Variables of Clinical Significance Predictive of Difficulty of Third Molar Surgery: An Institutional Analysis of 200 Consecutive Procedures

Abstract

Aims and Objectives: To successfully evaluate the difficulty of third molar extraction prior to the surgical procedure, clinical and radiographic findings must be taken into account. The purpose of this research oriented study was to evaluate the importance of variables (patient variables, dental and operative variables) such as radio graphically assessed dental factors i.e., tooth morphology, position of the tooth, proximity to the inferior alveolar canal which are of clinical significance posing difficulty in removal of the impacted third molars. Materials and Methods: This prospective study was conducted in 3 years period (January 2012-December 2014) on 200 patients (140 males, 60 females) who had undergone third molar surgery under local anesthesia at Oral and Maxillofacial Surgery Department, Tatyasaheb Kore Dental College and Research Centre, Kolhapur, Maharashtra, India. Certain variables such as preoperative radiographic assessment, surgeon′s perspective were assessed accordingly. A variety of data was gathered for each patient including age, gender of the patient, bone impaction, unfavorable root formation, operation time, etc. surgical difficulty was evaluated preoperatively using a parant scale. At the end of each surgery, the clinician recorded the technique used and the duration of each operation. Results and Observations: A total of 200 impacted third molars were removed surgically (140 males, 60 females) over a 3 years period and it was observed that increased age, gender predisposition, unfavorable root pattern, depth of impaction, close relationship to inferior alveolar nerve increased the operative time which was statistically significant. The mean operative time was 37 ± 5 minutes. Conclusion: This study demonstrates that preoperative radiological assessment should be taken into account while planning difficult third molar surgery. Although variables such as patient parameters, dental and surgeon′s parameters should be evaluated accordingly.