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Surgical Removal of Retained Roots at #24 with Guided Bone Regeneration

Surgical Removal of Retained Roots
Retained Root
Surgical Removal of Retained Roots at #24 with Guided Bone Regeneration

Chief Complaint

Patient presented with retained and infected roots of tooth #24.

Clinical Findings

  • Retained roots at #24 with infection.

  • Buccal bone deficiency identified.

  • Pre-operative CBCT and photographs taken for assessment.

Treatment Plan

  • Surgical removal of retained roots at #24.

  • Guided Bone Regeneration (GBR) with autogenous bone grafting and biomaterial overlay at the #24 site.

  • Patient counseled on risks, benefits, and procedure details.

  • Informed consent obtained.

Pre-operative Assessment

  • CBCT and photographs reviewed.

  • No contraindications for local anesthesia.

  • Plan included harvesting autogenous bone from posterior mandible.

Anesthesia

  • Local infiltration administered at #24.

Left inferior dental nerve block, lingual nerve block, and long buccal nerve block administered for autogenous bone harvesting site.

Surgical Procedure

Tooth #24 (Retained Root Removal and GBR)

  • Patient cleaned and draped under sterile conditions.

  • Incision made, buccal flap raised.

  • Bone guttering and tooth sectioning performed.

  • #24 roots elevated in 2 pieces.

  • Curettage performed; granulation tissue completely removed.

  • Palatal sliding flap raised for additional access.

Autogenous Bone Harvest

  • Incision made at buccal of ascending ramus and oblique ridge.

  • Autogenous bone harvested with trephine and chisel.

  • Harvested bone crushed and prepared for grafting.

Grafting and Closure

  • Crushed autogenous bone packed into #24 socket and buccal defect.

  • Osteon II collagen applied over autogenous bone as an overlay.

  • Buccal flap released and repositioned.

  • Primary closure achieved with 12 sutures (6/0 Surgipro Polypropylene) and 5 sutures (4/0 BSS).

Hemostasis achieved.

Post Operation Gallery

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Post-operative Assessment

  • CBCT and photographs reviewed.

  • No contraindications for local anesthesia.

  • Plan included harvesting autogenous bone from posterior mandible.

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