Wisdom Tooth Removal for #38
Surgical Removal
Buried and Impacted
Chief Complaint
Patient reports a hole distal to tooth #37 with food trapping.
Clinical Findings
Impacted and partially erupted tooth #38, completely buried in bone.
Gross subgingival calculus noted around tooth #38.
Pre-operative CBCT revealed #38 in close proximity to the left inferior dental nerve (IDN), with the nerve pressed against the lingual bone plate and near the distal root of #38.
Treatment Plan
Surgical removal of tooth #38 was advised due to the risk of nerve injury during distal bone guttering. A strategy focusing on tooth sectioning over bone guttering was planned.
Pre-operative Assessment
The patient was informed of the risks, including potential parasthesia to the lower lip and tongue, and the surgical procedures involved.
Informed consent was obtained.
Anesthesia
Local anesthesia was administered, including a block for the left IDN, LN, and LBN.
Surgical Procedure
The patient was cleaned and draped.
An incision was made, and a buccal flap was raised.
Bone guttering was performed as needed.
Tooth #38 was sectioned and elevated out in three pieces.
The area was curetted and irrigated with saline.
BSS x 03 was placed for primary closure.
Post Operation Gallery
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Post-operative Assessment
The patient was informed of the risks, including potential parasthesia to the lower lip and tongue, and the surgical procedures involved.
Informed consent was obtained.