Surgical Removal of #38, #28
Surgical Removal
Extraction
Chief Complaint
Pain and swelling on the left side of the throat due to a horizontally impacted tooth #38 with a severe food trap and multiple episodes of pericoronitis.
Clinical Findings
Tooth #38 is horizontally impacted, leading to recurrent pericoronitis and pain. The patient reports swelling and discomfort extending down the left side of the throat.
Treatment Plan
Local anesthesia (LA) for the surgical removal of tooth #38 and extraction of tooth #28.
Pre-operative Assessment
Pre-op CBCT taken and reviewed.
Risks of paraesthesia to the lower lip and tongue, as well as OAP/OAF, were discussed.
Procedures explained.
Patient understood and agreed to proceed.
Informed consent obtained.
Anesthesia
Local anesthesia administered (block left IDN, LN, and LBN) with LA infiltration for tooth #28.
Surgical Procedure
Patient cleaned and draped.
Incision made, buccal flap raised.
Bone guttering performed.
Tooth sectioned.
Mid-op CBCT taken to assess the proximity of the IDN to the retained mesial root.
Mesial root removed using periotomes.
Tooth #38 elevated out in nine pieces.
Curettage performed, followed by irrigation with saline.
BSS x 03 placed for primary closure.
Haemostasis achieved.
LA XAP performed on tooth #28.
Irrigation with saline followed by haemostasis.
Post-op CBCT taken, confirming no tooth remnants.
IDN and maxillary sinus were intact and not involved in the surgery.
Post Operation Gallery
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Post-operative Assessment
Pre-op CBCT taken and reviewed.
Risks of paraesthesia to the lower lip and tongue, as well as OAP/OAF, were discussed.
Procedures explained.
Patient understood and agreed to proceed.
Informed consent obtained.