Mandibular Molar Extraction — MFDS Part 1 MCQ

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EasyOral Surgery PrinciplesMandibular Molar ExtractionMFDS Part 1

During routine closed forceps extraction of a fully erupted mandibular first molar with separate mesial and distal roots and no abnormal root morphology, which movement is used primarily to expand the socket?

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Correct answer: D — Alternating buccal and lingual rocking

The correct answer is D. A mandibular first molar with separate mesial and distal roots is loosened primarily by controlled alternating buccal and lingual rocking, which progressively expands the alveolar socket around the multirooted tooth. Rotation around the long axis is not the principal movement and may increase the risk of root fracture, particularly with divergent or curved roots. Sustained pressure in only one direction does not provide controlled circumferential socket expansion, while occlusal traction alone is generally insufficient before adequate mobility has been achieved. A figure-of-eight movement is not the standard primary forceps movement for mandibular molars. The final direction of delivery can vary with root and alveolar anatomy, so the assertion that delivery is usually buccal is not required to answer.

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. https://pubmed.ncbi.nlm.nih.gov/37200314/