Wisdom Tooth Removal Impacted #38 and Extraction #37
Surgical Removal
Impacted Wisdom Tooth
Chief Complaint
Patient complained of swelling in the third quadrant and mobility in tooth #38. Deep probing depths on the mesial and lingual aspects were noted. Tooth #37 showed involvement of both periodontal and endodontic tissues. #38 was impacted and covered with a rough calculus layer that was subgingival and inaccessible for periodontal management.
Clinical Findings
Tooth #38: Mobility I → II, TTP, non-tender to palpation, negative bite test.
Tooth #37: Perio-endo involvement, deep probing depths.
General: Swelling in the third quadrant.
Treatment Plan
XAP #37
LA OP removal of impacted #38
Pre-operative Assessment
Pre-operative CBCT taken.
Inferior dental nerve (IDN) plotted, noting close proximity to #38.
Risks of paraesthesia to the lower lip and tongue, oro-antral perforation (OAP), and oro-antral fistula (OAF) explained.
Procedures explained thoroughly.
Patient understood and agreed to proceed.
Informed consent obtained.
Anesthesia
Local anesthesia block (left IDN, LN, and LBN).
Surgical Procedure
Preparation:
Patient cleaned and draped.
Incision made, buccal flap raised.
2. Extraction of #37:
Bone guttering performed.
Tooth sectioned.
#37 elevated out in 2 pieces.
Curettage and irrigation with saline.
Five bone support structures (BSS) placed for primary closure.
Haemostasis achieved, post-operative instructions (POI) given.
Post Operation Gallery
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Post-operative Assessment
Pre-operative CBCT taken.
Inferior dental nerve (IDN) plotted, noting close proximity to #38.
Risks of paraesthesia to the lower lip and tongue, oro-antral perforation (OAP), and oro-antral fistula (OAF) explained.
Procedures explained thoroughly.
Patient understood and agreed to proceed.
Informed consent obtained.