Surgical Removal of Impacted #38 with XAP of #37 and #28
Surgical Removal
Impacted Wisdom Tooth
Chief Complaint
Patient complains of pain and swelling in the lower left side.
Clinical Findings
Tooth #38: Completely buried in bone and impacted.
Tooth #37: Deep caries to the pulp with associated periapical lesion.
Tooth #28: Non-functional and supra-erupted.
Treatment Plan
Local anaesthetic (LA) surgical removal of impacted tooth #38.
LA extraction (XAP) of tooth #37 and #28.
Pre-operative Assessment
Pre-operative CBCT taken.
Patient informed of risks including paraesthesia to lower lip and tongue, oro-antral perforation/fistula.
Procedures and associated risks explained.
Patient understood and consented to proceed.
Anesthesia
Left inferior dental nerve (IDN), lingual nerve (LN), and long buccal nerve (LBN) block.
Infiltration anesthesia at sites #37 and #28.
Surgical Procedure
Patient cleaned and draped.
Incision made and buccal flap raised.
Bone guttering performed.
Extraction (XAP) of #37 completed.
Tooth #38 sectioned and elevated in two pieces.
Granulation tissue and pus curetted and removed.
Irrigation with saline.
7 BSS sutures placed for primary closure.
Hemostasis achieved.
Extraction (XAP) of #28 completed.
Irrigation with saline.
Hemostasis achieved.
Post-operative CBCT taken — no remnants noted.
Inferior dental nerve and maxillary sinus intact and not involved in surgery.
Post Operation Gallery
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Post-operative Assessment
Pre-operative CBCT taken.
Patient informed of risks including paraesthesia to lower lip and tongue, oro-antral perforation/fistula.
Procedures and associated risks explained.
Patient understood and consented to proceed.