Surgical Extraction of Impacted Lower Third Molar, Evaluation of a New Scale of Difficulty

Introduction: Assessment of the surgical complexity of lower third molar extractionis a crucial step to formulate an optimal treatment plan, balancing the advantagesand disadvantages of the surgical extraction procedure to manage intraoperative complicationsand postoperative pain. Aim: This study aimed to evaluate the accuracy ofa new scale of surgical difficulty for the extraction of the impacted lower third molar.Patients and methods: Fifty-four patients were attended for lower third molar extraction.All patients undergoing the same surgical approach including anesthesia, incision,and elevation of the mucoperiosteal flap, ostectomy, and tooth sectioning, elevation,and avulsion according to the root axis, socket debridement, and suturing. The periodof this study extended for 2 years. Results: The mesio angular impaction was the mostcommon type of impaction, followed by horizontal impaction. There was agreementbetween the preoperative and the postoperative assessment of a simple operation. 26third molars (48.15%) were considered preoperatively medium difficulty group, and80.77% was agreement between the preoperative and the postoperative assessments ofmoderately simple (p < 0.001). Conclusion: Our scale is effective since the mandibularthird molars with the highest scores were significantly correlated to longer ostectomytime and total surgical time.