Removal of a buried lower third molar

This patient was a 53-year-old female with a repeated pain history associated with her unerupted third molar.

The referring practitioner had made several attempts over 18 months to resolve the pain and swelling with antibiotics, however the chronic infection persisted.

This case illustrates the simple surgical management of a buried troublesome third molar. Repeated use of antibiotics in this case was only able to provide a short-term solution. Buried third molars may be likely to cause these type of infections only if there is some form of intra-oral communication.

Figures 1 and 2 (see right): The radiograph indicated bone loss around the crown of this tooth and there were no other abnormalities (i.e. caries or other pathology).

Figures 3 and 4: Local anaesthetic was used and a buccal flap raised. The lingual nerve was protected with a Howarth’s periosteal elevator.

Figures 5 and 6: There was extensive chronic inflammatory soft tissue, which was removed by a curette.

Figures 7 and 8: The tooth was elevated after irrigated bone removal. The socket was cleaned, irrigated and sutured.

Figure 9: The extracted tooth.

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