Surgical Removal of Retained #25 Roots with Socket Bone Grafting Under Local Anesthesia
Surgical Procedure
Chief Complaint
Px presented for review and management of retained roots at #25 with future implant replacement planned.
Clinical Findings
#25
Gross subcrestal caries
Retained roots present
Very TTP and TTPp
Mobility and probing depth WNL
Slight metallic percussion sound noted
KIV dense surrounding bone and possible ankylosis
CBCT reviewed.
Sound surrounding bone level maintained
Large periapical lesion associated with retained #25 roots
Treatment Plan
Surgical removal of retained #25 roots under local anesthesia
Socket preservation with bone grafting for future implant replacement
Risks, benefits, procedures, and post-operative expectations explained to Px.
Pre-operative Assessment
Clinical and CBCT assessments performed prior to surgery.
Retained roots associated with large periapical pathology and possible ankylotic changes.
Risks including bleeding, swelling, infection, sinus involvement, graft failure, retained fragments, and post-operative discomfort discussed.
Px understood and agreed to proceed.
Informed consent obtained.
Anesthesia
Local anesthesia administered to surgical site.
Surgical Procedure
Px cleaned and draped in sterile manner.
Incision made and buccal flap raised.
Bone guttering performed.
Tooth sectioning carried out.
#25 retained roots elevated and removed atraumatically in 2 pieces.
Socket curettage performed with complete removal of apical granulation tissue.
Socket irrigated thoroughly with saline.
Socket grafted using Dentium Osteon II collagen artificial bone grafting material.
Spongiostan x1 placed to cover socket opening.
BSS x3 placed for secondary closure.
Haemostasis achieved.
POI given.
Post-operative Assessment
Post-operative CBCT taken.
No retained root remnants noted.
Bone graft densely packed and stable within socket.
Healing satisfactory post-operatively.
Px reassured and discharged in stable condition.