Surgical Removal of Retained Root and Tooth #24
Surgical Removal
Extraction, Retained Root
Chief Complaint
Patient has caries to pulp in #23 with a retained root and caries to pulp in #24, which is considered hopeless.
Clinical Findings
#23: Retained root, very tender to percussion, slight mobility, probing depth within normal limits, slight metallic sound on percussion. Dense bone suspected, possible ankylosis.
#24: Gross caries with pulp involvement and perio-endo involvement, deemed hopeless.
Treatment Plan
Extraction of retained root in #23.
Removal of tooth #24.
Consider options for replacing missing teeth such as implant, bridge, or denture, or leaving the space empty.
Pre-operative Assessment
Pre-operative CBCT taken, revealing a buried inverted supernumerary tooth next to the nasopalatine nerve. No cystic formation observed. Patient prefers not to remove the supernumerary tooth.
Advised removal of retained root and extraction of #24.
Anesthesia
Local anesthesia administered.
Patient cleaned and draped.
Surgical Procedure
Incision made and buccal flap raised.
LA XAP for #24 successfully completed.
Granulation tissue removed.
Bone guttering performed.
Tooth sectioning conducted.
#23 elevated out in two pieces.
Curettage performed and area irrigated with saline.
Eight BSS placed for primary closure.
Hemostasis achieved, post-operative instructions provided.
Post Operation Gallery
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Post-operative Assessment
Pre-operative CBCT taken, revealing a buried inverted supernumerary tooth next to the nasopalatine nerve. No cystic formation observed. Patient prefers not to remove the supernumerary tooth.
Advised removal of retained root and extraction of #24.