Retained Root Removal of #36
Surgical Removal
Extraction, Retained Root
Chief Complaint
Patient complains of recurring swelling in the third quadrant since February 22, 2022.
Clinical Findings
Incomplete removal of tooth #38 took over 2 hours on February 22, 2022.
Seen by M.O. on April 3, 2022; prescribed antibiotics and painkillers.
Antibiotics reported to help reduce swelling in the third quadrant.
Patient seen on March 1, 2022, by the original operator who removed #38; swelling not resolved.
Treatment Plan
Advised CBCT to investigate the area.
CBCT taken; findings include distal retained root of #38 and large PA lesion forming a sinus tract on the buccal of #36.
Buccal bone eroded by abscess/radicular cyst.
Informed patient about the risks of paresthesia to the lower lip and tongue, and the possibility of OAP/OAF.
Patient agreed to the surgical removal of the retained root of #38 and XAP of #36.
Pre-operative Assessment
Patient shown CBCT findings.
Informed consent taken.
Anesthesia
LA block (L) IDN, LN, and LBN administered.
Surgical Procedure
1. Tooth #38:
Incision and buccal flap raised.
Root located and bone guttering performed.
#38 retained root elevated and removed after being luxated with peritomes.
Curettage and irrigation with saline.
2. Tooth #36:
LA XAP performed.
Granulation tissue removed.
Curettage and irrigation with saline.
3. Post-operative CBCT:
Noted a portion of the distal root of #38 still in the socket.
Further bone guttering and exploration performed.
Remnant root structure of #38 removed.
Irrigation with saline.
BSS x 05 placed for primary closure.
Hemostasis achieved, POI given.
Post Operation Gallery
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Post-operative Assessment
Patient shown CBCT findings.
Informed consent taken.