Surgical Removal of Impacted Wisdom Tooth (#38) and Surgical Removal of Upper Left Third Molar (#28)
Surgical Removal
Chief Complaint
Patient presented with pain and swelling in the lower left posterior region and requested removal of tooth #38.
Clinical Findings
Deep horizontally impacted lower left third molar (#38).
Associated pain and swelling.
Upper left third molar (#28) indicated for removal.
CBCT taken pre-operatively.
Treatment Plan
Surgical removal of tooth #38 under local anesthesia.
Surgical removal of tooth #28 under local anesthesia.
Risks of paraesthesia to lower lip and tongue, as well as oro-antral communication, were explained.
Patient was informed of the procedures, understood, and provided written consent.
Pre-operative Assessment
Patient clinically and radiographically assessed with CBCT.
No contraindications for local anesthesia noted.
Anesthesia
Left inferior dental nerve, lingual nerve, and long buccal nerve block administered.
Local infiltration at #28 region.
Surgical Procedure
Patient prepared with standard draping.
Incision made and buccal flap raised at #38.
Bone guttering performed.
Tooth sectioned; #38 elevated and delivered in multiple pieces.
Curettage and copious saline irrigation.
Closure achieved with 4/0 Vicryl sutures ×3.
Hemostasis secured.
#28 Surgical Removal
Flap raised, tooth elevated.
Site irrigated with saline.
Hemostasis achieved.
Post-operative Assessment
Post-operative CBCT confirmed no retained fragments.
Inferior dental nerve and maxillary sinus intact and not involved.
Patient reassured and provided post-operative instructions.