Surgical Removal of Retained Roots #26
Surgical Removal
Chief Complaint
Patient presented with gross caries to the pulp and retained roots on tooth #26.
Clinical Findings
Sub-crestal caries
Very tender to percussion (TTP) and pressure (TTPp)
Mobility within normal limits with increased probing depth on buccal side
Slight metallic sound on percussion
Possible very dense bone or ankylosis
Treatment Plan
Advised for LAP OP removal of #26 retained roots
Patient understood and agreed to proceed
Pre-operative CBCT taken
Pre-operative Assessment
Tooth #26:
Sub-crestal grossly carious retained roots
Three-rooted structure
Long, wide, and flattened (mb) and (db) roots
Thin and long (p) root
Large periapical (PA) lesion around (mb) and (db) roots
PA lesion on (p) root
Roots extending into maxillary sinus
Anesthesia
Local anesthesia administered for the procedure.
Surgical Procedure
Patient cleaned and draped
Incision made, buccal flap raised
Bone guttering performed
Tooth #26 sectioned
Tooth #26 elevated out in five pieces
Curettage and irrigation with saline
BSS x 03 placed for secondary closure
Haemostasis achieved, post-operative instructions given
Post-operative CBCT taken, showing no remnants
Maxillary sinus and adjacent teeth not involved
Post-operative Assessment
No remnants noted
Maxillary sinus and adjacent teeth not involved