The mandibular premolars are among the easiest teeth to remove. The roots tend to be straight and conic, albeit sometimes slender. The overlying alveolar bone- is thin on the buccal aspect and somewhat heavier on the lingual side.
The lower universal (no. 151) forceps is usually chosen for the extraction of the mandibular premolars. The no. 151A forceps and the English style of forceps are both popular alternatives for extraction of these teeth.
The forceps is apically forced as far as possible, with the basic movements being toward the buccal aspect, returning to the lingual aspect, and, finally, rotating.Rotational movement is used more when extracting these teeth than any others, except perhaps the maxillary central incisor. The tooth is then delivered in the occlusobuccal direction (Fig. 7-68). Careful preoperative radio graphic assessment must be performed to assure the operator that no root curvature exists in the apical third of the tooth. If such a curvature does exist, the rotation all movements should be reduced or eliminated from the extraction procedure (Fig. 7-69).