abrahamsen, DDS, MS FACP
It is generally thought that the physical change of expanding the dental alveolar bone (socket) along with the severing of the periodontal ligament is the basis of a tooth extraction. Albeit that this does happen, an understanding of what is occurring biochemically is even more important. When the periodontal ligament is traumatized with forceps or elevators, hyaluronidase (hyaluronate glycanohydrolase) is released. This is an enzyme that catalyzes the hydrolysis of the interstitial barrier, hyaluronan (hyaluronic acid), which is the cement substance (extracellular matrix) of all human tissue. Once this chemical breakdown of the periodontal ligament by hyaluronidase is sufficient, the tooth is released from its attachment to the alveolus and can be removed.
This explains why the PHYSICS FORCEPS, with its steady unrelenting trauma to the periodontal ligament, quantitatively creates a greater release of hyaluronidase in a shorter period of time than traditional forceps or elevators extractions because the trauma from those techniques is intermittent. Hence the use of PHYSICS FORCEPS is more efficient, faster and less traumatic to the alveolar bone.
Reference: Frasher,J. R. E et al; Laurent, T.C. ; Laurent, U.B.G. (1997) "Hyaluronan: its nature, distribution, functions and turnover", Journal of Internal Medicine 242: 27-33
Curieux d'essayer cette nouvelle instrumentation proposée par la société WAM, j'ai donc pu la tester cliniquement depuis plusieurs mois. Les considérant initialement comme des instruments complémentaires, les "Physics Forceps" se sont avérés rapidement indispensables et à utiliser en première intention. En améliorant sensiblement le principe de l'ancienne Clé de Garangeot, ils permettent l'avulsion grâce à une vestibulo-version en porte-à-faux et point d'appui vestibulaire dont l'efficacité est surprenante. Nous assistons aujourd'hui à une révolution du geste le plus ancien de l'odontologie. Utilisable chez l'adulte ou chez l'enfant, ils abaissent considérablement le niveau de l'extractraction dite « difficile ». Il est fondamental de suivre scrupuleusement le protocole proposé afin que la rupture du ligament aboutisse à une extraction atraumatique en accord avec les principes actuels, surtout dans le cadre d'une implantation immédiate. Essayé et adopté. »
Dr Magneville (Marseille)
L'information Dentaire n°40, Novembre 2012
An Efficient Approach to Full-Mouth Extractions
"Having a technique of extracting teeth with less risk of complications is a more desired approach for many practitioners. This article will describe the processes involved from diagnosis and treatment planning to full-mouth extractions and restoration[...]"
DDS Ara Nazarian
pp2-6 Oral Surgery - DENTISTRYTODAY - august 2011
Atraumatic Extractions : A biomechanical rationale
"Over the last decade there has been an increased interest in atraumatic tooth extractions in order to maintain bone for implant insertion. Recently, an atraumatic extractor was developed that primarily uses the biomechanical advantages of a first-class lever, creep, and stress distribution. The purpose of this article is to review the biomechanics of a periotome, an elevator, and extraction forceps (Figure 1). Those methods will be compared to the biomechanical principles used in the atraumatic extraction of teeth utilizing a new forceps design."
Dr Misch & Dr Perez -
Drs. Misch and Perez are consultants for Physics Forceps. They are not paid any royalties or reimbursements for any products or sales.
Oral Surgery - DENTISTRYTODAY - august 2008
Clinical Case from Dr Kosinski T. (USA)
Clinical case from Dr Benhamou (Aix en Provence)
5 clinical cases (with french comment)
Clinical case with molar forceps (french comment)
Clinical case from Dr Magneville (Marseille)
How do the Physics Forceps® differ from the conventional forceps?
Regular extraction forceps' beaks are adapted to the buccal and lingual contours of the tooth. Rotational and tractional movements are used (squeezing, pulling, grabbing). Current Instruments require two equal forces placed on the crown of the tooth, and a third force to extract the tooth with your arm. If the crown is missing or the tooth is decayed you need to lay a flap, cut the bone, and perform surgery to remove the tooth. This is time consuming, painful, and traumatic for the patient.
The Physics Forceps® requires no squeezing, pulling, or grabbing. Instead, once in position the handles are rotated toward the facial aspect of the tooth. The Physics Forceps® require two opposing forces. The first force is placed into the lingual sulcus of the tooth below the gingival with the beak. The second force is placed on the alveolar ridge with the bumper. Therefore there is only one point of contact on the tooth with the Physics Forceps. These two opposing forces cancel the need for a third force. If the crown is missing or the tooth is decayed there is no need to lay a flap because these same principles apply.
Where are the instruments made?
The Physics Forceps® Instruments are made of Premium 410 German Stainless Steel Forgings and final production takes place in Germany.
How many instruments are there?
Standard Set- includes an upper anterior, upper right, upper left and a lower universal.
Posterior Set-includes 2 forceps (EZ1 and EZ2)
Pedodontic Set- same as the standard set but 30% smaller
Is elevating required with the Physics Forceps®?
No elevation is required. Although in some cases you may want to separate the gingival attachment from the tooth.
Do the Physics Forceps® fracture the buccal bone?
If used properly the Physics Forceps® will rarely cause fracture. When a rotating force is applied, the stress to the tooth and periodontal complex is increased. The force applied to the gums and bone by the bumper of the Physics Forceps® is a compressive force that braces the buccal bone. If you think there is a slight possibility we suggest taking a flame shaped diamond bur to remove buccal tooth structure a mm or two apically.
Do you need to reflect a flap with these instruments?
No. The Physics Forceps® virtually eliminates the need for surgical flaps.
Does the Physics Forceps® work on teeth that have divergent roots?
Yes, sectioning is advised only on lower molars when roots appear to be divergent.
Does the use of the disposable rubber bumper diminish soft tissue trauma, bruising, and post-op discomfort?
Yes, the rubber bumpers significantly reduce bruising to the mucosa, supporting immediate implant placement procedures.
Do the Physics Forceps® work on endodontically treated teeth?
Yes, extraction of endodontically treated teeth requires a greater distance between the bumper and beak, and requires a good purchase point. While extracting these teeth one must go exceptionally slow (suggested extra 15 to 20-seconds, or more).
Do the instruments work on teeth that have been decayed at the gumline?
Yes. When necessary, create a small trench on the lingual, with a small flame shaped diamond burr to engage the beak more securely on solid root surface.
Do you deliver the tooth right away with the Physics Forceps?
The Physics Forceps is designed to disengage the tooth. Deliverly is entirely up to the ability of the doctor. We recommend using what ever the doctor is most comfortable with, for instance, a rongeur, hemostat, etc after the disengagement has occured with the Physics Forceps.
How much horizontal movement does there have to be to get the needed verticla movement that releases the ligament?
Minimal, and the method to achieve this is to make sure that the bumper is seated well apically in order to achieve the arc of rotation.
Which teeth are contraindictated for using these forceps? Difficult root anatomy?
Curved roots, bulbous roots, or flared roots on a multi-rooted tooth? None
Teeth in esthetics zone of discriminating patients? None
Teeth where you want immediate implant placement? None
None, (except for impacted teeth) again with operator knowledge of how to handle different situations, any erupted tooth including crown facturs are canidates