Surgical Removal of Partially Erupted Wisdom Tooth #38 with Pericoronitis
Surgical Removal
Chief Complaint
Patient presented with pain and swelling around the lower left wisdom tooth. Patient requested removal of tooth #38.
Clinical Findings
Clinical examination revealed partially erupted tooth #38 with signs of pericoronitis, associated with inflammation and swelling of the surrounding gum tissue.
CBCT imaging was taken to evaluate the position of the tooth and its relationship to the inferior dental nerve.
Treatment Plan
Initial recommendation was to prescribe antibiotics for 3–4 days to control infection before surgical removal.
However, patient preferred to proceed with immediate surgical removal of tooth #38 under local anesthesia.
Pre-operative Assessment
CBCT was taken for surgical planning and evaluation of proximity to the inferior dental nerve.
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 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.
Surgical Procedure
Patient was cleaned and draped under sterile conditions.
A surgical incision was made and a buccal flap was raised to expose the impacted tooth. Bone guttering was performed to gain access. Tooth sectioning was carried out to facilitate removal. The tooth was elevated and removed in three fragments.
The socket was curetted and irrigated thoroughly with saline. Sutures were placed for primary closure 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 remained intact and was not involved in the surgery.
Patient was reassured after the procedure.