Surgical Removal of #37, #38
Surgical Removal
Extraction
Chief Complaint
The patient reports severe pain in tooth #37, which has caries extending to the pulp. The patient also requests the removal of tooth #38, which is deeply impacted.
Clinical Findings
Tooth #37 has caries to the pulp with extensive decay and thin surrounding walls.
Very long, thin roots observed.
Slight metallic sound on percussion.
Bone is dense.
Deeply impacted tooth #38 with long roots noted on OPG.
Treatment Plan
XAP of tooth #37.
Surgical removal of retained roots if necessary.
Surgical removal of impacted tooth #38 if extraction of #37 is required.
Consideration for implant or bridge to replace the missing tooth or leave the space empty.
Pre-operative Assessment
Pre-operative CBCT was reviewed, and the IDN was plotted. Risks of paraesthesia to the lower lip and tongue, as well as potential IDN injuries, were discussed with the patient.
Anesthesia
Local anesthesia block was administered to the left IDN, LN, and LBN.
Local anesthesia XAP was performed for #37.
Surgical Procedure
The patient was cleaned and draped.
An incision was made, and a buccal flap was raised.
Bone guttering and tooth sectioning were performed.
Tooth #37 was elevated in 09 pieces.
Curettage and irrigation with saline were done.
Tooth #38 was deeply embedded and horizontally impacted, elevated in 11 pieces.
Bone guttering and tooth sectioning for #38 were carried out.
BSS x 06 was placed for primary closure.
Haemostasis was achieved.
Post Operation Gallery
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Post-operative Assessment
Pre-operative CBCT was reviewed, and the IDN was plotted. Risks of paraesthesia to the lower lip and tongue, as well as potential IDN injuries, were discussed with the patient.