Surgical Removal of Retained Roots #24, #25 & #27
Surgical Procedure
Chief Complaint
Follow-up for suture removal at #12 & #14 sites; patient also reports pain related to upper left premolars and molars.
Clinical Findings
Teeth #24, #25, #27:
Gross caries with pulpal involvement
Very TTP, TTPp
Mobility WNL
Probing depth WNL
#25 and #27: retained roots with pus exudate (reduced after prior medication)
Pre-op CBCT:
Advanced caries
Root retention
No adjacent structural involvement
Diagnosis: Non-restorable #24, #25 & #27 with retained roots requiring extraction.
Treatment Plan
XAP #24
LA OP removal of retained roots #25 & #27
Possible surgical removal of #24 if fractured (later confirmed)
Pre-operative Assessment
Risks and procedure steps explained
Patient understood and agreed
Informed consent obtained for XAP #24 and LA OP removal of #25 & #27
Anesthesia
Local infiltration: #24, #25, #27.
Surgical Procedure
Patient cleaned and draped
Incision made; buccal flap raised
Tooth #24:
LA XAP attempted
#24 fractured → retained roots present
Bone guttering performed
Tooth sectioned
Teeth #24, #25, #27:
Sectioned components removed
Total of 5 pieces elevated
Curettage and saline irrigation performed
BSS × 9 placed over all three sites for secondary closure
Hemostasis achieved
POI given
Post-operative Assessment
Post-op CBCT confirmed no retained fragments
Adjacent teeth unaffected
Patient stable and reassured