Retained Root Removal for #14
Surgical Removal
Retained Root, Extraction
Chief Complaint
Patient complains of a fractured tooth #14 approximately two days ago.
Clinical Findings
Tooth #14: hopeless, sub-gingival and possibly sub-crestal fracture.
Very sensitive to cold, very painful at night.
Very tender to percussion, non-tender to palpation.
Metallic sound on percussion.
Palatal portion lost.
Suspected ankylosis or very dense bone.
Indian race and heavy body build.
Suspected long roots with very dense bone and potential ankylosis.
Treatment Plan
CBCT to check if tooth #14 is single or double rooted and to determine root length.
Patient agreed, and CBCT was taken, revealing:
Tooth #14 is two-rooted with long, divergent roots.
Dense bone present.
Advised surgical removal of retained roots of tooth #14 under local anesthesia.
Risks and procedures explained, including higher infection risks due to uncontrolled diabetes.
Patient understood and agreed to proceed.
Informed consent obtained.
Pre-operative Assessment
CBCT taken to assess root structure and bone density.
Anesthesia
Local anesthesia infiltration for tooth #14.
Surgical Procedure
Patient cleaned and draped.
Incision made, buccal flap raised.
Bone guttering performed.
Tooth sectioned.
Tooth #14 elevated out in three pieces.
Surgery was very difficult due to dense bone and the need to conserve bone for future implant.
Curettage and irrigation with saline.
Bone substitute placed for primary closure.
Hemostasis achieved and post-operative instructions given.
Post Operation Gallery
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Post-operative Assessment
CBCT taken to assess root structure and bone density.