Maxillary Molar Extraction Technique — MFDS Part 1 MCQ

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EasyOral Surgery PrinciplesMaxillary Molar Extraction TechniqueMFDS Part 1

A healthy adult attends for routine closed forceps extraction of a fully erupted permanent maxillary first molar with three divergent roots. Which principal luxation movement should be applied with the forceps before the tooth is delivered?

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Correct answer: B — Controlled alternating buccal and palatal rocking movements

Explanation lettering: C = shown as A · A = shown as B · D = shown as C · B = shown as D

A is correct. A three-rooted maxillary first molar is principally luxated using controlled alternating buccal and palatal rocking, progressively enlarging the socket before delivery. Experimental movement analysis found movement around the mesiodistal axis—corresponding to buccopalatal rocking—to be dominant for the upper first molar, while rotation around its longitudinal axis was limited. D is therefore inappropriate for a tooth with divergent roots; axial rotation is more applicable to teeth with a conical single root. B and C provide pressure in only one direction and do not produce the required reciprocal socket expansion. E describes traction used to deliver the tooth after adequate mobility has been obtained, rather than the principal luxation movement.

Reference: van Riet T, de Graaf W, de Lange J, Kober J. Analysis of movements in tooth removal procedures using robot technology. PLoS One. 2023;18(5):e0285503. Abstract and Figure 4. https://pubmed.ncbi.nlm.nih.gov/37200314/