Surgical Removal of Wisdom Teeth #38, #48
Surgical Removal
Chief Complaint
Patient presents with pain and swelling, with teeth #38 and #48 completely buried under the gingiva and impacted. Patient requested removal of both teeth.
Clinical Findings
Impacted teeth #38 and #48, buried completely under the gingiva.
Swelling and pain observed.
Treatment Plan
Surgical removal of impacted #38 and #48.
Pre-operative Assessment
Pre-operative CBCT taken.
Risks of paresthesia to the lower lip and tongue, as well as potential oronasal fistula (OAF) and oroantral perforation (OAP), discussed with the patient.
Procedures explained in detail.
Patient understood and agreed to proceed.
Informed consent obtained.
Anesthesia
Local anesthesia block administered to left and right inferior dental nerves (IDN), lingual nerves (LN), and long buccal nerves (LBN).
Surgical Procedure
1. Patient cleaned and draped.
2. Incision made, and buccal flap raised.
3. Bone guttering performed.
4. Tooth sectioning and elevation of #38 and #48 completed.
5. Curettage and irrigation with saline.
6. Bone grafting material (BSS) applied:
- BSS x 04 for #48
- BSS x 03 for #38
7. Haemostasis achieved, and post-operative instructions provided.
Post-operative Assessment
Post-operative CBCT taken.
No tooth remnants noted.
Inferior dental nerve (IDN) and maxillary sinus intact, not involved in surgery.
Patient reassured.