Surgical Removal of Retained Root #13 and Extractions of #12 & #14
Surgical Procedure
Chief Complaint
Walk-in patient with pain involving #12 and #14.
Clinical Findings
Teeth #12 & #14:
Gross caries extending to pulp (confirmed on prior OPG)
Very TTP, TTPp
Mobility WNL
Probing depth WNL
Slight metallic percussion sound
Possible dense bone; KIV ankylosis
Tooth #13:
Retained root present
Pus exudate previously noted
Swelling and pus reduced after earlier medication
Diagnosis:
#12 & #14: Caries to pulp with risk of fracture during extraction
#13: Infected retained root
Treatment Plan
LA XAP of #12 and #14
LA OP surgical removal of #13 retained root
Possible need for surgical removal of #12 and #14 if fractured during extraction
Curettage, irrigation, and closure
Pre-operative Assessment
Risks and procedures explained
Quotation provided
Patient understood and agreed
Informed consent obtained for LA XAP #12 & #14 and LA OP removal of #13
Anesthesia
Local infiltration for #12, #13, and #14.
Surgical Procedure
Patient cleaned and draped
LA XAP attempted for #12 & #14
Incision made; buccal flap raised
Tooth #13 & #14 Surgical Removal:
During extraction, #14 coronally fractured
Bone guttering performed
Tooth sectioning
#13 and #14 elevated in 3 pieces
Curettage and saline irrigation
BSS × 7 placed for secondary closure
Hemostasis achieved; POI provided
Post-operative Assessment
Post-op CBCT showed no retained fragments
Adjacent teeth uninvolved
Patient discharged in stable condition