Surgical Removal of Fully Buried Impacted Wisdom Tooth – Tooth #38
Surgical Removal
Chief Complaint
Patient complained of pain and swelling in the lower left posterior region and requested removal of the affected wisdom tooth.
Clinical Findings
Tooth #38:
Completely buried in soft tissue
Impacted
Associated with pain and swelling
Pre-operative CBCT reviewed
Relationship of tooth #38 to surrounding anatomical structures assessed
Treatment Plan
Surgical removal of fully buried impacted wisdom tooth #38 under local anesthesia
Post-operative imaging to confirm complete removal and nerve integrity
Pre-operative Assessment
Pre-operative CBCT reviewed
Risks, benefits, and procedural steps explained
Specific risks discussed included:
Paraesthesia involving the lower lip and tongue
Oroantral communication and oroantral fistula
Patient understood and agreed to proceed
Informed consent obtained
Anesthesia
Local anesthesia via left 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 #38 elevated and removed in three 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