Surgical Removal of Retained Root with Radicular Cyst Enucleation – Tooth #22
Surgical Procedure
Chief Complaint
Patient presented with severe pain and buccal swelling associated with the upper left lateral incisor (tooth #22).
Clinical Findings
Tooth #22:
Fractured with retained root
Gross caries present
Buccal swelling noted
Very tender to percussion (vertical)
Not tender to percussion (lateral)
Mobility within normal limits
Probing depth within normal limits
Initial extraction attempt unsuccessful due to repeated tooth disintegration during forceps extraction and elevation
Pre-operative CBCT findings:
Retained root of #22
Associated large radicular cyst
Treatment Plan
Initial attempt at extraction under local anesthesia
Surgical removal of retained root of tooth #22
Enucleation and removal of associated radicular cyst
Post-operative imaging to confirm complete removal
Pre-operative Assessment
Pre-operative CBCT reviewed
Risks, benefits, and procedural steps explained
Patient understood and agreed to proceed
Informed consent obtained
Anesthesia
Local anesthesia administered
Surgical Procedure
Patient cleaned and draped
Buccal incision made and flap raised
Bone guttering performed
Tooth sectioned
Retained root of #22 elevated and removed in two pieces
Radicular cyst enucleated and removed in entirety
Thorough curettage performed
Surgical site irrigated with saline
Three bone substitute sponges placed for secondary closure
Hemostasis achieved
Post-operative instructions provided
Post-operative Assessment
Post-operative CBCT taken
No residual root fragments or cystic tissue noted
Adjacent teeth not involved
Patient reassured