Surgical Removal of #37
Surgical Removal
Chief Complaint
Patient complains of swelling and inability to bite down fully for the past week, including through Christmas, on the left-hand side. Reports swelling distal of tooth #37.
Clinical Findings
#27 disto-buccal cusp causing a traumatic bite on the ridge distal of #37, leading to food trapping into the gingival sulcus distal of #37.
Treatment Plan
Advised reduction of #27 disto-buccal cusp to prevent food trapping and traumatic bite.
Patient was agreeable to the treatment.
Pre-operative Assessment
#27 disto-buccal cusp reduced, and finishing done.
Tooth #48 completely buried in gingiva and bone, horizontally impacted.
Patient reports pain and swelling and requested removal of tooth #48. Pre-operative CBCT was taken.
Anesthesia
Local anesthesia (LA) block administered to the right IDN, LN, and LBN.
Surgical Procedure
Patient cleaned and draped.
Incision made, and buccal flap raised.
Bone guttering and tooth sectioning performed.
Tooth #48 elevated out in 18 pieces.
Curettage and saline irrigation were done.
Bone grafting at the #48 surgical site to promote bone regeneration and coverage of the #47 distal root surfaces.
Two syringes of 1.0 cc EthOss artificial bone grafting material placed.
BSS x 05 placed for primary closure.
Haemostasis achieved.
Post-operative Assessment
Post-operative CBCT taken.
No tooth remnants noted.
IDN intact and not involved in the surgery.
Bone graft dense.
Patient reassured.