Extraction and Removal of Retained Carious Roots for Tooth #37
Surgical Removal
Retained Root
Chief Complaint
Patient presents with buccal swelling at tooth #37.
Clinical Findings
Buccal probing depth of approximately 10mm at tooth #37.
Furcation involvement: Class III.
Previous root filling (RF), core, and crowning on tooth #37.
Leaking crown with recurrent caries.
Poor periodontal prognosis for tooth #37.
Periapical (PA) radiograph taken:
Dense but incomplete RF.
No periapical lesion.
Radiolucency at tooth #37 furcation.
Treatment Plan
Extraction (XAP) of tooth #37
Potential operative procedure (OP) if needed
Risks and procedures explained.
Patient understood and agreed to proceed.
Informed consent obtained.
Pre-operative Assessment
Anesthesia
LA block: left inferior dental nerve (IDN), lingual nerve (LN), and long buccal nerve (LBN).
Surgical Procedure
Initial Extraction Attempt (LA XAP #37):
Coronal portion of tooth #37 crumbled off.
Gross caries observed beneath the crown.
Attempted elevation of #37 roots; roots were very firm.
Bone density noted to be very high.
2. Operative Removal of Retained Carious Roots (LAOP #37):
Advised for operative removal of retained carious roots:
CBCT taken.
Patient agreed to proceed.
Patient cleaned and draped.
Incision made; buccal flap raised.
Bone guttering performed.
Tooth sectioning carried out.
Tooth #37 elevated out in four pieces.
Curettage and irrigation with saline.
Bioactive synthetic scaffold (BSS) placed x6 for primary closure.
Hemostasis achieved, post-operative instructions given.
Post Operation Gallery
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