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Removal of Impacted 48 and Non-functional 18

Surgical Removal
Impacted Wisdom Tooth
Removal of Impacted 48 and Non-functional 18

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 Gallary

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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.

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