Surgical Removal of Retained Roots #18 and Extraction of Non-Functional Supra-Erupted #17
Surgical Procedure
Chief Complaint
Food trapping between #16 and #17
Discomfort
Bad smell from #18
Difficulty maintaining oral hygiene around #18
Clinical Findings
Tooth #17
Non-functional
Supra-erupted (+++)
Very firm
Tooth #18
Firm retained roots
Grossly carious retained roots
Poor oral hygiene
Long, bulbous fused roots
Fractured with retained root segments
Treatment Plan
Extraction of non-functional, supra-erupted #17
Surgical removal (LA OP) of retained roots of #18
Pre-op CBCT for assessment and surgical planning
Discussed risks:
Oro-antral penetration
Possible fistula formation
Patient understood and consented
Pre-operative Assessment
CBCT taken and reviewed
Anatomical structures evaluated
Risks, benefits, and procedure steps explained
Informed consent obtained
Anesthesia
Local anesthesia administered
Patient cleaned and draped
Surgical Procedure
#18 – Retained Roots (Surgical Removal)
Incision made
Buccal flap raised
Bone guttering
Tooth sectioning
Retained roots of #18 elevated completely
Curettage and saline irrigation
#17 – Extraction
LA XAP performed
Very firm tooth
Coronal fracture
Retained roots identified
Bone guttering
Tooth sectioning
#17 elevated in 4 pieces
Closure
BSS ×7 placed for secondary closure
Hemostasis achieved
POI given
Post-operative Assessment
Post-op CBCT taken
No remaining fragments
IDN and adjacent teeth not involved
Patient reassured