Surgical Removal of Retained Roots #16
Surgical Removal
Retained Root
Chief Complaint
Patient presents with severe tenderness to percussion and pressure (TTP, TTPp) in the area of tooth #16.
Clinical Findings
Tooth #16: Gross caries with retained roots. Mobility and probing depth within normal limits (WNL). Slight metallic sound on percussion, indicating potential dense bone or ankylosis.
Fractured retained roots: Three roots identified—mesial buccal (mb) and palatal (p) roots are long, wide, flattened, and jointed; distal buccal (db) root is separated.
Additional finding: Caries on the distal surface of tooth #25.
Treatment Plan
The patient was advised to undergo the removal of the retained roots of tooth #16 under local anesthesia, with options to consider an implant, bridge, denture, or leaving the space empty post-extraction. The patient agreed to proceed with the extraction.
Pre-operative Assessment
A CBCT scan was taken to evaluate the retained roots and surrounding structures. Risks of oroantral perforation (OAP) and oroantral fistula (OAF) were discussed with the patient, who understood and provided informed consent.
Anesthesia
Local anesthesia was administered.
Surgical Procedure
Patient cleaned and draped
Incision made, buccal flap raised
Bone guttering performed
Tooth sectioned
Tooth #16 elevated out in four pieces
Curettage performed, irrigated with saline
Three bone suture splints (BSS) placed for secondary closure
Haemostasis achieved and post-operative instructions (POI) provided
Post Operation Gallery
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Post-operative Assessment
A CBCT scan was taken to evaluate the retained roots and surrounding structures. Risks of oroantral perforation (OAP) and oroantral fistula (OAF) were discussed with the patient, who understood and provided informed consent.