Oral Hygiene Instruction and Extraction of Tooth #26

Surgical Removal

Extraction

Chief Complaint

The patient presented for oral hygiene instruction and reported issues with tooth #26.

Clinical Findings

Tooth brushing technique was advised and revised.

iO3 Oral-B electric toothbrush was introduced, and a demonstration was provided. CHX mouthwash was recommended.

Tooth #26:

Non-tender to percussion.

Metallic sound on percussion.

Very dense thick bone or possible ankylosis.

Mobility within normal limits.

Probing depth within normal limits.

Bite test negative.

Transillumination test positive.

A deep mesio-buccal to disto-palatal crack was noted after removal of calculus, plaque, and stains.

The crack extends beyond the crestal level on probing, indicating a hopeless prognosis.

Treatment Plan

Extraction of tooth #26 (XAP).

Potential need for LA OP removal of retained roots if coronal fracture occurs during extraction.

Pre-operative Assessment

The patient was informed about the hopeless prognosis of tooth #26. Pre-operative CBCT was taken.

The patient agreed to proceed with the extraction and was informed about the potential need for surgical removal of retained roots if a coronal fracture occurred.

Anesthesia

Local anesthesia block administered to the right inferior dental nerve (IDN), lingual nerve (LN), and long buccal nerve (LBN).

Surgical Procedure

Tooth #26 fractured coronally during forceps extraction, leaving firm retained roots.
LA OP removal of retained roots was required.
The patient was cleaned and draped.
An incision was made, and a buccal flap was raised. Bone guttering and tooth sectioning were performed.
Tooth #26 was elevated in 18 pieces.
BSS x 04 was placed for primary closure.
Haemostasis was achieved.

Post Operation Gallery

Post-operative Assessment