Surgical Removal of Fully Impacted Lower Wisdom Tooth (#48)
Surgical Removal
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Chief Complaint
Patient presented with pain and swelling associated with the lower right wisdom tooth region.
Clinical Findings
Tooth #48 fully buried within the mandibular bone
Diagnosis: Completely impacted lower right third molar
Clinical symptoms consistent with inflammation associated with impaction
Treatment Plan
Surgical removal of impacted tooth #48 under local anaesthesia
Post-operative radiographic confirmation to ensure complete removal and nerve integrity
Pre-operative Assessment
CBCT imaging reviewed together with the patient
Surgical approach, risks, and expected outcomes explained
Risk of paraesthesia involving the lower lip and tongue was discussed
Patient demonstrated understanding and provided informed consent
Anesthesia
Local anaesthesia administered:
Right Inferior Dental Nerve (IDN) block
Lingual Nerve (LN) block
Long Buccal Nerve (LBN) block
Surgical Procedure
Patient cleaned and draped under sterile conditions
Buccal incision made and full-thickness flap raised
Bone guttering performed to access the impacted tooth
Tooth #48 sectioned and removed in multiple fragments
Thorough curettage of the socket
Surgical site irrigated with sterile saline
Primary closure achieved using sutures
Hemostasis confirmed

Post-operative Assessment
Post-operative CBCT taken
No retained tooth fragments detected
Inferior Dental Nerve confirmed intact and not involved in the surgical site
Patient reassured and provided post-operative instructions
