Impacted Mandibular Canine Extraction

Open Dropdown

Preoperative Considerations

Consent:

  • Damage & devitalization of adjacent teeth
  • Periodontal defects

Anesthesia/Positioning:

  • Reclined or supine

Other:

  • None

Armamentarium:

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

Technique

Postoperative Considerations

Immediate:

  • Soft diet

Follow Up:

  • None

Operative Note

Surgeon(s): ***

Assistant Surgeon(s):  ***

Preoperative Diagnosis: ***

Postoperative Diagnosis: Same

Procedure(s): ***

Anesthesia: General

Implants: None

Specimen:***

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.

A sulcular incision was made and a full thickness mucoperiosteal flap was elevated in a subperiosteal plane to expose the anterior mandible. Care was taken to prevent injury to the mental nerves and their branches. After bony exposure, a bur was used to unroof the impacted tooth. The crown was then sectioned and removed and the root was extracted. Remaining follicle was carefully curetted and the site was irrigated with NS. 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.

Coding

  • 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.