Surgical Removal of Impacted Tooth #38 and Extraction of Tooth #28
Surgical Removal
Impacted Wisdom Tooth
Chief Complaint
Patient requires surgical removal of impacted tooth #38 and extraction of tooth #28.
Clinical Findings
Tooth #38: Impacted
Tooth #28: Indicated for extraction
Treatment Plan
LAOP removal of impacted tooth #38
XAP extraction of tooth #28
Pre-operative CBCT to assess IDN and surgical planning
Pre-operative Assessment
Pre-operative CBCT taken and IDN plotted
Risks and procedures explained to the patient
Patient understood and agreed to proceed
Informed consent obtained for LAOP removal of #38
Anesthesia
LA block: left inferior dental nerve (IDN), lingual nerve (LN), and long buccal nerve (LBN)
LA infiltration for tooth #28
Surgical Procedure
Tooth #38 (LAOP):
Patient cleaned and draped
Incision made, buccal flap raised
Bone guttering performed
Tooth sectioned
Tooth #38 elevated out in six pieces
Curettage performed, irrigated with saline
Bioactive synthetic scaffold (BSS) placed x3 for primary closure
Procedure was difficult due to limited access
2. Tooth #28 (LA XAP):
Extraction performed
Procedure was difficult due to very dense bone
Hemostasis achieved, post-operative instructions given
Post Operation Gallery
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Post-operative Assessment
Pre-operative CBCT taken and IDN plotted
Risks and procedures explained to the patient
Patient understood and agreed to proceed
Informed consent obtained for LAOP removal of #38