Retained Root Removal for Tooth #24
Surgical Removal
Retained Root
Chief Complaint
Patient complains of pain in the 2nd quadrant.
Clinical Findings
Teeth #24 and #25 show gross subgingival and subcrestal caries on the buccal side.
Buccal cusps lost to caries.
Caries extending to the pulp.
Poor restorative prognosis for both teeth.
Treatment Plan
Extraction of teeth #24 and #25 under local anesthesia (LA).
Possible operative procedure if complications arise.
Pre-operative Assessment
Periapical (PA) radiograph taken.
Risks and procedures explained to the patient.
Patient agrees to proceed.
Pre-operative CBCT taken for further assessment.
Anesthesia
Local anesthesia administered for extraction of #24 and #25 using periotomes and elevators.
Surgical Procedure
Tooth #24 coronal portion fractured off subgingivally, possibly subcrestally.
Tooth #25 luxated with elevators and extracted completely.
Patient prepped for LA operative removal of #24 retained roots.
Risks of sinus complications emphasized due to #24 retained roots being surrounded by the sinus; costs explained again.
Patient understood and agreed to proceed.
Patient cleaned and draped.
Incision made, and buccal flap raised.
Bone guttering performed.
Tooth sectioning done.
Tooth #24 elevated out in 4 pieces.
Curettage performed and irrigated with saline.
BSS (bone substitute sponge) x 5 placed for primary closure.
Hemostasis achieved and post-operative instructions given.
Post Operation Gallery
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Post-operative Assessment
Periapical (PA) radiograph taken.
Risks and procedures explained to the patient.
Patient agrees to proceed.
Pre-operative CBCT taken for further assessment.