Retained Root Removal #17 and Composite Restoration #46
Surgical Removal
Retained Root
Chief Complaint
Patient complains of food trapping in a deep occlusal depression of tooth #46 and issues with non-functional tooth #17.
Clinical Findings
Tooth #46: Composite resin (TCR) leakage and deficiency on occlusal (o) surface.
Tooth #17: Distal occlusal pulp (dop) caries extending to the pulp; egg-shell tooth, non-functional.
Treatment Plan
Tooth #46:
Removal of existing TCR
Prophylaxis (CF)
Etch, prime, and bond
Placement of new composite resin (CR) A2
Occlusion check and finishing
2. Tooth #17:
Extraction (XAP) of tooth #17
Quoted $80 - $300 with a potential operative procedure (OP) cost of $1000+ if retained roots are inaccessible
Pre-operative Assessment
Pre-operative CBCT taken
Risks and procedures explained
Patient understood and agreed to proceed
Informed consent obtained for the extraction and potential retained root removal
Anesthesia
Local anesthesia for extraction of tooth #17
Surgical Procedure
Tooth #46:
TCR removed
Complete prophylaxis (CF)
Etch, prime, and bond
CR A2 placed
Occlusion checked and finishing done
2. Tooth #17:
Extraction under local anesthesia
Coronal fracture occurred, leaving retained roots
Attempted to luxate retained roots without success
Proceeded with local anesthesia operative (LAOP) removal of retained roots
Patient cleaned and draped
Incision made, buccal flap raised
Bone guttering performed
Tooth sectioned
Tooth #17 elevated out in five pieces
Curettage and irrigation with saline
Bioactive synthetic scaffold (BSS) placed x4 for primary closure
Hemostasis achieved, post-operative instructions given
Post Operation Gallery
 |  |  |
|---|---|---|
 |  |  |
Post-operative Assessment
Pre-operative CBCT taken
Risks and procedures explained
Patient understood and agreed to proceed
Informed consent obtained for the extraction and potential retained root removal