Surgical Removal for #38
Surgical Removal
Chief Complaint
Patient complains of pain and swelling in the area of tooth #38. The patient requested the removal of the impacted tooth.
Clinical Findings
Tooth #38 completely buried in bone and impacted.
Pain and swelling associated with the impacted tooth.
Treatment Plan
Removal of impacted tooth #38 under local anesthesia.
Pre-operative CBCT reviewed.
Pre-operative Assessment
Patient informed of the risk of paresthesia to the lower lip and tongue.
The procedure was explained, and the patient understood and agreed to proceed.
Informed consent obtained.
Anesthesia
Local anesthesia administered: left inferior dental nerve (IDN), lingual nerve (LN), and long buccal nerve (LBN) block.
Surgical Procedure
Patient cleaned and draped.
Incision made, buccal flap raised.
Bone guttering performed.
Tooth sectioned and elevated in 10 pieces.
Curettage and irrigation with saline.
Four BSS (Bone Spongiosa Substitute) placed for primary closure.
Haemostasis achieved, and post-operative instructions given.
Post-operative Assessment
Post-operative CBCT taken; no tooth remnants noted.
Inferior dental nerve (IDN) intact, not involved in the surgery.
Patient reassured and given 8 days of medical leave.
Additional Notes
Patient inquired about orthodontic treatment.
Cost and treatment modalities explained.
Discussion included clear aligners, metallic, and ceramic appliances.
Retention protocols and requirements explained.