Surgical Removal of Buried and Impacted #38
Surgical Removal
Chief Complaint
Patient complains of pain and swelling in the lower left posterior region.
Clinical Findings
Tooth #38: Completely buried and impacted.
Pain and localized swelling present.
Patient requested extraction of #38.
Treatment Plan
Surgical removal of tooth #38 under local anaesthesia (LA OP).
Pre-operative Assessment
Pre-operative CBCT reviewed.
Inferior dental nerve (IDN) plotted.
Risks of paraesthesia to lower lip and tongue discussed.
Procedure and potential complications explained to patient and guardian.
Patient and parent provided informed consent and agreed to proceed.
Anesthesia
LA block administered: left IDN, lingual nerve (LN), and long buccal nerve (LBN).
Surgical Procedure
Patient cleaned and draped in sterile fashion.
Buccal flap raised after incision.
Bone guttering performed.
Tooth #38 sectioned.
#38 elevated in 16 pieces.
Thorough curettage of socket.
Irrigated with saline.
3 sutures placed with 4/0 BSS for primary closure.
Hemostasis achieved.
Photos and video taken for documentation.
Post-operative CBCT taken.
Post-operative Assessment
No retained tooth fragments observed on post-op CBCT.
IDN intact and not involved in surgery.
Patient reassured.