Elevators, luxating elevators and ligament saws all work in the same place: the periodontal ligament (PDL) space between the root and the alveolar bone. What separates them is the thickness of the blade and what the blade does to the ligament fibres – stretching and tearing them, or cutting them. This guide summarises how dental and veterinary dental sources describe each instrument and where a micro-serrated ligament saw such as the NiTi Perio Saw® fits. It is a summary for clinicians, not a substitute for hands-on training or for the instructions for use of any instrument.
Elevator
An elevator has a relatively strong, thick blade with a concave working surface [1]. It is seated in the PDL space and worked with a side-to-side rocking or rotational motion and gentle apical pressure, so that the ligament fatigues and tears [1]. Winged elevators are rotated with slow, constant tension to stretch and tear the ligament fibres [2], and they are made to match a root diameter, so the size has to fit the root being extracted [3]. Elevators are described as forgiving instruments and are widely used [1].
Luxating elevator
A luxating elevator has a thinner, sharper, tapered blade [1]. Used with a semicircular rocking and cutting motion under apical pressure, it cuts the ligament rather than only fatiguing it [1]; one board-certified author compares its tip to a miniature scalpel blade [2]. The trade-off is technique sensitivity: it is not built to withstand heavy force and can chip or break if used to pry [1].
Ligament saw (NiTi Perio Saw®)
The NiTi Perio Saw® is a hand-held ligament saw: no motor and no handpiece. Its tip is a nickel-titanium shape-memory alloy (ASTM F2063) rather than steel, and its edge is micro-serrated [4]. Instead of stretching or prying, the blade is placed in the ligament space along the root and moved with a short push-and-draw stroke so that the serrations cut the periodontal ligament around the root [4]. The instructions for use describe the sequence as: position the tip at the targeted tooth in the ligament space along the root, push and draw back gently to cut the ligament, then extract the tooth with minimal force [4]. It must not be twisted, must not be used to elevate the root, and must not be used on an ankylosed tooth [4].
At a glance
| Elevator | Luxating elevator | NiTi Perio Saw® | |
|---|---|---|---|
| Blade | Thicker, concave, steel | Thin, sharp, tapered, steel | Thin, flat, micro-serrated nickel-titanium |
| Effect on the PDL | Fatigues and tears | Cuts | Saws through along the root |
| Typical motion | Rotation with sustained apical pressure | Semicircular rocking with apical pressure | Short push-and-draw stroke along the root |
| Main caution | Size must match the root | Chips or breaks if used to pry | Never twist or elevate; not for ankylosed teeth |
Human and veterinary use
The ligament is the same structure in a human and in an animal tooth, and the instrument principle is the same. The NiTi Perio Saw® is made in a veterinary edition, which veterinarians and veterinary clinics can order in this shop, and in a human dental edition, which is a medical device subject to country-specific approval and is supplied by enquiry only – see NiTi Perio Saw® for human dentistry. Each edition has its own instructions for use.
Which instrument first?
That is the clinician's decision. A principle repeated in current veterinary teaching is to start with the least traumatic instrument and to escalate only when needed, keeping bone removal as the last resort [2]. Pre-extraction radiographs matter, because they show whether a PDL space is present at all; where there is no ligament space there is nothing for a thin instrument to cut [2].
The NiTi Perio Saw® comes in four tip shapes – see Choosing and caring for NiTi Perio Saw® tips.
Sources
- Evans T. Luxator or elevator? The ultimate question. Veterinary Practice News Canada, 15 April 2021. https://www.veterinarypracticenews.ca/luxator-or-elevator-the-ultimate-question/
- Lewis JR. A look at advanced techniques in minimally invasive tooth extraction. Veterinary Practice News, 6 January 2026. https://www.veterinarypracticenews.com/advanced-techniques-minimally-invasive-tooth-extraction/
- Lobprise H. Essential tools to have in a dental extraction kit, according to a dental specialist. dvm360, 23 December 2025. https://www.dvm360.com/view/essential-tools-to-have-in-a-dental-extraction-kit-according-to-a-dental-specialist
- HANS Korea Co., Ltd. Instructions for Use – NiTi Perio Saw (Veterinary), HKIFU_VT_001 Rev. 0, 30 September 2026. PDF
Reviewed: 22 October 2026