Burried broken extraction instrument fragment
A 60 year old female reported to this centre for rehabilitation of the periodontally compromised anterior teeth. In routine radiographical examination, a triangular radiopaque mass was identified in the orthopantomogram [] in the left mandibular third molar region. On history, an uneventful extraction of the third molar ten years back in some other surgery was performed. There was no history of pain, swelling, discharge or paraesthesia elicited. Based on the history and clinical correlation, the object was assumed to be a tip of an elevator. A three dimensional Cone Beam Computerized Tomography was performed and reformatting done.\nIt was observed that the metallic tip was positioned in an oblique fashion with the tip directed distally. [] There was a split in the bone with radiographical evidence of a wedge like split in the mandible in the region []. This was observed in axial section. The tip of the elevator had a good clearance with the Inferior Alveolar Nerve. The tip was planned to be removed under local anesthesia with curettage of any granulation tissue. After achieving adequate anesthesia with lignocaine, a trough was made in the area after reflection of the mucoperiosteal flap. Bone was removed for a depth for about 3 mm and the tip was localized. There was a grayish tissue material surrounding the tip []. A trough was cut surrounding the upper half of the tip of the elevator. The tip [] was retrieved using artery forceps and the area thoroughly curetted. The tissue was closed with sutures. The healing was uneventful.