Variability in Positions and Factors Contributing to Surgical Difficulty of Impacted Third Molars.

Objectives:  This study aimed to provide valuable insights into the variability of third molar positions and factors influencing their surgical time and technique.

Materials and methods:  This cross-sectional study included a total of 48 eligible participants, aged 18 to 45 years, diagnosed with impacted teeth, and who had undergone surgery. Exclusion criteria comprised the absence of the second molar, the presence of systemic diseases, a history of radiation therapy, and pregnancy or lactation. Participants completed a questionnaire covering demographic data, physical metrics, and information on systemic conditions and disorders. Preoperative assessments included vital sign measurements. Panoramic imaging was employed to evaluate the third molar distance to the occlusal plane, degrees of angulation, eruption space, and distance to the alveolar inferior canal. Surgical difficulty in this study was measured by two outcomes: surgical time and technique.

Statistical analysis:  To assess differences in impacted third molar positions among groups, Independent samples t-test and One-way analysis of variance were used for normally distributed data without outliers; otherwise, the Mann-Whitney U test and Kruskal-Wallis H test were utilized. The Spearman's rank correlation was utilized to explore relationships between vital signs, impacted third molar positions, surgical time, and surgical technique.

Results:  There were no significant differences in third molar positions between age and body mass index groups. Significant differences in distance to the occlusal plane were observed between third molars in quadrants 2 and 3 (p = 0.002) and quadrants 2 and 4 (p = 0.005). A significant difference in eruption space was found between sexes (p = 0.016). A significant negative correlation was discovered between surgical time and respiration rate per minute (p = 0.028).

Conclusion:  This study found that males have greater third molar eruption space than females, and maxillary third molars have a greater distance to the occlusal plane compared with mandibular third molars. The importance of vital signs as contributing factors to surgical difficulty is highlighted, emphasizing their relevance in clinical practice.