Wisdom Tooth Operation for Quadrant 4
Surgical Removal
Retained Root
Chief Complaint
Patient complains of pain in the fourth quadrant.
Clinical Findings
Tooth #18: Traumatic bite on tooth #48 operculum.
Tooth #48: Partially erupted with pericoronitis and pus exudate, not impacted.
Treatment Plan
OPG (Orthopantomogram) taken.
Advised extraction (XAP) of teeth #18 and #48:
Possible operative procedure (OP) if complications arise during XAP:
Patient understood and agreed to proceed.
Pre-operative Assessment
Anesthesia
Local anesthesia (LA) for extraction of teeth #18 and #48.
Surgical Procedure
Initial Extractions:
LA XAP for teeth #18 and #48.
Tooth #18: Distobuccal (db) root fractured and retained.
Tooth #48: Coronal portion completely fractured, retained roots.
2. Operative Removal of Retained Roots (LAOP):
Patient agreed to proceed with LAOP for removal of retained roots of teeth #18 and #48.
Pre-operative CBCT taken.
Risks of paresthesia to lower lip and tongue, and potential for oroantral perforation/fistula (OAP/OAF) explained.
Procedures, costs, and potential complications discussed.
Patient understood and agreed to proceed.
Informed consent obtained.
3. Operative Procedure:
Increased local anesthesia administered.
Patient cleaned and draped.
Incision made, buccal flap raised on teeth #18 and #48.
Bone guttering performed.
Tooth sectioning carried out.
Tooth #18 elevated out in two pieces.
Tooth #48 elevated out in three pieces.
Curettage performed, irrigated with saline.
Bioactive synthetic scaffold (BSS) placed x3 for primary closure of the #18 site.
BSS placed x3 for primary closure of the #48 site.
Hemostasis achieved, post-operative instructions given.
Post Operation Gallery
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