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Oral Surgery · single question

During an attempted extraction, the crown of a tooth fractures at the furcation, below the gingival margin. What is the MOST appropriate next step?

  1. Attempt forceps extraction with a narrower beak
  2. Use a bone rongeur to remove the tooth
  3. Raise a subperiosteal (mucoperiosteal) flap and sectioning of the tooth
  4. Raise a subperiosteal flap on the lingual side only
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Correct answer: C. Raise a subperiosteal (mucoperiosteal) flap and sectioning of the tooth

  • A. Attempting forceps extraction on a fractured root is likely to cause further complications and insufficient access.
  • B. A bone rongeur removes alveolar bone and is not used to grasp and remove tooth fragments.
  • C. Correct. When a tooth fractures at the furcation level, the best approach is to raise a full-thickness mucoperiosteal flap to gain access and visibility, then section the tooth (separate the roots) for individual root removal.
  • D. A lingual-only flap provides inadequate access for furcation-level fractures in multi-rooted teeth.

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