Surgical Removal of #48, #18, #47
Surgical Removal
Chief Complaint
Pain and swelling in the lower right region.
Clinical Findings
Tooth #48 is impacted
Tooth #47 has caries extending to the pulp
Tooth #18 has retained roots
Treatment Plan
Extraction of tooth #48 and #18
X-ray assessment of tooth #47
Pre-operative Assessment
CBCT taken
Identification of the inferior alveolar nerve (IDN) plotted
Procedure details and risks explained to the patient
Informed consent obtained
Anesthesia
Block anesthesia for right IDN, lingual nerve (LN), and buccal nerve (LBN)
Local infiltration for tooth #18
Surgical Procedure
Extraction of tooth #48: Incision, buccal flap raised, bone guttering, tooth sectioning, and extraction in six pieces
Extraction of tooth #18: Incision, buccal flap raised, bone guttering, tooth sectioning, and extraction in two pieces
Successful X-ray assessment of tooth #47 after extraction of #48
Curettage and saline irrigation performed after each extraction
Sutures placed for primary closure
Post-operative Assessment
Post-operative CBCT taken
No remnants of teeth noted
IDN and maxillary sinus intact and unaffected
Patient reassured