Retained Root Removal for Tooth #37
Surgical Removal
Retained Root
Chief Complaint
Patient complains of pain from retained root of tooth #37.
Clinical Findings
Tooth #37 is very tender to palpation (TTP) and tender to percussion (TTPp).
Mobility and probing depth within normal limits (WNL).
Diagnosed with pulpitis and grossly carious retained roots in tooth #37.
Caries extend to the furcation and subcrestal regions.
Treatment Plan
Advised local anesthesia operative removal (LAOP) of #37 retained roots.
Discussed procedures, risks, costs, and replacement alternatives with the patient.
Patient understood and agreed to proceed with the removal of the retained root of #37 under LAOP.
Pre-operative Assessment
Pre-operative CBCT taken, showing:
Inferior dental nerve (IDN) plotted.
Retained root of #37 with class III furcation involvement.
Caries extending to the furcation.
Mesial root with a large periapical lesion.
Very long roots.
Anesthesia
Local anesthesia block administered to the left inferior dental nerve (IDN), lingual nerve (LN), and long buccal nerve (LBN).
Surgical Procedure
Patient cleaned and draped.
Incision made, and buccal flap raised.
Bone guttering performed.
Tooth sectioned, and #37 elevated out in three pieces.
Curettage performed, granulation tissue, and radicular cyst removed.
Irrigation with saline carried out.
Five black silk sutures (BSS) placed for primary closure.
Hemostasis achieved, post-operative instructions (POI) given.
Post Operation Gallery
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Post-operative Assessment
Pre-operative CBCT taken, showing:
Inferior dental nerve (IDN) plotted.
Retained root of #37 with class III furcation involvement.
Caries extending to the furcation.
Mesial root with a large periapical lesion.
Very long roots.