Surgical Removal of Impacted Supernumerary Tooth (Mesiodens) in Palatal Region of #21
Surgical Removal
Chief Complaint
Presence of an additional tooth identified on radiographic examination; advised removal to prevent interference with eruption and alignment of adjacent teeth.
Clinical Findings
Impacted mesiodens located palatally to #21
Completely embedded in bone
No signs of infection
Surrounding dentition intact and vital
Treatment Plan
Surgical extraction of impacted mesiodens under local anesthesia.
Discussed risks including:
Possible numbness of palatal tissues
Potential devitalization of adjacent teeth (#11 and #21)
Parent agreed to proceed. Informed consent obtained.
Pre-operative Assessment
CBCT taken pre-operatively to confirm position and relation to adjacent roots and nasal floor.
No contraindications for local anesthesia or surgery noted.
Anesthesia
Local anesthesia infiltration given to palatal and buccal region surrounding the impacted tooth.
Surgical Procedure
Patient cleaned and draped.
Buccal incision made and flap raised.
Bone guttering performed to expose crown of mesiodens.
Tooth sectioned and removed in fragments.
Socket curetted thoroughly.
Irrigation with sterile saline.
BSS x 05 placed and primary closure achieved.
Haemostasis confirmed.
Post-operative CBCT taken.
Post-operative Assessment
Patient stable and comfortable.
Standard post-operative instructions provided.
Advised to monitor for swelling, prolonged bleeding, or altered sensation.
Review appointment scheduled.