Removal of Partially Erupted and Horizontally Impacted Tooth #48 and Carious Tooth #18
Surgical Removal
Impacted Wisdom Tooth
Chief Complaint
Patient requests the removal of partially erupted and horizontally impacted tooth #48 and disto-buccal tilted carious, non-functional tooth #18.
Clinical Findings
Tooth #48: Partially erupted, horizontally impacted
Tooth #18: Disto-buccal tilted, carious, non-functional
Treatment Plan
Removal of tooth #48 and tooth #18
Pre-operative CBCT taken
Explained risks of paresthesia to lower lip and tongue, and potential for oroantral perforation/fistula (OAP/OAF)
Emphasized close proximity of tooth #48 to inferior dental nerve (IDN) and tooth #18 to maxillary sinus
Patient understood and agreed to proceed
Informed consent obtained for local anesthesia operative (LAOP) removal of tooth #48
Pre-operative Assessment
Anesthesia
LA block: right inferior dental nerve (IDN), lingual nerve (LN), and long buccal nerve (LBN)
LA infiltration for tooth #18
Surgical Procedure
Tooth #48:
Patient cleaned and draped
Incision made, buccal flap raised
Bone guttering performed
Tooth sectioned
Tooth #48 elevated out in four pieces
Curettage and irrigation with saline
Bioactive synthetic scaffold (BSS) placed x5 for primary closure
Hemostasis achieved, post-operative instructions given
2. Tooth #18:
Extraction under local anesthesia (LA XAP)
Irrigation with saline
Hemostasis achieved, post-operative instructions given
Post Operation Gallery
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