Journal of the Korean Association of Oral and Maxillofacial Surgeons

The Korean Association of Oral and Maxillofacial Surgeons (대한구강악안면외과학회)
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Modified difficult index adding extremely difficult for fully impacted mandibular third molar extraction

  • Kim, Jae-Young (Department of Oral and Maxillofacial Surgery, Gangnam Severance Hospital, Yonsei University College of Dentistry) ;
  • Yong, Hae-Sung (Department of Oral and Maxillofacial Surgery, Gangnam Severance Hospital, Yonsei University College of Dentistry) ;
  • Park, Kwang-Ho (Department of Oral and Maxillofacial Surgery, Gangnam Severance Hospital, Yonsei University College of Dentistry) ;
  • Huh, Jong-Ki (Department of Oral and Maxillofacial Surgery, Gangnam Severance Hospital, Yonsei University College of Dentistry)
  • Received : 2019.07.22
  • Accepted : 2019.11.02
  • Published : 2019.12.31
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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.

Keywords

References

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