Surgical Removal of Impacted and Infected Wisdom Tooth – Tooth #38
Surgical Procedure
Chief Complaint
Patient complained of pain and swelling on the lower left side and requested removal of the affected tooth.
Clinical Findings
Tooth #38:
Mesially impacted
Gross caries extending into the pulp
Associated pain and swelling
Diagnosis consistent with pulpitis
Pre-operative CBCT findings:
Caries to pulp on #38
Mesially curved root tip
Impacted position confirmed
Incidental finding:
Retained roots noted at tooth #48 site
Patient informed of the finding
Treatment Plan
Surgical removal of impacted and infected wisdom tooth #38 under local anesthesia
Post-operative imaging to confirm complete removal
Pre-operative Assessment
Pre-operative CBCT reviewed
Risks, benefits, and procedural steps explained
Specific risks of paraesthesia involving the lower lip and tongue discussed
Patient understood and agreed to proceed
Informed consent obtained
Anesthesia
Local anesthesia via left inferior dental nerve (IDN), lingual nerve (LN), and long buccal nerve (LBN) block
Surgical Procedure
Patient cleaned and draped
Buccal incision made and flap raised
Bone guttering performed
Tooth sectioned
Tooth #38 elevated and removed in five pieces
Thorough curettage performed
Surgical site irrigated with saline
Four bone substitute sponges placed for primary closure
Hemostasis achieved
Post-operative instructions provided
Post-operative Assessment
Post-operative CBCT taken
No residual tooth fragments noted
Inferior dental nerve and maxillary sinus intact and not involved
Patient reassured