Wisdom Tooth Removal for #37, #38
Surgical Removal
Extraction, Impacted Wisdom Tooth
Chief Complaint
Patient complains of swelling in the 3rd quadrant.
Clinical Findings
#38 shows mobility from grade I to II.
Deep probing depths on mesial and lingual sides.
Tender to percussion (TTP), non-tender to palpation (NTTPp).
Negative bite test.
#37 shows perio-endo involvement.
#38 is impacted with a rough calculus layer felt subgingivally.
Unable to access #38 for periodontal management.
Treatment Plan
Extraction of #37 and local anesthesia (LA) operation for removal of #38.
Pre-operative Assessment
CBCT taken showing the inferior dental nerve (IDN) close to #38.
Risks of paresthesia to the lower lip and tongue, and oroantral perforation/oro-antral fistula (OAP/OAF) explained to the patient.
Procedures were explained; the patient understood and agreed to proceed.
Informed consent obtained.
Anesthesia
Local anesthesia block for the left inferior dental nerve (IDN), lingual nerve (LN), and long buccal nerve (LBN).
Surgical Procedure
1. Patient was cleaned and draped.
2. Incision made, buccal flap raised.
3. Bone guttering performed.
4. Tooth sectioned.
5. #37 was elevated out in total.
6. #38 was elevated out in two pieces.
7. Curettage and irrigation with saline performed.
8. BSS x 05 placed for primary closure.
9. Hemostasis achieved and post-operative instructions (POI) given.
Post Operation Gallery
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Post-operative Assessment
CBCT taken showing the inferior dental nerve (IDN) close to #38.
Risks of paresthesia to the lower lip and tongue, and oroantral perforation/oro-antral fistula (OAP/OAF) explained to the patient.
Procedures were explained; the patient understood and agreed to proceed.
Informed consent obtained.