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Retained Root Fragment — ORE Part 1 MCQ

Instant feedback + full explanation. One question, done properly.

ModerateOral SurgeryRetained Root FragmentORE Part 1

A 35-year-old patient requires extraction of a previously root-treated upper left first premolar restored with a post, core and crown. During extraction, the root fractures at the junction of the middle and apical thirds. A periapical radiograph confirms a 5 mm apical root fragment. The socket is not infected. Retrieving the fragment would require flap elevation and substantial buccal bone removal. What is the most appropriate management?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: D — Retain the fragment, explain and document the event, then arrange review

**A is correct.** A small, deeply placed, non-infected retained root fragment should not be retrieved when doing so would require substantial bone removal and create greater morbidity than benefit. The patient must be informed, the event and advice documented, and the area reviewed clinically, with radiographs where indicated. UK oral-surgery referral guidance states that asymptomatic retained roots without infection do not require referral; escalation is reserved for difficult anatomy, pathology, medical complexity or failed attempts. **B** ignores proportionality of surgical risk. **C** is not justified by an uncomplicated asymptomatic fragment and GA is not a default solution. **D** is wrong because antibiotics are not indicated in the absence of infection and non-disclosure breaches valid consent. **E** risks damaging or mobilising the adjacent tooth and is poor exodontia technique.

Reference: NHS England Devon, Cornwall and Isles of Scilly, Oral Surgery Referral Guidelines, section “Management of Retained Roots”, current webpage: https://rms.cornwall.nhs.uk/information_for_gdps__dental_practices/oral_surgery_referral_guidelines