Surgical Removal of Retained Roots – Tooth #14
Surgical Procedure
Chief Complaint
Patient presented with a fractured upper premolar (tooth #14) with the crown fragment still attached to gingival tissue, causing discomfort.
Clinical Findings
Tooth #14:
Subgingival fracture
Retained roots present
Fractured crown segment attached via gingival tissue
Root morphology: long, wide and flattened roots
Two previously root-filled canals
Thin roots with distal curvature at mid-root level
Pre-operative CBCT findings:
Fractured tooth with retained roots confirmed
Relationship to adjacent structures assessed
Treatment Plan
Surgical removal of retained roots of tooth #14 under local anesthesia
Discussion of tooth replacement options including implant, bridge, denture, or leaving the space unrestored
Pre-operative Assessment
Pre-operative CBCT reviewed
Risks, benefits, alternatives, and procedural steps explained
Possible risks including paraesthesia discussed
Patient understood and agreed to proceed
Informed consent obtained
Anesthesia
Local anesthesia administered
Surgical Procedure
Patient cleaned and draped
Buccal incision made and flap raised
Bone guttering performed
Tooth sectioned
Retained roots of tooth #14 elevated and removed in three pieces
Thorough curettage performed
Surgical site irrigated with saline
Three bone substitute sponges placed for secondary closure
Hemostasis achieved
Post-operative instructions provided
Post-operative Assessment
Post-operative CBCT taken
No residual root fragments noted
Maxillary sinus and adjacent teeth not involved
Patient reassured