Background: Impacted mandibular third molar extraction varies in difficulty, based on angulation, depth, and anatomical relations. Conventional indices remain subjective; hence, a software might offer standardized preoperative assessment to enhance diagnostic accuracy and surgical planning. Objectives: To evaluate the difficulty of impacted third molar surgery before extraction using an algorithm based software and correlate it clinically based on surgeon’s feedback postoperatively with parameters such as angulation, WAR line dimensions and universal difficulty assessment indices. Methods: This cross sectional study included 96 panoramic radiographs of 96 patients. The software utilized multiple indices (Pell and Gregory classification, WHARFE assessment, Pederson scale, and Malik’s assessment) to generate a difficulty score as per software interpretation, which was compared with postoperative surgeons’ interpretations. Results: The software demonstrated 86% accuracy ( P < 0.001), with 90.7% sensitivity (95% CI: 80.1%–96.4%) and 86.5% specificity (95% CI: 71.2%–95.0%). Multiclass F1-scores ranged from 82.1% to 89.0%. Cohen’s Kappa revealed strong agreement (κ = 0.764, P < 0.001) between software and surgeon assessments. Conclusion: The “3M-Difficulty Index Calculator” provides a standardized, algorithm-driven tool for preoperative third molar extraction assessment, enhancing diagnostic precision and surgical planning and might be incorporated in day-to-day dental practice.
Waghmare et al. (Thu,) studied this question.