Surgical Removal of Retained Roots at #24 with Guided Bone Regeneration
Surgical Removal of Retained Roots
Chief Complaint
Patient presented with retained and infected roots of tooth #24.
Clinical Findings
Retained roots at #24 with infection.
Buccal bone deficiency identified.
Pre-operative CBCT and photographs taken for assessment.
Treatment Plan
Surgical removal of retained roots at #24.
Guided Bone Regeneration (GBR) with autogenous bone grafting and biomaterial overlay at the #24 site.
Patient counseled on risks, benefits, and procedure details.
Informed consent obtained.
Pre-operative Assessment
CBCT and photographs reviewed.
No contraindications for local anesthesia.
Plan included harvesting autogenous bone from posterior mandible.
Anesthesia
Local infiltration administered at #24.
Left inferior dental nerve block, lingual nerve block, and long buccal nerve block administered for autogenous bone harvesting site.
Surgical Procedure
Tooth #24 (Retained Root Removal and GBR)
Patient cleaned and draped under sterile conditions.
Incision made, buccal flap raised.
Bone guttering and tooth sectioning performed.
#24 roots elevated in 2 pieces.
Curettage performed; granulation tissue completely removed.
Palatal sliding flap raised for additional access.
Autogenous Bone Harvest
Incision made at buccal of ascending ramus and oblique ridge.
Autogenous bone harvested with trephine and chisel.
Harvested bone crushed and prepared for grafting.
Grafting and Closure
Crushed autogenous bone packed into #24 socket and buccal defect.
Osteon II collagen applied over autogenous bone as an overlay.
Buccal flap released and repositioned.
Primary closure achieved with 12 sutures (6/0 Surgipro Polypropylene) and 5 sutures (4/0 BSS).
Hemostasis achieved.
Post-operative Assessment
Post-operative CBCT confirmed dense bone graft in place.
Inferior dental nerve spared at graft site.
Photographs documented post-surgical outcome.
Patient satisfied with results.