[Sacamuelas]

Things to note:
1. Maxillary molars have at least three roots. Two are side by side on the outside (buccal) portion and one is on the palatal side of the tooth. You always want to attempt to get the palatal root out in one piece if possible. I will cover how to do that in the technique part.

2. In about 30% of people, the upper First molar has secondary innervation by another nerve to its outside root towards the midline of the face side (Mesio-buccal root). This means that sometimes an extra infiltration injection is needed slightly towards the midline of the first molar.

3. Major Complication: The maxillary sinus lies directly above the teeth in question. In some cases, the roots are in the sinus itself. Something to remember when chasing after small fragments or when using your elevators to "push up" and wedge a root out (which can push the fragment up into the sinus).

I will post the same x-ray as before with the maxillary sinus identified by a blue dotted line. I will also label roots to make more sense of the above description in red. As you can see, the roots in the example could definitely be in the maxillary sinus. You can also see the two smaller buccal roots with superimposed over the larger palatal root.