Surgical Removal of Retained Roots of Tooth #17
Surgical Removal
Chief Complaint
Patient presented with pain and tenderness in the upper left posterior region (#17).
Clinical Findings
Tooth #17 showed mesio-occlusal caries extending to the pulp.
Very tender to percussion and palpation.
Probing depth and mobility within normal limits.
Slight metallic sound on percussion, raising suspicion of ankylosis.
Probing exposed pulp at mesio-occlusal aspect.
Treatment Plan
Attempt conventional extraction (XAP) of #17.
If unsuccessful, proceed with surgical removal of retained roots.
Discussed future options: implant, bridge, denture, or leaving the space empty.
Pre-operative Assessment
Initial attempt at extraction under LA led to coronal fracture and retained roots.
Pre-operative CBCT taken.
Radiographic findings: fused 3-rooted retained roots, dense surrounding bone.
Potential risks including paraesthesia to lower lip and tongue explained.
Procedure and alternatives discussed; informed consent obtained.
Anesthesia
Local infiltration administered to region of #17.
Surgical Procedure
1. Patient cleaned and draped.
2. Buccal flap raised.
3. Bone guttering performed.
4. Tooth sectioned.
5. Retained roots of #17 removed in three pieces.
6. Curettage of socket and irrigation with saline.
7. 3 BSS sutures placed for secondary closure.
8. Hemostasis achieved.
Post-operative Assessment
Post-op CBCT confirmed no residual root fragments.
Maxillary sinus and adjacent teeth not involved.
Patient tolerated procedure well and was reassured.