Surgical Removal of Impacted Wisdom Tooth #38
Surgical Removal
Chief Complaint
Patient presented with pain and swelling at tooth #38 region.
Clinical Findings
Sub-gingival and interproximal calculus (+++).
Oral hygiene poor.
Tooth #38: Completely buried in bone, impacted.
CBCT reviewed — confirmed full bony impaction of #38.
Treatment Plan
Root planing quadrant by quadrant (3rd quadrant: #31–#37).
Local anesthesia root planing.
Hand instrumentation performed.
Irrigation with chlorhexidine mouthwash.
Surgical removal of impacted tooth #38.
Risks (paresthesia to lower lip and tongue) explained.
Procedure explained, patient understood and agreed.
Informed consent taken.
Pre-operative Assessment
Medical history reviewed.
CBCT assessed for root and nerve relation.
Patient fit for procedure.
Anesthesia
Local anesthetic: Left inferior dental nerve (IDN), lingual nerve (LN), and long buccal nerve (LBN) block.
Adequate anesthesia achieved.
Surgical Procedure
Patient cleaned and draped under aseptic conditions.
Incision made and buccal flap raised.
Bone guttering performed.
Tooth #38 sectioned.
#38 elevated in 4 pieces.
Curettage of socket performed.
Irrigation with saline.
6/0 Surgipro monofilament polypropylene sutures (BSS x06) placed for primary closure.
Hemostasis achieved.
Post-operative instructions provided.
Patient reassured.
Post-operative Assessment
Patient stable post-procedure.
Post-op CBCT taken.
Plan: Review in 1 week for suture removal.