Surgical Removal of Impacted Wisdom Teeth #38, #28
Surgical Removal
Extraction, Impacted Wisdom Tooth
Chief Complaint
Patient complains of pain and swelling in the lower left posterior area, with inflammation of the operculum of #38 due to traumatic bite from #27. Teeth #38 and #28 are impacted.
Clinical Findings
Vertically impacted #38 and mesially impacted #28.
Inflammation and swelling observed in the operculum of #38.
Treatment Plan
Surgical removal of vertically impacted #38 and mesially impacted #28.
Pre-operative Assessment
Pre-operative CBCT performed.
Risks of paresthesia to lower lip and tongue, as well as the possibility of oronasal fistula (OAF) and oroantral perforation (OAP), explained.
Procedures thoroughly discussed.
Patient understood and agreed to proceed.
Informed consent obtained.
Anesthesia
Local anesthesia block administered to left inferior dental nerve (IDN), lingual nerve (LN), and long buccal nerve (LBN).
Local infiltration for #28.
Surgical Procedure
1. Patient cleaned and draped.
2. Removal of #38:
- Incision made and buccal flap raised.
- Bone guttering performed.
- Tooth sectioned and elevated in two pieces.
- Curettage and irrigation with saline.
- Bone grafting material (BSS x 03) applied for primary closure.
- Haemostasis achieved, and post-operative instructions provided.
3. Removal of #28:
- Incision made and buccal flap raised.
- Bone guttering performed.
- Tooth sectioned and elevated in two pieces.
- Curettage and irrigation with saline.
- Bone grafting material (BSS x 06) applied for primary closure.
- Haemostasis achieved, and post-operative instructions provided.
Post Operation Gallery
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Post-operative Assessment
Pre-operative CBCT performed.
Risks of paresthesia to lower lip and tongue, as well as the possibility of oronasal fistula (OAF) and oroantral perforation (OAP), explained.
Procedures thoroughly discussed.
Patient understood and agreed to proceed.
Informed consent obtained.