Sir, we read with interest Dr Shuttleworth's reflective letter on his surgical practice and the origins of the Luxator.1 The same week the head nurse in our department brought to our attention six damaged Luxators returned by the sterile services department (Fig. 1).

Figure 1
figure 1

Damaged mishandled Luxators

Full size image

Clearly these instruments have been abused and used as elevators with significant damage to the instruments in a relatively short time. This has prompted us to review the use of Luxators in our department. The vast majority of routine oral surgery/exodontia procedures has been and can be safely and effectively carried out with the additional use of conventional elevators. This can be in the form of Warwick James, Coupland's chisels and Cryer's elevators, which are routinely available in the MOS sets.

The senior author after three decades in oral surgery has adopted the use of Luxators in the last year for flapless atraumatic extractions preparatory for immediate implant placement. Luxators may be suitable for select cases of fractured roots or apices used carefully under direct vision and in a controlled and careful manner.

We would like to emphasise the cautious use of these sharp instruments as an adjunct in select MOS cases. It is advisable to use them with minimal pressure and appropriate finger rests to avoid any tissue damage when being applied in the periodontal space in case the instrument slips.