Impacted Incisior Extraction

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Preoperative Considerations


  • Damage/devitalization of adjacent teeth
  • Numbness


  • Local or sedation
  • If GA, oral or nasal tube. Take precaution if tooth is near floor of the nose to avoid nasotracheal tube damage


  • Communicate plan with orthodontist/referring dentist
  • Consider space maintenance or bone grafting depending on restorative plan


  • Local anesthesia
  • #15 blade
  • Minnesota retractor
  • #9 periosteal elevator
  • High speed electric handpiece
  • Fissure & round diamond bur
  • Irrigation
  • 3-0 Chromic suture


Postoperative Considerations


  • If child patient, advise parents to ensure child isn't biting anesthetized lip

Follow Up:

  • None

Operative Note

Surgeon(s): ***

Assistant Surgeon(s):  ***

Preoperative Diagnosis: ***

Postoperative Diagnosis: Same

Procedure(s): ***

Anesthesia: General

Implants: None


Drains: None

Fluids: See anesthesia record

EBL: Minimal

Complications: None

Counts:  Correct x2

Indications: ​***

Findings: As expected

Procedure in Detail:

The patient was seen in the preoperative holding area with a H&P was updated, consents were verified, surgical site marked, and all questions and concerns related to the proposed procedure were discussed in detail.  The patient was transferred to the operating room by the anesthesia team.  The patient underwent general anesthesia with endotracheal intubation. Tegaderms were placed over the eyes. The patient was prepped and draped in the standard fashion for maxillofacial procedures.  A time-out was performed and the procedure began.

2% lidocaine with 1:100,000 epi was used to deliver bilateral infraorbital nerve blocks and local infiltration. A #15 blade was used to make a sulcular incision and a trapezoidal flap was elevated in a subperiosteal plane. The bony protrubrance caused by the impacted tooth was located and a round diamond bur was used to unroof the impacted tooth. The tooth was carefully sectioned and extracted. Any remaining follicle was carefully removed. The site was irrigated with NS and the flap was replaced and sutured with 3-0 chromic gut.

The patient's face was then cleaned and the posterior pharynx was suctioned. An OG tube was used to suction out the contents of the stomach. Tegaderms were removed from the eyes. Dressings were placed. The patient was then transferred back to the care of the anesthesia team for extubation and recovery.


  • D7230: Removal of impacted tooth - partially bony. This code is used when a tooth is partially impacted in bone and requires mucoperiosteal flap elevation and bone removal.
  • D7240: Removal of impacted tooth - completely bony. This code applies when a tooth is completely impacted in bone, necessitating extensive surgical intervention, including the removal of bone and sectioning of the tooth.
  • D7241: Removal of impacted tooth - completely bony, with unusual surgical complications. This code is for cases where the tooth is completely impacted in bone, and the extraction involves unusual surgical complications.