Surgical Removal of Retained Roots #15, #17
Surgical Removal
Chief Complaint
Patient reports a loose crown on tooth #17.
Clinical Findings
Tooth #17 is part of a 3-unit PFM bridge with tooth #15.
Tooth #15 exhibits gross caries beneath the abutment crown, with possible retained roots.
The PFM abutment crown on #17 is loose.
Tooth #15 has grossly carious retained roots with caries extending to and beyond the crestal level.
Tooth #17 has deep caries.
Treatment Plan
Remove the PFM bridge to assess the condition of the bridge abutments and formulate a treatment plan.
Conduct CBCT to evaluate the condition of the bridge abutments and plan further treatment.
Tentatively plan for surgical removal of #15 retained roots and consider options for #17 including crowning or root canal therapy.
Pre-operative Assessment
CBCT taken to assess the condition of the bridge abutments and determine the extent of damage.
Tooth #15 is found to have hopelessly carious retained roots.
Tooth #17 has caries extending to the pulp.
Discussion of options for #17, including root canal therapy or extraction with possible implant placement.
Anesthesia
LA infiltration administered to teeth #15 and #17.
Surgical Procedure
Patient cleaned and draped.
Incision made and buccal flap raised.
Bone guttering performed.
Tooth #15 sectioned and elevated out in 2 pieces.
Curettage and saline irrigation completed.
BSS x 03 placed for secondary closure.
LA XAP performed on #17.
BSS x 02 placed for secondary closure.
Haemostasis achieved.
Post-operative Assessment
Post-op CBCT taken.
No remnants noted.
Maxillary sinus and adjacent teeth not involved.
Patient reassured.