CASE STUDY: Removal of retained and infected tooth root

Patient history

A 44 year old female patient presented with pain in the area of tooth 38. For two weeks, she had been experiencing trismus (reduced opening of the jaw caused by spasm of the muscles of mastication).
Approximately one month prior, complete removal of the root in the area of tooth 38 had been attempted but had not been achieved.
This patient had no other relevant medical or dental history.
On examination, the retained root in the area of tooth 38 was identified and trismus was observed.
A CBCT scan was performed.

Diagnosis

The diagnosis made was infection of the retained root in the area of tooth 38. If left untreated, the infection would not resolve.

Treatment

The agreed upon treatment was the removal of the retained root in the area of tooth 38 under general anaesthesia.
This treatment was performed.

Results

The retained root in the area of tooth 38 was completely removed.
After ten days, the patient’s trismus had subsided and she was able to open her mouth to a normal extent. She also had no swelling.
The patient indicated that she was happy with the outcome of the treatment.