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A 26-year-old female complained of dull throbbing pain in her lower right wisdom teeth which started 3 days ago, accompanied by gum swelling in the same region. History of pain and swelling in the same area 6 months ago, which subsided by taking painkillers and use of mouthwash. A panoramic radiograph was taken.
i. Classify the impacted tooth
ii. State the difficulty index
iii. Discuss the radiographic findings
iv. Briefly explain the procedure for removal of that tooth
Thanks for sharing.
1. Horizontal impacted 48??
i. Horizontally impacted 48. Class 3. Position B
ii. Pederson difficulty index: 7
Difficulty score: difficult
iii. Horizontally impacted 48 with two roots. Both apical third of the roots are in close relation to inferior alveolar nerve canal.
iv. Local anesthesia is given. Incision is made and mucoperiosteal triangular flap is raised. Bone guttering is done to expose the crown of 48 til CEJ. Crown is sectioned from its roots and removed. Roots are separated and removed individually. Sharp bony edges are smoothened with bone file. Socket is irrigated and then sutured.
Correct?
Hi Lee Ming Chan,
Maybe can add in radiographic interpretation:
1. mesial root of 48 curves distally
2. radiolucency surrounding the crown of 48 extending from CEJ suggestive of dental follicle.