Retained Root Removal for #36

Chief Complaint

Patient requests removal of painful teeth in the 3rd and 4th quadrants.

Tooth #47: cracked, split with pus exudate, very tender to percussion and palpation, hopeless tooth, sub-crestal split.
Tooth #38: perio-endo involved, very tender to percussion and palpation, hopeless tooth.
Tooth #36: retained roots, tender to percussion, non-tender to palpation, mobile with probing depths within normal limits.

Removal of tooth #38 and #47.
Local anesthesia and surgical removal of retained roots of tooth #36.
Patient agreeable to the procedure after being informed of risks including parasthesia to lower lip and tongue, and oral-antral perforation or fistula.

Local anesthesia block (right and left) for inferior dental nerve, lingual nerve, and long buccal nerve.

Patient cleaned and draped.
Incision made, buccal flap raised.
Bone guttering performed.
Tooth #36 retained root elevated out in three pieces, curettage, and irrigation with saline. Bone substitute placed for primary closure. Hemostasis achieved, post-operative instructions given.
Tooth #38 extracted under local anesthesia. Profuse bleeding managed with curettage and irrigation with saline. Bone substitute placed for primary closure. Hemostasis achieved, post-operative instructions given.
Tooth #47 (cracked/split) extracted under local anesthesia. Profuse bleeding managed with curettage, granulation tissue removed, and irrigation with saline. Bone substitute placed for primary closure. Hemostasis achieved, post-operative instructions given.