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Surgical Removal of Fully Impacted Lower Wisdom Tooth (#48)

Surgical Removal

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

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