Forceps and their Movements in Tooth Extraction

Forceps Types and Forces Applied: 

There are various forceps types designed to accommodate the diverse anatomical features of teeth. Each forceps type is uniquely crafted to match the contours of specific teeth, facilitating a secure grip and controlled extraction. The forces applied during extraction are carefully calibrated to ensure effective tooth removal while avoiding unnecessary trauma.

• Root-Tip Forceps: Used for extracting teeth with fractured crowns or roots. Special care is taken to engage the root tip and exert controlled force.

• Molar Forceps: Designed with longer handles and beaks, these forceps are effective for extracting molars by applying buccal and lingual forces, considering the differential bone thickness.

• Incisor Forceps: Characterized by delicate beaks, these forceps are suitable for incisors and smaller teeth, allowing rotational and controlled movements.

• Canine Forceps: Designed for maxillary canines, these forceps ensure the proper application of rotational, buccal, and lingual forces.

Forceps Movements and Types in Tooth Extraction 

Tooth extraction is a critical procedure in dentistry, requiring precise forceps movements for successful outcomes. The technique of applying forceps movements varies depending on the tooth type, location, and the condition of the surrounding bone. The application of forceps movements involves a combination of rotational, buccal, lingual, and palatal forces, tailored to each specific situation.

Rotational Force: Rotational force is employed primarily in extracting maxillary incisors and lower premolars. This technique involves gently rotating the tooth around its axis to loosen its attachment to the periodontal ligament. This movement minimizes trauma to the surrounding tissues and facilitates a smoother extraction process.

Buccal and Lingual Forces: In cases where rotational force isn't suitable, buccal and lingual forces are applied. Maxillary canines are a prime example; these teeth are often pulled out transversely using rotational force, otherwise, buccal and lingual forces are utilized. These forces are also commonly used for other mandibular and maxillary teeth, providing controlled pressure to dislodge the tooth without excessive trauma.

Palatal and Buccal Forces: Maxillary posterior teeth present a unique challenge due to their complex root morphology. To extract these teeth effectively, a combination of palatal and buccal forces is applied. This approach minimizes the risk of fracturing the tooth while ensuring efficient removal.

Lingual and Buccal Forces in Lower Molars: Lower molars require careful consideration due to the variation in bone thickness. The lingual side of the alveolar bone is generally thinner, making it susceptible to fractures. Thus, more force is applied on the lingual side during extraction, while less force is exerted on the buccal side. This differential force distribution helps maintain the structural integrity of the bone.

Delivery of Teeth: The standard approach for delivering teeth in both jaws is on the buccal side. This ensures minimal trauma to adjacent soft tissues and preserves the patient's post-extraction comfort. In certain cases, lower molars might also be pulled out on the lingual side, depending on the specific anatomy and clinical judgment. 

Conclusion: In tooth extraction procedures, the application of appropriate forceps movements is pivotal for successful outcomes. Understanding the specific techniques required for different tooth types and their anatomical nuances enhances the dentist's ability to execute extractions with precision and minimal patient discomfort. The variety of forceps types available caters to the unique needs of each extraction, contributing to the overall success of the procedure.

This concept was explained by Dr. Muhammad Ahmed, at Farooq Hospital Westwood Branch, Lahore.