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Surgical Removal of Impacted Wisdom Tooth #38

Surgical Removal
Impacted Wisdom Tooth
Surgical Removal of Impacted Wisdom Tooth #38

Chief Complaint

Patient presented with pain and swelling at tooth #38 region.

Clinical Findings

  • Sub-gingival and interproximal calculus (+++).

  • Oral hygiene poor.

  • Tooth #38: Completely buried in bone, impacted.

  • CBCT reviewed — confirmed full bony impaction of #38.

Treatment Plan

  1. Root planing quadrant by quadrant (3rd quadrant: #31–#37).

  • Local anesthesia root planing.

  • Hand instrumentation performed.

  • Irrigation with chlorhexidine mouthwash.

  1. Surgical removal of impacted tooth #38.

  • Risks (paresthesia to lower lip and tongue) explained.

  • Procedure explained, patient understood and agreed.

  • Informed consent taken.

Pre-operative Assessment

  • Medical history reviewed.

  • CBCT assessed for root and nerve relation.

  • Patient fit for procedure.

Anesthesia

  • Local anesthetic: Left inferior dental nerve (IDN), lingual nerve (LN), and long buccal nerve (LBN) block.

  • Adequate anesthesia achieved.

Surgical Procedure

  • Patient cleaned and draped under aseptic conditions.

  • Incision made and buccal flap raised.

  • Bone guttering performed.

  • Tooth #38 sectioned.

  • #38 elevated in 4 pieces.

  • Curettage of socket performed.

  • Irrigation with saline.

  • 6/0 Surgipro monofilament polypropylene sutures (BSS x06) placed for primary closure.

  • Hemostasis achieved.

  • Post-operative instructions provided.

  • Patient reassured.

Post Operation Gallery

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Post-operative Assessment

  • Medical history reviewed.

  • CBCT assessed for root and nerve relation.

  • Patient fit for procedure.

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