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Tooth extraction, once a traumatic and painful procedure, has been revolutionized with the advent of atraumatic methods. Extractions were once mechanical force-based involving the use of conventional forceps and elevators at the expense of alveolar bone loss, gingival trauma, and long recovery.
Atraumatic forceps — particularly physics forceps — are a major step ahead, with the aim of reducing trauma but increasing operator control, efficiency, and patient benefit. From general practice to implant practice to oral and maxillofacial surgery, they are becoming the norm in practices committed to tissue conserving and minimalist treatment.
Atraumatic forceps are one of the surgical instruments for controlled, gentle tooth extraction with minimal tissue trauma.
•tap into rotation or controlled leverage rather than conventional pulling or pressing.
•Use constant pressure to lift the tooth with minimal force.
•Tip to maintain buccal bone plate, periodontal ligament, and soft tissue.
•Special application in implantology, orthodontic extraction, and pediatric dentistry.
One of the most common designs in the atraumatic forceps category is the Physics Forceps on biomechanical principles.
•Beak: Engages with the tooth below the cementoenamel junction (CEJ).
•Bumper or Countertraction Pad: Sits on the alveolar ridge or nearby bone to serve as a fulcrum.
•Handle: Assists in one-way rotation slowly instead of squeezing or jerking.
•Function as a class I lever (fulcrum at one end).
•Gradually break down the periodontal ligament fibers.
•Apply constant tension in order to enable passive elevation of the tooth over time.
• There is no twisting or force required.
• Reduces risk of root fracture.
• Prevents damage to the alveolar bone, which is required for preserving the implant site.
Even though the Physics Forceps are the tool of choice, there are several atraumatic designs that have been adapted to fulfill individual dental requirements:
• Physics Forceps (Beak and Bumper model)
• Periotome-Assisted Extraction Systems
• Luxator-Type Atraumatic Forceps
• Pediatric Atraumatic Forceps
• Hybrid Atraumatic Elevators-Forceps instruments
All of them receive varying tooth morphology and anatomical constraints.
Atraumatic forceps find extensive usage in various dental and surgical disciplines:
• Dental Implantology: Preserves the bone to aid success of implant.
• Orthodontics: Sanitary removal when extracting guided by tooth movement.
• Prosthodontics: Prosthetic planning easier because of preservation of ridge.
• Periodontics: Reduction in trauma expedites healing.
• Pediatric Dentistry: Less harmful to oral tissues forming.
• Medically Compromised Patients: Lowers complication during post-op.
• Trauma and Fracture Management: Preservation of adjacent tissues to use as a splint.
Instrument is useful but the technique renders its action improved.
Radiographic and clinical assessment of root form and bone density.
Local anesthesia with tissue preservation.
Located below CEJ without forceful crown contact.
Bumper on alveolar ridge for leverage.
Normal, gentle rotation for 30–60 seconds.
Tooth raised out of socket without pulling.
Post-op irrigation and membrane placement as necessary.
Clinical advantage of atraumatic forceps attested by thousands of systematic reviews and randomized trials.
• Preservation of alveolar bone
• Lower rate of root fracture
• Postop healing faster
• Less swelling and pain
• Procedure time reduced
• Most suitably applied to potential implant cases
• Less operator fatigue
Some practice limitations and to the clinical environment despite benefits:
• Cost: More expensive than conventional instruments.
• Learning Curve: Needs an understanding of biomechanical principles.
• Technique Sensitivity: Misalignment decreases efficiency.
• Ankylosed and impacted teeth inappropriate.
• Not indicated in limited access or extensive decay.
• Patole & Chidambar, in their 2021 publication, reported Physics Forceps decreased the time of operation and enhanced healing results compared to the conventional method.
• Indian Journal of Dental Research (2020) reported a 40% decrease in socket wall trauma when Physics Forceps were employed.
• Springer (2025) reported a prospective study with a significantly decreased rate of buccal bone loss using Physics Forceps.
• Fewer postoperative complications were established in a systematic review by MDPI (2021).
• Much less anxiety and better procedural tolerance in children were reported in pediatric trials.
• Less invasive ridge preservation
• No flap reflection
• Less recession of soft tissues
• Papillae support for anterior esthetics
• More emergency profile for prosthetics
• Better control of surgery
• Reduced physical stress for dentists
• Reduced post-operative pain for the patient
• Reduced reliance on elevators or on multiple instruments
• Natural socket contours
• Proper bone landmarks
• Ideal for guided implant surgery
• Autoclave sterilization only
• Do not use ultrasonic cleaners with abrasive chemicals
• Regularly check the bite alignment
• Replace worn bumpers and grips
• "They're only for anterior teeth": Most models are well-suited to molars and roots.
• "They don't require skill": Proper angulation and positioning are crucial.
• "They're slow": In practice, most extractions are less than 60 seconds.
• "Too costly": Long-term cost benefits from decreased complexity and accelerated procedures warrant initial expense.
• Torque sensor-equipped smart-forceps.
• Root variation-tuned 3D-printed tips.
• Biomechanical model-controlled surgical arms with AI.
• AR-supported dental procedures integrated.
Atraumatic forceps are not merely a dental surgical instrument, but also a reflection of a philosophic change in dentistry toward tissue preservation, minimally invasive treatment, and long-term restorative planning.
As the dental practice moves further toward an era of digital inclusion, implantology, and patient-centered practice, atraumatic forceps will probably continue to be a common tool in every clinician's surgical case.
Written by: Beauty Teck
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