title: P Elevator: An Innovatively Designed Elevator for Extraction of Third Molars.
abstract: OBJECTIVE
  To modify the conventional straight elevator with a unique and innovative design in respect to approach and accessibility during extraction for patients with abrasions around corners of the mouth and with thick buccal mucosa, without causing overstretching of angles of the mouth.
  
  
  METHODS
  The shank of the straight elevator in the shape of a 'U' was modified, giving it a shape similar to 'P' in the English alphabet hence it is named the P Elevator. The P elevator utilises a 'U' shaped bend in the shank of the conventional straight elevator making space for the buccal soft tissues and the angle of the mouth, to accommodate properly in the 'U' shank. The application of this elevator in the successful removal of third molars is described.
  
  
  RESULTS
  Two hundred patients underwent extraction of third molars with the P elevator including 166 patients with disimpaction of all third molars, 23 patients with abrasion around the angle of the mouth, and 11 patients with thick buccal mucosa. Satisfactory results were obtained in all the cases with no postoperative complications.
  
  
  CONCLUSIONS
  The P elevator permits prudent, meticulous, innovative and proficient extraction of third molars in patients with thick buccal mucosa and abrasions around the angle of the mouth, without overstretching the corners of the mouth. We introduce novel applications of the P elevator in third molar extraction that provide substantial advantages over a conventional straight elevator.
authors.forename: Pradeep
authors.initials: P
authors.lastname: Singh
authors.forename: Shui Sheng
authors.initials: SS
authors.lastname: Xiao
authors.forename: Deepal Haresh
authors.initials: DH
authors.lastname: Ajmera
mesh_terms: D000293:Adolescent; D000328:Adult; D004867:Equipment Design; D006801:Humans; D007431:Intraoperative Complications / Q000517:prevention & control; D008046:Lip / Q000293:injuries; D008047:Lip Diseases / Q000150:complications; D008875:Middle Aged; D008964:Molar, Third / Q000601:surgery*; D009061:Mouth Mucosa / Q000473:pathology; D010146:Pain / Q000517:prevention & control; D013499:Surface Properties; D014081:Tooth Extraction / Q000295:instrumentation*; D055815:Young Adult