Surgical Removal of Impacted #48 with Adjunctive Debridement of #47 Buccal Abscess
Surgical Removal
Chief Complaint
Pain and swelling over the lower right posterior region.
Patient requested removal of wisdom teeth.
Clinical Findings
Intraoral examination revealed:
Buccal abscess associated with #47
Impacted #48
Localized infection in lower right posterior region
Pre-operative CBCT taken for surgical assessment.
Treatment Plan
Surgical removal of impacted #48 under local anesthesia
Root surface debridement and open flap debridement of #47
Irrigation and primary closure of surgical site
Risks explained, including possible paresthesia involving lower lip and tongue.
Patient understood and consent obtained prior to procedure.
Pre-operative Assessment
CBCT evaluation performed.
Relationship between impacted tooth and inferior alveolar nerve assessed.
No contraindications to surgery identified.
Anesthesia
Inferior Dental Nerve block
Lingual nerve block
Long buccal nerve block
Supplementary infiltration at #47 and #48 regions
Surgical Procedure
Patient prepared and draped under sterile conditions.
Procedure performed as follows:
Local anesthesia achieved
Buccal incision made
Buccal flap elevated
Bone guttering performed
Tooth sectioned
Impacted #48 removed in three segments
Open flap debridement performed at #47
Curettage completed
Surgical site irrigated with saline
Primary closure achieved with sutures
Hemostasis confirmed
Post-operative CBCT taken.
No retained tooth fragments detected.
Inferior alveolar nerve remained intact and not involved intraoperatively.
Post-operative Assessment
Surgical removal completed successfully.
No complications observed.
No nerve involvement detected radiographically.
Patient reassured and post-operative instructions provided.