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Open Access 01-12-2023 | Research

Mandibular third molar extraction: perceived surgical difficulty in relation to professional training

Authors: María Isabel Sánchez Jorge, Rosa Acevedo Ocaña, Carolina Valle Rodríguez, Barbara Peyró Fernández-Montes, Cristina Rico-Romano, Santiago Bazal-Bonelli, Luis Sánchez-Labrador, Jorge Cortés-Bretón Brinkmann

Published in: BMC Oral Health | Issue 1/2023

Abstract

Background

Establishing the level of surgical difficulty pre-operatively is an essential step in ensuring correct treatment planning. This study set out to determine whether the knowledge and experience acquired by dentists who had received different levels of training influenced, firstly, the perceived levels of difficulty of a variety of cases of mandibular third molar (MTM) extraction and, secondly, the perceived difficulty deriving from a series of factors (patient-related factors, anatomical and radiographic factors, operative factors).

Methods

This cross-sectional, descriptive, observational study took the form of a survey. Using a visual analog scale (VAS), participants evaluated both the perceived difficulty of 30 cases of MTM extraction described by means of digital panoramic radiographs and the perceived difficulty deriving from a series of factors conditioning MTM extraction. The results underwent statistical analysis with SPSS Statistics 28.0 software. Non-parametric tests (Mann Whitney test for independent samples and the Kruskal–Wallis test) were applied.

Results

A total of 389 surveys were available for analysis. Dental practioners with no surgical training saw the intervention as presenting greater difficulty. Professionals with postgraduate training in oral surgery considered patient-related factors more important than operative factors, in contrast to dentists who had not received oral surgery training.

Conclusions

Dental training has a signficant influence on the perceived difficulty of MTM extraction and also affects opinions about which factors have greater or lesser influence on surgical difficulty.

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Donado M, Martínez JM. Oral surgery, pathology and technique. 5th ed. Barcelona: Elsevier Masson; 2019. p. 199–212.

Kwon D, Ahn J, Kim CS, Kang DO, Paeng JY. A deep learning model based on concatenation approach to predict the time to extract a mandibular third molar tooth. BMC Oral Health. 2022;22(1):571. https://doi.org/10.1186/s12903-022-02614-3.CrossRefPubMedPubMedCentral

Alfadil L, Almaied E. Prevalence of impacted third molars and the reason for extraction in Saudi Arabia. Saudi Dent J. 2020;32(5):262–8. https://doi.org/10.1016/j.sdentj.2020.01.002.CrossRefPubMedPubMedCentral

Khojastepour L, Khaghaninejad M, Hasanshahi R, Forghani M, Ahrari F. Does the Winter or Pell and Gregory Classification System Indicate the Apical Position of Impacted Mandibular Third Molars? J Oral Maxillofac Surg. 2019;77(11):2222.e1-2222.e9. https://doi.org/10.1016/j.joms.2019.06.004.CrossRefPubMed

Bali A, Bali D, Sharma A, Verma G. Is Pederson Index a True Predictive Difficulty Index for Impacted Mandibular Third Molar Surgery? A Meta-analysis. J Maxillofac Oral Surg. 2013;12(3):359–64. https://doi.org/10.1007/s12663-012-0435-x.CrossRefPubMed

Akadiri O, Obiechina AE. Assessment of difficulty in third molar surgery- a systematic review. J Oral Maxillofac Surg. 2009;67(4):771–4. https://doi.org/10.1016/j.joms.2008.08.010.CrossRefPubMed

Al-Samman AA. Evaluation of Kharma scale as a predictor of lower third molar extraction difficulty. Med Oral Patol Oral Cir Bucal. 2017;22(6):e796–9. https://doi.org/10.4317/medoral.22082.CrossRefPubMedPubMedCentral

Roy I, Baliga S, Louis A, Rao S. Importance of clinical and radiological parameters in assessment of surgical difficulty in removal of impacted mandibular 3rd molars: a new index. J Maxillofac Oral Surg. 2015;14(3):745–9. https://doi.org/10.1007/s12663-014-0731-8.CrossRefPubMed

Sammartino G, Gasparro R, Marenzi G, Trosino O, Mariniello M, Riccitiello F. Extraction of mandibular third molars: proposal of a new scale of difficulty. Br J Oral Maxillofac Surg. 2017;55(9):952–7. https://doi.org/10.1016/j.bjoms.2017.09.012.CrossRefPubMed

10.

de Carvalho RWF, Vasconcelos BC. Pernambuco index: predictability of the complexity of surgery for impacted lower third molars. Int J Oral Maxillofac Surg. 2018;47(2):234–40. https://doi.org/10.1016/j.ijom.2017.07.013.CrossRefPubMed

11.

