Fig. 23.
For the removal of roots towards the back of the mouth.
When the more extensive decay has taken place on the buccal side the order of proceeding is slightly different. The first blade to be applied should be the palatine, the outer blade being closed upon whichever of the buccal roots is considered the stronger.
The extractive force should be applied first outwards and then inwards, these movements being repeated if necessary, the principal force being outwards, as the object in view is to prevent the instrument slipping off the more decayed side.
When a molar is so decayed that but little of the crown remains, but all the roots are still united, root forceps are indicated. In such a case the inner blade is to be applied to the palatine root first, the outer blade being closed upon the stronger of the buccal fangs. Inward followed by outward movement should be employed, the point to bear in mind being to use force towards the side of the tooth which is considered the weaker. In the majority of such cases the three roots come away together, but even if this does not happen, one or perhaps two will be removed, the remainder being subsequently removed with but little difficulty.
In cases where the resistance presented by the roots is very great and an unsuccessful attempt has been made with ordinary root forceps, an instrument with a buccal blade similar to that shown in [fig. 24] may be used. The inner blade is first applied, the outer one being brought so as to come, if possible, into the space between the buccal roots. A firm hold of the roots having been gained, an attempt to extract should be made by force applied in an inward and outward direction; this failing, sufficient pressure should be put upon the handles to split the roots asunder. The sharp outer blade of the forceps will then pass between the divided buccal roots on to the palatine root, which can thus readily be brought away. A pair of ordinary upper root forceps should be employed for removing the buccal roots.
If all the three roots of a molar are separate, their extraction presents but little difficulty, a slight rotary movement generally sufficing.
In all cases where there is a fear of a molar fracturing, root in preference to ordinary forceps should be used.