I forgot to add, there's other factors besides the tool that you use to extract. One is an intuition and strategy for extraction. If the root is curved, you have to see how your path of extraction is going to be (hint: it's not always straight coronally, buccal, or lingual), what bone and adjacent teeth are in the way, density of the bone, and how much tooth structure do you have to grip on to via elevator and/or forceps. If bone is hard and/or patient is older, you probably need to remove more bone since the bone won't expand. How do you know if the bone is hard? PDL anesthetic resistance is a good benchmark for me in terms of how easy it will be to expand the bone. If there's a tooth that is in the way your path of extraction, how do you fix that? You got a few options, some feasible, some not (like shaving the adjacent tooth). Feasible options include removing bone to change path of extraction or modifying the tooth you're extracting by removing a marginal ridge or other structure, however, by modifying the tooth you're going to remove, you also have to understand that you need a certain bulk of tooth to apply force and prevent it from snapping off. If you mod the tooth too much, your next application of force will result in parts of the tooth in snapping off and making your job a lot harder. Last, is tactile feedback from the bone and tooth (just like endo!). You know that the bone is expanding if there's detectable micromovement from the tooth. If there is none, application of additional force will result in a fracture. On the flip side, look at the tooth you're trying to remove. if there's severe decay on a wall, you need to direct your force away from that wall. For example, if you have a severely broken distal ridge and lingual wall, you need to grip a little more on the mesial, make sure your forcep engages a lot more apically on the lingual beak, and if you can't get your forcep to engage, then practice a little crown lengthening on the lingual to get your beaks to engage more on the lingual. If it's a multirooted tooth, there's almost nothing to work with, the fastest way around it is to use your forcep as a decoronator, exposure the furcation, and start troughing.
Anyway, hopefully this brain dump helps. Good luck!
