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Crown Cementation on Teeth #36 & #37 with Surgical Removal of Retained Roots – Tooth #15

Surgical Procedure

Chief Complaint

Patient attended for definitive cementation of crowns on lower left molars (teeth #36 and #37).
Patient also reported pain at the retained root site of upper right premolar (tooth #15).

Clinical Findings

Teeth #36 & #37

  • Asymptomatic

  • Not tender to percussion (vertical and lateral)

  • Mobility and probing depth within normal limits

  • Temporary crowns removed

  • Crown trial fit satisfactory with good marginal adaptation

  • Patient satisfied with aesthetics and occlusion

Tooth #15

  • Previously root-filled tooth with coronal fracture

  • Total loss of crown and coronal tooth structure

  • Retained roots present

  • Tender to percussion (vertical and lateral)

  • Mobility and probing depth within normal limits

Treatment Plan

  • Definitive adhesive cementation of crowns on teeth #36 and #37

  • Surgical removal of retained roots of tooth #15

  • Pre- and post-operative CBCT imaging for surgical assessment and confirmation

Pre-operative Assessment

  • Clinical examination performed for crown fit and occlusion

  • Pre-operative CBCT taken for tooth #15

  • Risks, benefits, and procedural steps explained

  • Patient understood and agreed to proceed

  • Informed consent obtained for surgical removal of retained roots

Anesthesia

Local anesthesia administered for surgical site #15

Surgical Procedure

Crown Cementation – Teeth #36 & #37

  • Temporary crowns removed

  • Crown preparation prophylaxis performed

  • Definitive crowns cleaned with disinfectant solution and alcohol

  • Crowns primed with MDP primer

  • Tooth preparations etched with dentine conditioner and primed with MDP primer

  • Adhesive cementation performed using resin cement

  • Occlusion checked and adjusted

  • Finishing and polishing completed

Surgical Removal – Tooth #15

  • Patient cleaned and draped

  • Buccal incision made and flap raised

  • Bone guttering performed

  • Tooth sectioned

  • Retained roots elevated and removed in two pieces

  • Thorough curettage performed

  • Surgical site irrigated with saline

  • Three bone substitute sponges placed for secondary closure

Hemostasis achieved

Post-operative Assessment

  • Post-operative CBCT taken

  • No residual root fragments noted at site #15

  • Maxillary sinus, adjacent implant and prosthesis, and adjacent teeth not involved

  • Patient reassured

  • Post-operative instructions provided

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