Removal of Impacted 48 and Non-functional 18
Surgical Removal
Impacted Wisdom Tooth
Chief Complaint
Patient reported pain and swelling around impacted tooth #48 due to food trapping between teeth #48 and #47.
Clinical Findings
Tooth #48: Horizontally impacted.
Tooth #47: Distal caries (KIV - keep in view).
Tooth #18: Non-functional, disto-buccally tilted, supra-erupted, and very close to the lower ridge.
Treatment Plan
Surgical Removal of tooth #48 under local anesthesia (LA).
Extraction of tooth #18 under local anesthesia (LA).
Pre-operative Assessment
Pre-operative CBCT taken.
Inferior Dental Nerve (IDN) plotted.
Risks of parasthesia to lower lip and tongue, and oro-antral perforation (OAP) or oro-antral fistula (OAF) explained to the patient.
Procedures thoroughly explained.
Patient understood and agreed to proceed.
Informed consent obtained.
Anesthesia
Left IDN, LN, and LBN blocks administered.
LA infiltration at #18.
Surgical Procedure
Preparation:Patient cleaned and draped.
Buccal flap raised with an incision.
Removal of #48:Bone guttering performed.
Tooth sectioned and elevated out in five pieces.
Curettage and irrigation with saline.
Four bone support structures (BSS) placed for primary closure.
Achieved haemostasis.
Post-operative instructions (POI) given.
Extraction of #18:Irrigation with saline.
Achieved haemostasis.
POI given.
Post Operation Gallery
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Post-operative Assessment
Pre-operative CBCT taken.
Inferior Dental Nerve (IDN) plotted.
Risks of parasthesia to lower lip and tongue, and oro-antral perforation (OAP) or oro-antral fistula (OAF) explained to the patient.
Procedures thoroughly explained.
Patient understood and agreed to proceed.
Informed consent obtained.