Surgical Removal of #28, #37, #38
Surgical Removal
Extraction
Chief Complaint
Patient complains of pain and swelling on lower left side.
Clinical Findings
Deeply impacted tooth #38 with pericoronitis and pus exudate; only 1/8 of the coronal part of tooth #38 visible intra-orally.
Grossly decayed tooth #37 with caries extending to the pulp and 70% to 80% distal bone loss.
Non-functional tooth #28.
Treatment Plan
Extraction of teeth #28 and #37.
Local anesthesia (LA) for the removal of impacted and partially erupted tooth #38.
Pre-operative Assessment
Pre-operative CBCT taken.
Risks of parasthesia to lower lip and tongue, oroantral perforation (OAP), and oroantral fistula (OAF) explained.
Procedures explained, patient understood and agreed to proceed.
Informed consent taken.
Anesthesia
Local anesthesia block for left inferior dental nerve (IDN), lingual nerve (LN), and long buccal nerve (LBN).
Local anesthesia infiltration for tooth #28.
Surgical Procedure
Patient cleaned and draped.
Incision made, buccal flap raised.
Bone guttering performed.
Tooth #38 sectioned and elevated out in 7 pieces.
Tooth #37 elevated out in 1 piece.
Curettage and irrigation with saline.
BSS x 10 placed for primary closure.
Hemostasis achieved, post-operative instructions (POI) given.
LA extraction of tooth #28.
Irrigation with saline.
Hemostasis achieved, POI given.
Post-operative CBCT taken.
Post Operation Gallery
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Post-operative Assessment
Pre-operative CBCT taken.
Risks of parasthesia to lower lip and tongue, oroantral perforation (OAP), and oroantral fistula (OAF) explained.
Procedures explained, patient understood and agreed to proceed.
Informed consent taken.