Tooth #25 Extraction
Surgical Removal
Chief Complaint
Discomfort and history of grossly decayed tooth at #25, with difficulty in removal during previous extraction attempt.
Clinical Findings
Large PA lesion approximately 4mm to 5mm in diameter noted in CBCT.
Tooth #25 is tender to percussion, non-tender to palpation.
Mobility and probing depth are within normal limits.
A slight metallic sound is noted on percussion.
Considerations include very dense bone and possible ankylosis.
Treatment Plan
Surgical removal (LA OP) of retained roots of #25.
Curettage and saline irrigation of socket.
Post-op CBCT to confirm complete removal.
Patient advised on potential risks, including oroantral perforation/fistula (OAP/OAF).
Pre-operative Assessment
CBCT reviewed.
Tooth #25 has retained roots, long, wide, and flattened fused roots, with a large PA lesion that bridges the cortical bone.
Anesthesia
LA infiltration administered to #25.
Surgical Procedure
Patient cleaned and draped.
Incision made and buccal flap raised.
Bone guttering performed.
Tooth sectioning executed.
Tooth #25 split and elevated out in 2 pieces.
Curettage and saline irrigation completed.
BSS x 03 placed for secondary closure.
Haemostasis achieved.
Post-operative Assessment
Post-op CBCT taken.
No remnants noted.
The maxillary sinus and adjacent teeth are not involved in the surgery.