Impacted #48, Carious #47, and Retained Roots of #18
Surgical Removal
Impacted Wisdom Tooth, Retained Root
Chief Complaint
Patient reported pain and swelling on the lower right side.
Clinical Findings
Tooth #48: Impacted.
Tooth #47: Distal-occlusal-buccal-lingual (dobl) caries extending to the pulp.
Tooth #18: Retained roots.
Treatment Plan
Removal of impacted tooth #48 and retained roots of #18 under local anesthesia (LA).
Extraction (XAP) of carious tooth #47 under local anesthesia (LA).
Pre-operative Assessment
Pre-operative CBCT taken.
Inferior Dental Nerve (IDN) plotted.
Risks of paraesthesia to lower lip and tongue, and oro-antral perforation (OAP) or oro-antral fistula (OAF) explained to the patient.
Procedures thoroughly explained.
Patient understood and agreed to proceed.
Informed consent obtained.
Anesthesia
Right IDN, LN, and LBN blocks administered.
LA infiltration at #18.
Surgical Procedure
Preparation:
Patient cleaned and draped.
Extraction of #47:
Initial LA XAP attempt blocked by impacted #48.
Removal of #48:
Incision made and buccal flap raised.
Bone guttering performed.
Tooth sectioned and elevated out in six pieces.
Curettage and irrigation with saline.
Completion of #47 Extraction:
Successfully completed LA XAP for #47.
Curettage and irrigation with saline.
BSS placed for primary closure.
Achieved haemostasis.
POI given.
Removal of #18:
Incision made and buccal flap raised.
Bone guttering performed.
Tooth sectioned and elevated out in two pieces.
Curettage and irrigation with saline.
BSS placed for closure.
Achieved haemostasis.
POI given.
Post Operation Gallery
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Post-operative Assessment
Pre-operative CBCT taken.
Inferior Dental Nerve (IDN) plotted.
Risks of paraesthesia to lower lip and tongue, and oro-antral perforation (OAP) or oro-antral fistula (OAF) explained to the patient.
Procedures thoroughly explained.
Patient understood and agreed to proceed.
Informed consent obtained.