Surgical Removal of #28, #37, #38
Surgical Removal
Chief Complaint
Patient complains of pain in the 3rd quadrant and requests exploratory periapical surgery (XAP).
Clinical Findings
Tooth #37: buccal swelling with deep buccal and lingual probing depths, perio-endo involvement.
Tooth #38: impacted with severe food trap between #38 and #37.
Tooth #28: non-functional.
Treatment Plan
XAP of #37.
Extraction (EXO) of #37, #38, and #28.
Pre-operative Assessment
CBCT taken, showing impacted #38 and non-functional #28.
Risks and procedures explained.
Patient understood and agreed to proceed.
Informed consent obtained.
Anesthesia
Local Anesthesia (LA) for XAP of #28 and #37.
Surgical Procedure
XAP of #28 and #37 performed successfully.
EXO of #38 complicated by retained mesial (m) and distal (d) roots.
CBCT taken, tracing inferior dental nerve (IDN).
Advised LA OP removal of #38 retained roots.
Patient agreeable, informed consent obtained.
Patient cleaned and draped.
Incision made, buccal flap raised.
Bone guttering performed.
#38 (m) and (d) roots picked out.
Currettage performed, granulation tissues removed.
Irrigation with saline.
BSS (biodegradable sutures) x 05 placed for primary closure.
Hemostasis achieved, post-operative instructions (POI) given.
Post-operative CBCT taken, no remnants noted, IDN spared.
Post-operative Assessment
Hemostasis achieved.
Post-operative CBCT showed no remnants and IDN spared.
Patient satisfied with the outcome.