Surgical Removal of Impacted #18
Surgical Removal
Extraction, Impacted Wisdom Tooth
Chief Complaint
Patient complains of sensitivity in the upper right posterior region.
Clinical Findings
Tooth #18 impacted with #17.
Significant food trapping.
Pre-op CBCT shows #18 vertically impacted with #17.
Very thin bone around the root of #18 and close proximity to the maxillary sinus.
High risk of Oro-Antral Perforation (OAP) and Oro-Antral Fistula (OAF).
Tooth #17 has distal cervical caries, causing sensitivity.
Impacted #48 also noted.
Treatment Plan
LA OP removal of #18 today.
LA OP removal of #48 at a later date.
Pre-operative Assessment
Risks of OAP/OAF informed and emphasized.
Procedures explained, and patient understood and agreed to proceed.
Informed consent obtained.
Anesthesia
Local anesthesia (LA) infiltration at #18.
Surgical Procedure
Patient cleaned and draped.
Incision made and buccal flap raised.
Bone guttering performed.
Tooth #18 sectioned and elevated out in two pieces.
Curettage and irrigation with saline.
BSS x 02 placed for secondary closure.
Haemostasis ensured, and post-operative instructions given.
Post Operation Gallery
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Post-operative Assessment
Risks of OAP/OAF informed and emphasized.
Procedures explained, and patient understood and agreed to proceed.
Informed consent obtained.