Surgical Removal of Impacted Upper Left Wisdom Tooth (#18) and Extraction of Tooth #17
Surgical Removal
Chief Complaint
Patient presented with pain and swelling on the upper left region and requested removal of tooth #18 and #17.
Clinical Findings
Tooth #18: Partially buried in bone; impacted.
Tooth #17: Periodontal-endodontic involvement.
Pain and swelling present.
Pre-operative CBCT taken; no additional pathology noted.
Treatment Plan
Surgical removal (LA OP) of impacted #18.
Extraction (LA XAP) of #17.
Discussed risks including paresthesia to lower lip/tongue and OAC/OAF.
Patient understood and consented.
Pre-operative Assessment
CBCT reviewed.
No proximity concerns with IDN or maxillary sinus.
Medical history reviewed; patient fit for LA.
Anesthesia
LA block: Left IDN, LN, LBN.
LA infiltration at #18 and #17.
Surgical Procedure
Tooth #18 (Impacted)
Patient cleaned and draped.
Incision and buccal flap raised.
Bone guttering performed.
Tooth sectioned.
#18 elevated in 2 pieces.
Complete curettage and saline irrigation.
Granulation tissue fully removed.
Primary closure with 7 sutures (BSS).
Hemostasis achieved; POI given.
Tooth #17 (XAP)
Socket curetted and irrigated with saline.
Hemostasis achieved; POI given.
Post-operative Imaging:
Post-op CBCT confirmed no root remnants.
IDN and maxillary sinus intact and not involved.
Patient reassured and discharged in stable condition.
Post-operative Assessment
Successful removal of impacted #18 and extraction of #17.
No complications noted.
IDN and sinus unaffected.
Patient tolerated procedure well.