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Official Journal of the Italian Society of Maxillofacial Surgery
Dua G. 1, Navin Kumar A. 1, Roy I. D. 2, Chattopadhyay P. K. 1, Roy S. K. 3
1 Oral and Maxillofacial Surgery, Army Dental Centre R&R, New Delhi, India;
2 Oral and Maxillofacial Surgery, AFMC, Pune;
3 HOD and Prof, Oral and Maxillofacial Surgery, Army Dental Centre R&R, New Delhi, India
The complexity in removing the third molar is topic of much debate owing to its varying degree of difficulty. The literature supports a number of studies that have been put forward in assessing the difficulty in its removal correlating a combination of patient, dental and operator variables. The various, in vogue classification systems were thus studied to devise a comprehensive preoperative difficulty criterion for our institution that may lead to an overall improvement in patients experience through third molar surgery. A pub med search was carried out which resulted in forty three articles. Out of which a total of 11 such articles were then selected and full texts obtained, studied and scrutinized. The similarities, differences, limitations and advantages were then compared with pre-existing classification systems such as Winter’s, Pell and Gregory, Mac Gregor, Pederson, Modified Parant and Gintaras and Posilas difficulty scales. A comprehensive evaluation system for degree of difficulty for third molar removal was then formulated based on patient, dental and operator variables. The interaction between these additional factors contributes to the final outcome and difficulty in third molar removal. Although the radiographic variable remains the gold standard in assessing third molar surgery difficulty as has been the base line of most of the existing classification systems. A comprehensive assessment criterion is proposed here-in based on patient and radiological examination promising to be a helpful tool for assessment as well as for planning for surgical operation.