A) Extraction of the mandibular premolar. The mandible is stabilized, soft tissue is retracted, and No. 151 forceps are positioned. (B) The hand position is modified slightly for the behind-the-patient technique. (C) English-style forceps can also be used. (D) The forceps are seated apically as far as possible to displace the center of rotation and to begin the expansion of crestal bone. (E) Buccal forceps are applied to begin the luxation process. (F) Slight lingual pressure is used. (G) The tooth is delivered with a rotational, tractional force. Asterisk notes the center of rotation.