Wisdom Tooth Removal for #38, 28
Surgical Removal
Wisdom Tooth, Extraction
Chief Complaint
Patient desires removal of impacted tooth #38 and grossly carious tooth #28.
Clinical Findings
Pre-operative CBCT indicates:
Impacted tooth #38, grossly carious tooth #28.
Caries on the following teeth:
#16 distal (d)
#17 mesial (m) kiv
#24 distal (d)
#26 distal (d)
#34 occlusal (o)
#35 occlusal (o)
#36 occlusal (o) and distal (d)
#37 distal (d) kiv
Treatment Plan
Local anesthesia operation (LA OP) for the removal of impacted tooth #38 and grossly carious tooth #28.
Scaling and root planing (SRP) and follow-up (C/UP).
Crown (CAP) restorations for identified carious teeth.
Pre-operative Assessment
Pre-operative CBCT taken and inferior dental nerve (IDN) plotted.
Risks of parasthesia to lower lip and tongue, oral-antral perforation (OAP)/oral-antral fistula (OAF) discussed.
Specific procedures for LAOP removal of impacted tooth #38 and grossly carious tooth #28 explained.
Tooth #38 is deeply horizontally impacted, close to IDN with curved roots, and root tips in the lingual cortical bone, making the operation difficult.
Patient understood and agreed to the treatment plan, including potential risks and complications, and provided informed consent.
Anesthesia
Local anesthesia (LA) block for left IDN, lingual nerve (LN), and long buccal nerve (LBN).
LA infiltration for tooth #28.
Surgical Procedure
Patient cleaned and draped.
Incision made, buccal flap raised.
Bone guttering performed.
Tooth sectioning conducted.
Tooth #38 elevated out in seven pieces.
Currettage and irrigation with saline.
Five bone substitute materials (BSS) placed for primary closure.
Hemostasis achieved, post-operative instructions (POI) provided.
Post Operation Gallery
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Post-operative Assessment
Pre-operative CBCT taken and inferior dental nerve (IDN) plotted.
Risks of parasthesia to lower lip and tongue, oral-antral perforation (OAP)/oral-antral fistula (OAF) discussed.
Specific procedures for LAOP removal of impacted tooth #38 and grossly carious tooth #28 explained.
Tooth #38 is deeply horizontally impacted, close to IDN with curved roots, and root tips in the lingual cortical bone, making the operation difficult.
Patient understood and agreed to the treatment plan, including potential risks and complications, and provided informed consent.