Operculectomy and Surgical Exposure of Tooth #48
Surgical Procedure
Chief Complaint
Patient complained of worsening pain on biting on the right side, associated with headaches over the past few days and difficulty closing the mouth fully.
Clinical Findings
Traumatic bite injury to the operculum over tooth #48 caused by opposing tooth #17
Localised inflammation consistent with pericoronitis around #48
Purulent exudate noted at the operculum
OPG findings:
Tooth #48 erupting straight and vertically
Partially erupted with distal bone coverage
Vertical impaction considered
Treatment Plan
Two treatment options were discussed:
Operculectomy with surgical exposure of tooth #48 to allow natural eruption
Surgical removal of tooth #48
The patient elected to proceed with Option 1: Operculectomy and surgical exposure.
Pre-operative Assessment
OPG reviewed
Risks, benefits, and procedural steps explained
Patient and parent understood and agreed to proceed
Parental consent obtained from patient’s mother
Informed consent obtained from patient
Anesthesia
Local anesthesia via right inferior dental nerve (IDN), lingual nerve (LN), and long buccal nerve (LBN) block
Surgical Procedure
Patient cleaned and draped
Incision made and operculum dissected and removed
Surgical exposure of tooth #48 achieved
Traumatic contact between #17 and #48 eliminated
Laser used to refine soft tissue contour and achieve hemostasis
Post-operative clinical photographs taken
Post-operative Assessment
Immediate relief of traumatic soft tissue impingement achieved
Hemostasis satisfactory
Post-operative instructions provided