Surgical Removal of Impacted Teeth #38, #28, #37
Surgical Removal
Impacted Wisdom Tooth, Extraction
Chief Complaint
Pain in the back teeth on the lower left jaw.
Clinical Findings
Tooth #38: Horizontally impacted
Severe food trap between teeth #38 and #37
Tooth #37: Distal caries with possible involvement to the pulp and significant bone loss (~50%) on the distal aspect
Patient reported pain and swelling in the affected area
Treatment Plan
Local Anesthesia (LA) Outpatient Procedure: Removal of impacted teeth #38 and #28, and extraction of tooth #37.
Alternative Treatment: Removal of impacted teeth #38 and #28, and root canal treatment (RCT) followed by post and crown on tooth #37.
The patient chose the first option, which involves the removal of the impacted teeth and the extraction of the carious tooth.
Pre-operative Assessment
Cone Beam Computed Tomography (CBCT) scan was taken.
Findings:Mesially impacted and buried tooth #28
Horizontally impacted tooth #38
Tooth #37 with distal caries extending to the pulp and 50% bone loss
Anesthesia
Local anesthesia block for the left inferior dental nerve (IDN), lingual nerve (LN), and long buccal nerve (LBN).
Local infiltration anesthesia for tooth #28.
Surgical Procedure
Removal of Tooth #38 and Extraction of Tooth #37:
Incision and buccal flap raised
Bone guttering performed
Tooth #38 sectioned and removed in two pieces
Tooth #37 removed in one piece
Curettage and saline irrigation
BSS sutures placed for primary closure
2. Removal of Impacted Tooth #28:
Incision and buccal flap raised
Bone guttering performed
Tooth #28 sectioned and removed in two pieces
Curettage and saline irrigation
BSS sutures placed for primary closure
Post Operation Gallery
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Post-operative Assessment
Cone Beam Computed Tomography (CBCT) scan was taken.
Findings:Mesially impacted and buried tooth #28
Horizontally impacted tooth #38
Tooth #37 with distal caries extending to the pulp and 50% bone loss