Surgical Removal of Gross Caries and Retained Roots #26
Surgical Removal
Retained Root
Chief Complaint
Patient presented with gross caries to the pulp and furcation on tooth #26.
Clinical Findings
Gross caries
Fractured and lost (mp) cusp
Loose (dp) cusp due to tooth fracture
Very tender to percussion (TTP) and pressure (TTPp)
Mobility and probing depth within normal limits
Slight metallic sound on percussion
Possible very dense bone or ankylosis
Buccal sinus tract noted
Treatment Plan
Advised LAP OP removal of #26 retained roots
Risks and procedures explained
Patient understood and agreed to proceed
Pre-operative Assessment
Tooth #26:
Fractured; retained roots
Three-rooted structure
Roots of tooth #27 situated between (db) and (p) roots of #26
Roots of tooth #27 in close proximity to roots of #26
Periapical (PA) lesions noted on (mb), (db), and (p) roots of #26
Root apices close to maxillary sinus
Anesthesia
Local anesthesia infiltration at tooth #26.
Surgical Procedure
Patient cleaned and draped
Incision made, buccal flap raised
Bone guttering performed
Tooth sectioned
Tooth #26 elevated out in six pieces
Curettage and irrigation with saline
BSS x 03 placed for secondary closure
Haemostasis achieved, post-operative instructions given
Post-operative CBCT taken, showing no remnants
Maxillary sinus and adjacent teeth not involved
Post Operation Gallery
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Post-operative Assessment
Tooth #26:
Fractured; retained roots
Three-rooted structure
Roots of tooth #27 situated between (db) and (p) roots of #26
Roots of tooth #27 in close proximity to roots of #26
Periapical (PA) lesions noted on (mb), (db), and (p) roots of #26
Root apices close to maxillary sinus