Oral Surgery · single question

All of the following are correct regarding forceps placement for an extraction EXCEPT:

  1. The beaks are seated apical to the cementoenamel junction, on root surface
  2. Forceps are applied only after adequate luxation with an elevator
  3. The beaks are positioned parallel to the long axis of the tooth
  4. The beaks are seated at the middle third of the crown
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Correct answer: D. The beaks are seated at the middle third of the crown

  • A. This is correct practice. The beaks are seated apical to the CEJ so that force is transmitted directly to the root, and the beaks also act as a wedge expanding the socket as they are seated.
  • B. This is correct. Elevator luxation expands the socket and begins to tear the periodontal ligament, so that the forceps complete a movement that has already started rather than initiating it against an intact attachment.
  • C. This is correct. Aligning the beaks with the long axis directs force along the root rather than across it, minimising the shearing that causes root fracture.
  • D. CORRECT as the EXCEPTION. Seating the beaks on the crown is precisely what you must NOT do. Beaks applied to enamel have no purchase, concentrate force on the most brittle portion of the tooth, and predictably fracture the crown — leaving retained roots and converting a simple extraction into a surgical one. The beaks must engage ROOT structure.

Note: The mechanics of extraction are expansion, not traction. Slow controlled buccolingual pressure held long enough to let bone flex, with rotation reserved for single conical roots (maxillary and mandibular anteriors and the maxillary second premolar). Pulling harder is almost never the answer to a difficult extraction — reassessing purchase or going surgical is.

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