Surgical Removal of Mesially Impacted Wisdom Tooth (#38) and Surgical Removal of Upper Left Third Molar (#28)
Surgical Removal
Chief Complaint
Patient presented with pain and swelling at the lower left posterior region, associated with food impaction and inflamed operculum. Requested removal of tooth #38.
Clinical Findings
Mesially impacted lower left third molar (#38) with caries, food impaction, and inflamed operculum.
Upper left third molar (#28) indicated for removal.
Pre-operative CBCT taken.
Treatment Plan
Surgical removal of tooth #38 under local anesthesia.
Surgical removal of tooth #28 under local anesthesia.
Patient advised on risks including paraesthesia to lower lip and tongue, and risk of oro-antral communication.
Patient understood procedure, consented, and agreed to proceed.
Pre-operative Assessment
CBCT reviewed, no contraindications to local anesthesia.
Patient clinically and radiographically assessed.
Anesthesia
Left inferior dental nerve block, lingual nerve block, and long buccal nerve block administered for #38.
Local infiltration given at #28.
Surgical Procedure
Tooth #38
Patient prepared and draped.
Incision made, buccal flap raised.
Bone guttering performed.
Tooth sectioned and removed in 4 pieces.
Site curetted and irrigated with saline.
Closure achieved with 5 interrupted sutures (BSS).
Hemostasis secured, post-operative instructions given.
Tooth #28
Local access achieved.
Tooth elevated and removed.
Site irrigated with saline.
Hemostasis achieved.
Post-operative Assessment
Post-operative CBCT confirmed no tooth remnants.
Inferior dental nerve and maxillary sinus intact and uninvolved.
Patient reassured and given post-operative care instructions.