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Oral Surgery · single question

CASE 9 — During extraction of tooth #19, the crown fractures and only the apical third of the root remains. 'Leave and monitor' is NOT an option. What is the best next step?

  1. Raise a buccal flap and remove bone to access and retrieve the root tip
  2. Trough on buccal and lingual, then retrieve with a root pick
  3. Trough on mesial and distal, then retrieve with a root pick
  4. Raise a lingual flap and remove bone to retrieve the root tip
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Correct answer: A. Raise a buccal flap and remove bone to access and retrieve the root tip

  • A. For a retained apical third root fragment of a mandibular molar, a BUCCAL surgical approach with a mucoperiosteal flap and careful removal of buccal bone provides optimal access and visibility to retrieve the root tip with an elevator or root pick. This is the standard surgical approach.
  • B. Lingual troughing on a mandibular molar risks lingual nerve and lingual artery injury.
  • C. Mesial/distal troughing risks damage to adjacent tooth roots and does not provide direct access.
  • D. A lingual flap for mandibular molar root retrieval risks lingual nerve damage — this approach is avoided.

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