Dental News - Importance of a preoperative radiographic scale for evaluating surgical difficulty of impacted mandibular third molar extraction

Dr. Natalia Ribes Lainez et al.

Thu. 6. April 2017

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Objective: The objectives of the study were to evaluate the correlation between the degree of surgical difficulty measured by an established scale and the total surgical time, the ostectomy time and the tooth sectioning time, and to analyze which of the factors involved had a greater influence on total surgical time.

Materials and methods
A presurgical radiographic scale was developed, based on ten parameters. Each parameter was scored from 1 to 3, and the individual scores were summed. A retrospective analysis using panoramic radiographs was performed of patients subjected to surgical extraction of a mandibular third molar, with recording of the surgical times. A statistical analysis was performed to establish correlations between the study parameters and scale and the surgical times.

Results
A greater Winter’s distance prolonged ostectomy time and, conversely, a greater distance from the mandibular ramus to the distal surface of the second molar was observed to shorten ostectomy time. Separate or dysmorphic root shape increased ostectomy time and total surgical time. Total surgical time was longer in the presence of greater coronal width and a shorter distance from the ramus to the second molar. The only variable correlated to tooth sectioning time was coronal width.

Conclusion
The final score was correlated to ostectomy time and total surgical time. Ostectomy time in turn was influenced by Winter’s distance, the distance from the mandibular ramus to the second molar, and root shape. Tooth sectioning time was influenced by the coronal width of the third molar. The parameters with the closest correlation to total surgical time were coronal width and the distance between the ramus and second molar.

Editorial note: The full article was published in the 1/2017 issue of the Journal of Oral Science and Rehabilitation. It can be accessed free of charge at www.dtscience.com.

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