Cracked Tooth Removal of Tooth #14 with Dense Bone and Long Roots
Surgical Removal
Retained Root
Chief Complaint
Patient reported a fractured tooth #14 approximately two days ago.
Clinical Findings
Tooth #14: Subgingival and possible subcrestal fracture, diagnosed as hopeless.
Symptoms: Very sensitive to cold, very painful at night, very tender to percussion (TTP), not tender to palpation (NTTP).
Metallic sound on percussion.
Palatal portion of the tooth is missing.
Possible ankylosis or very dense bone.
Patient of Indian race with a heavy body build, potential for long roots with very dense bone.
Treatment Plan
Removal of retained roots of tooth #14.
CBCT advised to check if single or double rooted and to assess root length.
Pre-operative Assessment
Patient agreeable to CBCT.
CBCT results: Tooth #14 has two roots, long and divergent, with dense bone.
Advised LA OP removal of retained roots of #14.
Discussed risks, procedures, and potential for higher infection risks due to uncontrolled diabetes.
Patient understood and agreed to proceed.
Informed consent obtained.
Anesthesia
Local anesthesia infiltration administered for tooth #14.
Surgical Procedure
Patient cleaned and draped.
Incision made, buccal flap raised.
Bone guttering performed.
Tooth sectioned.
Tooth #14 elevated out in three pieces.
Surgery noted as very difficult due to dense bone and the need to conserve bone for future implant restoration.
Curettage and irrigation with saline.
BSS x 04 placed for primary closure.
Achieved haemostasis and provided post-operative instructions (POI).
Post Operation Gallery
 |  |  |
|---|---|---|
 |  |  |
Post-operative Assessment
Patient agreeable to CBCT.
CBCT results: Tooth #14 has two roots, long and divergent, with dense bone.
Advised LA OP removal of retained roots of #14.
Discussed risks, procedures, and potential for higher infection risks due to uncontrolled diabetes.
Patient understood and agreed to proceed.
Informed consent obtained.