During extraction of an endodontically treated, grossly carious #18, the tooth fractures below the gingival margin but above the furcation. What should you do?

Correct answer: D. Section the roots surgically and remove them individually

• A. Increased force on a brittle endodontically treated tooth causes further fragmentation and possible mandibular fracture.
• B. This is a manageable complication within the general dentist's scope; referral is reasonable only if the operator lacks surgical experience or equipment.
• C. Retaining infected root fragments from a grossly carious tooth risks persistent infection.
• D. Correct. Because the fracture is coronal to the furcation, the roots can still be separated. Raise a flap, section through the furcation with a surgical bur, and elevate each root independently.