message board this point I'm usually using a thin-tipped instrument like a spade proximator or a luxator to get into the PDL space around the root wherever it lets me. Step 6: Still a no-go? Remember how it presented on the X-ray and remind yourself to refer to an oral surgeon when it looks like that. Now start troughing on the buccal and using a thintipped instrument to get some mobility wherever you can. ■ 1/3/2018 Chmrb Member Since: 02/25/17 Post: 12 of 30 I am not a fan of the 301 elevator though it does work. I prefer the Hu-Friedy 11A Stout for elevation. The tip broadens as you move away from the tip so as you work the instrument in between the teeth it gradually elevates more and more. Frequently I find that the 301 elevates nicely to a point and then it just isn't wide enough to elevate any more. The 11A is my go-to elevator. Come to think of it, most teeth I remove I only use the 11A and, if necessary, forceps. I use the 11A to dig out all but the smallest root tips. I use it to remove anteriors and posteriors. I may begin using it to eat lunch-I like it that much. ■ 1/3/2018 Hoosh Member Since: 10/11/11 Post: 16 of 30 I really appreciate your feedback. Along with the other posters who gave their opinion and how they would go about it. So, I ended up getting to Step 5. Got out most of the tooth, then the D root split vertically and the lower apical-mesial portion of the distal root remained stuck. No PDL to even squeeze my spade proximator into. I elected to leave that sliver of root. Probably not what some others would have done. But I'm okay with my decision to do so. Just thought I would share for others who are in my shoes. We all have to start somewhere. Learning can be difficult, but fun! ■ 1/5/2018 bronco1 Member Since: 01/03/13 Post: 19 of 30 This was a disservice to the patient. OP knew several days ago he did not feel comfortable with this extraction. He came on, posted his concern, received several "ideas" on how to do it and talked himself into making a poor clinical decision and outcome ... ■ 1/5/2018 likeaduck Member Since: 08/15/16 Post: 20 of 30 Everyone learns somehow. If remaining piece of tooth that wasn't necrotic to begin with is less than 3mm it's okay to leave. ■ 1/5/2018 Hoosh Member Since: 10/11/11 Post: 23 of 30 rpiotrowski Member Since: 01/11/02 Post: 25 of 30 Bifid Uvula Member Since: 05/17/06 Post: 26 of 30 Definitely less than 3mm. Necrotic. Extracted six teeth this week. This one was the troublemaker. Moving on! ■ 1/5/2018 Inform the patient that it's there and tell them that "if" it ever gives them a problem, you'll take care of it for no charge. ■ 1/5/2018 Got a radiograph of the retained root portion to share with us? Did you inform the patient you left part of the tooth behind? How long did you work on the patient before you threw in the towel? ■ 1/5/2018 bronco1 Member Since: 01/03/13 Post: 28 of 30 50 Do not kid yourself into thinking it is appropriate to leave roots behind simply because you could not finish the case. We are all held to a standard of care. Leaving roots behind in this MARCH 2018 // dentaltown.comhttp://www.dentaltown.com