J Korean Assoc Oral Maxillofac Surg.  2019 Dec;45(6):309-315. 10.5125/jkaoms.2019.45.6.309.

Modified difficult index adding extremely difficult for fully impacted mandibular third molar extraction

Affiliations
  • 1Department of Oral and Maxillofacial Surgery, Gangnam Severance Hospital, Yonsei University College of Dentistry, Seoul, Korea. omshuh@yuhs.ac

Abstract


OBJECTIVES
The aim of this study was to evaluate the validity of the existing classification and difficulty index of impacted mandibular third molars in clinical situations and propose a more practical classification system.
MATERIALS AND METHODS
This study included 204 impacted mandibular third molars in 154 patients; panoramic x-ray images were obtained before tooth extraction. Factors including age, sex, and pattern of impaction were investigated. All impacted third molars were classified and scored for spatial relationship (1-5 points), depth (1-4 points), and ramus relationship (1-3 points). All variables were measured twice by the same observer at a minimum interval of one month. Finally, the difficulty index was defined based on the total points scored as slightly difficult (3-4 points), moderately difficult (5-7 points), very difficult (8-10 points), and extremely difficult (11-12 points).
RESULTS
The strength of agreement of the total points scored and difficulty index were 0.855 and 0.746, respectively. Most cases were classified as moderately difficult (73.0%). Although only 13 out of 204 cases (6.4%) were classified as extremely difficult, patients classified as extremely difficult were the oldest (P < 0.05).
CONCLUSION
For difficulty classification, the authors propose one more difficult category beyond the existing three-step difficulty index: the clinician should consider the patient's age in the difficulty index evaluation.

Keyword

Third molar; Tooth extraction; Impacted tooth; Classification

MeSH Terms

Classification
Humans
Molar, Third*
Tooth Extraction
Tooth, Impacted
Full Text Links
  • JKAOMS
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
    DB Error: unknown error