Surgical Removal of Retained Roots for #44, #45, #46
Surgical Removal
Retained Root
Chief Complaint
Fracture and loss of teeth #44 and #45 along with a supporting bridge.
Clinical Findings
Teeth #44 & #45: Retained roots with gross subgingival caries
Not tender to palpation (NTTP) or percussion (NTTPp)
Mobility and probing depths within normal limits (WNL)
Very firm retained roots
Tooth #48: Abutment intact
Tooth #46: Retained mesial root, buried and retained
Treatment Plan
Local Anesthesia (LA) Outpatient (OP) removal of retained roots in teeth #44, #45, and #46
Potential for implants, bridge, or denture to replace missing teeth, or the option to leave the space empty
Pre-operative Assessment
Pre-operative Cone Beam Computed Tomography (CBCT) scan taken
Findings: Long, curved retained roots in teeth #44 & #45, prior root fillings (RF), normal periapical region
Retained mesial root of tooth #46 plotted near the inferior dental nerve (IDN)
Anesthesia
Local anesthesia administered for the procedure.
Surgical Procedure
Patient cleaned and draped
Incision and buccal flap raised
Bone guttering performed
Tooth #45 elevated out in six pieces
Further bone guttering to expose the mesial retained root of tooth #46
Tooth #46's retained root loosened with peristomes and elevated out completely
Tooth #44 elevated out in two pieces
Curettage and irrigation with saline
Bone grafting performed using EthOss artificial bone grafting material to preserve sockets and bulk up areas with bone loss
Flap released and BSS sutures placed for primary closure
Post Operation Gallery
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Post-operative Assessment
Pre-operative Cone Beam Computed Tomography (CBCT) scan taken
Findings: Long, curved retained roots in teeth #44 & #45, prior root fillings (RF), normal periapical region
Retained mesial root of tooth #46 plotted near the inferior dental nerve (IDN)