Surgical Removal of #22, #23
Surgical Removal
Extraction
Chief Complaint
Patient reports severe pain in the area of teeth #22 and #23.
Clinical Findings
Tooth #22: Prior gross carious access preparation (CAP) before patient's trip to Taiwan. Painful after CAP with subsequent tooth fracture. Very tender to palpation (TTP) and percussion (TTPp). Mobility and probing depth within normal limits. Slight metallic sound on percussion. Dense bone and potential ankylosis noted.
Tooth #23: Very tender to palpation (TTP) and percussion (TTPp). Mobility increased from I to II, likely due to heavy occlusion load. Probing depth increased. Significant attrition approaching the pulp. Requires restorative work following root canal treatment (RCT).
Treatment Plan
Surgical extraction of #22.
Evaluation and X-ray of #23.
Pre-operative Assessment
Risks and procedures explained to the patient.
Informed consent obtained for the removal of #22 and X-ray of #23.
Pre-operative CBCT taken.
Anesthesia
Local anesthesia administered.
Surgical Procedure
1. Patient cleaned and draped.
2. Incision made, and buccal flap raised.
3. Bone guttering performed.
4. Tooth sectioning:
- **#22**: Elevated atraumatically in two pieces to minimize bone loss.
5. X-ray of **#23** performed.
6. Curettage and irrigation with saline.
7. BSS x 06 placed for secondary closure.
8. Haemostasis achieved and post-operative instructions provided.
Post Operation Gallery
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Post-operative Assessment
Risks and procedures explained to the patient.
Informed consent obtained for the removal of #22 and X-ray of #23.
Pre-operative CBCT taken.