INBDE (Integrated National Board Dental Examination) Practice Exam

What is the initial step when an endodontic instrument separates?

1. Extract the tooth

2. Use a larger instrument to remove

3. Use a smaller instrument to bypass

4. Immediately refer to a specialist

The correct answer is: Use a smaller instrument to bypass

When an endodontic instrument separates during a procedure, the initial step should be to use a smaller instrument to bypass the separated fragment. This is the correct approach because attempting to remove the separated instrument with a larger one or extracting the tooth outright may lead to further complications and potential damage to the tooth structure or surrounding tissues. Using a smaller instrument to bypass the separated fragment allows the dentist to navigate around the obstruction and continue the root canal procedure with minimal disruption. Referring the case to a specialist should be considered if the situation becomes complex and beyond the dentist's expertise, but it is not the immediate first step when an instrument separates. Therefore, the correct initial step when faced with a separated endodontic instrument is to use a smaller instrument to bypass the fragment.