Surgical extraction of impacted wisdom tooth 38

A healthy 25-year-old male patient presented to our clinic with an acute pain in lower left posterior region of mandible since last 2-3 days. Clinical examination revealed gingival swelling posterior to 37.

A digital OPG was taken which demonstrated a horizontally impacted tooth 38, with roots in close proximity to the inferior alveolar nerve canal. The patient was prescribed Amoxicillin 500mg + Clavulanic Acid 125mg TID for three days, along with Diclofenac + Paracetamol.

FIGURE 1. Pre-operative digital OPG demonstrating totally impacted tooth 38. A recommendation was made to remove tooth 38 under local anaesthetic once the acute phase of the infection had resolved.

The patient returned three days later for the removal of impacted tooth 38. Under local anaesthetic, a full thickness flap was elevated to expose tooth 38, which was then sectioned to facilitate its removal. An elevator was then used to extract the tooth and sutures were placed. Post-operative healing went uneventful.

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