Operation procedure: Removal of The left upper lateral incisor root
There is a broad band of healthy attached gingiva with no defect.
The papilla between the canine and the first premolar i s released, and the incision carried round the gingival margin of the canine to the crest of the edentulous ridge mesially. It then runs along the crest to the distal side of the central incisor. The relieving incision is
made at a slightly obtuse angle and need only just cross the broad attached gingiva.
The undermining of the flap commences at the relieving limb, using the curette end of a Mitchell’s trimmer. This makes it easier to insert the broader, blunter Howarth’s periosteal elevator, which is advanced along the bone and peels off the mucoperiosteal flap.
Elevation and delivery
The root can be clearly seen, and no overlying bone removal is necessary. A medium Coupland’s chisel is used to loosen the root from its attachment mesially and distally, and to define the buccal and palatal margins prior to the application of forceps.The root is easily removed, with care taken not to crush the hollow carious area between the blades.
The socket is clean and the margins smooth.
The first suture draws the flap into the mesial corner of the defect, and the second closes the gaping anterior relieving limb of the incision.
A week later, the sutures are removed and the area has healed well. There is some local plaque accumulation, and the patient needs to be encouraged to brush the area vigorously and not hold back for fear of damaging the healing wound.