Surgical Removal of #38, #37
Surgical Removal
Chief Complaint
Patient complains of pain and swelling, and requests the removal of tooth #38.
Clinical Findings
Tooth #38 is mesially impacted.
Tooth #28 has a traumatic bite on the operculum of #38.
Tooth #37 has periodontal-endodontic involvement with furcation class II to III.
Treatment Plan
Removal of impacted tooth #38 and extraction of tooth #37 under local anesthesia.
Pre-operative CBCT reviewed.
Pre-operative Assessment
Patient informed of the risks of paresthesia to the lower lip and tongue.
The procedure was explained, and the patient agreed to proceed.
Informed consent obtained for the removal of tooth #38 and #37 under local anesthesia.
The patient opted against the extraction of tooth #28 due to cost.
Anesthesia
Local anesthesia administered: left inferior dental nerve (IDN), lingual nerve (LN), and long buccal nerve (LBN) block.
Surgical Procedure
Patient cleaned and draped.
Incision made, buccal flap raised.
Bone guttering performed.
Tooth #38 sectioned and elevated in 2 pieces.
Tooth #37 elevated completely.
Curettage performed, with granulation tissue fully removed.
Irrigation with saline conducted.
Five BSS (Bone Spongiosa Substitute) placed for primary closure.
Haemostasis achieved, and post-operative instructions given.
Post-operative Assessment
Post-operative CBCT taken; no tooth remnants noted.
Inferior dental nerve (IDN) intact, not involved in the surgery.
Patient reassured.