Removal of Impacted Tooth #48 and Extraction of Teeth #18 and #47
Surgical Removal
Impacted Wisdom Tooth
Chief Complaint
Patient reported pain and swelling in the lower right jaw.
Clinical Findings
Tooth #47:
Deep occlusal (do) caries to the pulp.
Very tender to palpation (TTP) and percussion (TTPp).
Mobility and probing depth within normal limits (WNL).
Tooth #48:
Impacted with slight TTP and TTPp.
Mobility and probing depth WNL.
Tooth #18:
Non-functional with poor oral hygiene.
Treatment Plan
Root canal treatment (RCT) for tooth #47
Extraction of teeth #48 and #18.
Patient is not keen on keeping #47
Extraction of teeth #47, #48 and #18
Pre-operative Assessment
Pre-operative CBCT taken.
Inferior Dental Nerve (IDN) plotted.
Informed patient about the risks of paraesthesia to the lower lip and tongue, and oro-antral perforation (OAP) or fistula (OAF).
Procedures explained thoroughly.
Patient understood and agreed to proceed.
Informed consent obtained.
Anesthesia
Right IDN, LN, and LBN blocks administered.
Local infiltration for #18.
Surgical Procedure
Preparation:
Patient cleaned and draped.
Buccal flap raised with an incision.
Removal of Tooth #48:
Bone guttering performed.
Tooth sectioned and elevated out in two pieces.
Curettage performed.
Irrigation with saline.
Six balanced salt solutions (BSS) placed for primary closure.
Achieved haemostasis.
Extraction of Tooth #47:
Elevated out completely.
Curettage and irrigation with saline.
Haemostasis achieved.
Extraction of Tooth #18:
Local anesthesia administered.
Tooth extracted.
Irrigation with saline.
Achieved haemostasis.
Post-operative instructions (POI) given.
Post Operation Gallery
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Post-operative Assessment
Pre-operative CBCT taken.
Inferior Dental Nerve (IDN) plotted.
Informed patient about the risks of paraesthesia to the lower lip and tongue, and oro-antral perforation (OAP) or fistula (OAF).
Procedures explained thoroughly.
Patient understood and agreed to proceed.
Informed consent obtained.