Surgical Removal of Impacted Wisdom Tooth #38 and Extraction of Tooth #28
Surgial Removal
Chief Complaint
Patient presented with pain and swelling in the lower left posterior region.
Clinical Findings
Clinical examination revealed slight pus discharge from the distal area of tooth #37 with a greyish appearance suggestive of infection associated with the adjacent impacted wisdom tooth.
CBCT imaging showed tooth #38 to be unerupted and completely buried in soft tissue, indicating an impacted wisdom tooth. Patient also requested removal of tooth #28.
Treatment Plan
Surgical removal of impacted tooth #38 under local anesthesia.
Extraction of tooth #28 under local anesthesia.
Pre-operative and post-operative CBCT imaging for assessment and confirmation of complete removal.
Pre-operative Assessment
CBCT was taken to evaluate the position of impacted tooth #38 and its relationship to surrounding anatomical structures.
Risks including possible paraesthesia affecting the lower lip and tongue, as well as oroantral perforation or fistula, were explained.
Procedures were explained in detail.
Patient understood the risks and agreed to proceed.
Informed consent obtained.
Anesthesia
Local anesthesia administered via left inferior dental nerve block, lingual nerve block, and long buccal nerve block.
Additional local infiltration anesthesia administered for tooth #28.
Surgical Procedure
Tooth #38:
Patient was cleaned and draped under sterile conditions.
A surgical incision was made and a buccal flap was raised. Bone guttering was performed to access the impacted tooth. Tooth sectioning was carried out and the tooth was elevated and removed in multiple fragments. The socket was curetted and irrigated thoroughly with saline. Sutures were placed for primary closure and haemostasis achieved.
Tooth #28:
Extraction was performed under local anesthesia. The socket was irrigated with saline and haemostasis achieved.
Post-operative CBCT confirmed complete removal with no remaining tooth fragments.
Post-operative Assessment
Post-operative imaging confirmed no residual tooth fragments. The inferior dental nerve and maxillary sinus remained intact and were not involved in the surgery.
Patient was reassured after the procedure.