Extraction and Removal of Retained Root for Tooth #21 and Extraction of Tooth #16
Surgical Removal
Retained Root
Chief Complaint
Patient complains of a fractured tooth #21 and a large cavity on tooth #16 (distal-occlusal-pulpal [dop] cervical).
Clinical Findings
Tooth #16: Caries extending to the pulp, close to furcation with approximately 60%-70% distal bone loss.
Tooth #21: Retained root with periapical (PA) lesion.
Both teeth #16 and #21 are non-tender to palpation (NTTP) and non-tender to percussion (NTTPp).
Treatment Plan
Advised local anesthesia operative procedure (LAOP) removal of the retained root of tooth #21.
Recommended pre-operative CBCT to determine treatment options for tooth #16.
Patient agreed to proceed with LAOP removal of tooth #21 retained root and LA extraction (XAP) of tooth #16.
Pre-operative Assessment
Pre-operative CBCT taken:
Tooth #16: Caries extending to the pulp, very close to furcation with significant distal bone loss.
Tooth #21: Retained root with PA lesion.
Anesthesia
LA infiltration for teeth #16 and #21.
Surgical Procedure
Tooth #21:
Patient cleaned and draped.
Incision made, buccal flap raised.
Bone guttering performed.
Tooth sectioned.
Tooth #21 elevated out in two pieces.
Granulation tissue at the apical region of tooth #21 curetted and removed.
Irrigated with saline.
Bioactive synthetic scaffold (BSS) placed x5 for primary closure.
Hemostasis achieved, post-operative instructions given.
2. Tooth #16:
Local anesthesia extraction (LA XAP) performed.
Hemostasis achieved, post-operative instructions given.
Post Operation Gallery
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Post-operative Assessment
Pre-operative CBCT taken:
Tooth #16: Caries extending to the pulp, very close to furcation with significant distal bone loss.
Tooth #21: Retained root with PA lesion.