Surgical Extraction of Mandibular Third Molars: Risk Assessment and Predictable Complexity

Objective. The study aims to develop and validate new practical and simple but robust index to determine the complexity level of surgical extraction of mandibular third molars (MTM). Methods. A cross-sectional study with sample of 100 patients referred for management of MTM. Complexity index scores recorded twice at 6 weeks intervals preoperatively by oral and maxillofacial specialist. Prediction of the surgical difficulty and the degree of agreement of different variable indexes were calculated. Results. Out of 100, 78 patients with 139 impacted MTM, 26 were males and 52 were female, with a mean age of 26.40±6.39 years (range, 18-45 years). The prediction of operative difficulty was significant as measured by impaction angulation, distance to ramus, and impaction depth. Most cases were classified as complexity level II (63 [80%]). Although only 3 out of 100 cases (4%) were classified as complexity level III. There was no significant difference in age based on the gender (male: 27.54±7.35 years, female: 25.83±5.86 years; P=0.268). Conclusion. Using MTM complexity index as a preoperative tool to evaluate the surgical difficulty, including different patient-specific variables could facilitate treatment planning, help prevent complications and assess the possibility of referral.