Surgical Removal of Fully Bony Impacted Wisdom Tooth – Tooth #48
Surgical Removal
Chief Complaint
Patient complained of pain and swelling on the lower right side and requested removal of the affected wisdom tooth.
Clinical Findings
Tooth #48:
Completely buried within bone
Fully bony impacted
Associated with pain and swelling
Pre-operative CBCT reviewed together with the patient
Relationship of tooth #48 to surrounding anatomical structures assessed
Treatment Plan
Surgical removal of fully bony impacted wisdom tooth #48 under local anesthesia
Post-operative imaging to confirm complete removal and nerve integrity
Pre-operative Assessment
Pre-operative CBCT reviewed with the patient
Risks, benefits, and procedural steps explained
Specific risks of paraesthesia involving the lower lip and tongue discussed
Patient understood and agreed to proceed
Informed consent obtained
Anesthesia
Local anesthesia via right inferior dental nerve (IDN), lingual nerve (LN), and long buccal nerve (LBN) block
Surgical Procedure
Patient cleaned and draped
Buccal incision made and flap raised
Bone guttering performed
Tooth sectioned
Tooth #48 elevated and removed in seven pieces
Thorough curettage performed
Surgical site irrigated with saline
Three bone substitute sponges placed for primary closure
Hemostasis achieved
Post-operative instructions provided
Post-operative Assessment
Post-operative CBCT taken
No residual tooth fragments noted
Inferior dental nerve intact and not involved
Patient reassured