Santamaria J, Arteagoitia I. Radiologic variables of clinical significance in the extraction of impacted mandibular third molars. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1997;84(5):469–73. https://doi.org/10.1016/s1079-2104(97)90259-6.CrossRefPubMed

12.

Yuasa H, Kawai T, Sugiura M. Classification of surgical difficulty in extracting impacted third molars. Br J Oral Maxillofac Surg. 2002;40(1):26–31. https://doi.org/10.1054/bjom.2001.0684.CrossRefPubMed

13.

Gbotolorum OM, Arotiba GT, Ladeinde AL. Assessment of factors associated with surgical difficulty in impacted mandibular third molar extraction. J Oral Maxillofac Surg. 2007;65(10):1977–83. https://doi.org/10.1016/j.joms.2006.11.030.CrossRef

14.

Susarla SM, Dodson TB. Risk factors for third molars extraction difficulty. J Oral Maxillofac Surg. 2004;62(11):1363–71. https://doi.org/10.1016/j.joms.2004.05.214.CrossRefPubMed

15.

Susarla SM, Dodson TB. Estimating third molar extraction difficulty: a comparison of subjective and objective factors. J Oral Maxillofac Surg. 2005;63(4):427–34. https://doi.org/10.1016/j.joms.2004.12.003.CrossRefPubMed

16.

Renton T, Smeeton N, McGurk M. Factors predictive of difficulty of mandibular third molar surgery. Br Dent J. 2001;190(11):607–10. https://doi.org/10.1038/sj.bdj.4801052.CrossRefPubMed

17.

Sánchez-Torres A, Soler-Capdevila J, Ustrell-Barral M, Gay-Escoda C. Patient, radiological, and operative factors associated with surgical difficulty in the extraction of third molars: a systematic review. Int J Oral Maxillofac Surg. 2020;49(5):655–65. https://doi.org/10.1016/j.ijom.2019.10.009.CrossRefPubMed

18.

Alvira-González J, Figueiredo R, Valmaseda-Castellón E, Quesada-Gómez C, Gay-Escoda C. Predictive factors of difficulty in lower third molar extraction: A prospective cohort study. Med Oral Patol Oral Cir Bucal. 2017;22(1):e108–14. https://doi.org/10.4317/medoral.21348.CrossRefPubMed

19.

Jaroń A, Trybek G. The Pattern of Mandibular Third Molar Impaction and Assessment of Surgery Difficulty: A Retrospective Study of Radiographs in East Baltic Population. Int J Environ Res Public Health. 2021;18(11):6016. https://doi.org/10.3390/ijerph18116016.CrossRefPubMedPubMedCentral

20.

Diniz Freitas M, Lago-Mendez L, Gude-Sampedro F, Somoza- Martin JM, Gándara-Rey JM, García-García A. Pederson scale fails to predict how difficult it will be to extract lower third molar. Br J Oral Maxillofac Surg. 2007;45(1):23–6. https://doi.org/10.1016/j.bjoms.2005.12.004.CrossRefPubMed

21.

García AG, Sampedro FG, Rey JG, Vila PG, Martin MS. Pell-Gregory classification is unreliable as a predictor of difficulty in extracting impacted lower third molars. Br J Oral Maxillofac Surg. 2000;38(6):585–7. https://doi.org/10.1054/bjom.2000.0535.CrossRefPubMed

22.

Park KL. Which factors are associated with difficult surgical extraction of impacted lower third molars? J Korean Assoc Oral Maxillofac Surg. 2016;42(5):251–8. https://doi.org/10.5125/jkaoms.2016.42.5.251.CrossRefPubMedPubMedCentral

23.

Barreiro-Torres J, Diniz-Freitas M, Lago-Méndez L, Gude-Sampedro F, Gándara-Rey JM, García-García A. Evaluation of the surgical difficulty in lower third molar extraction. Med Oral Patol Oral Cir Bucal. 2010;15(6):e869–74. https://doi.org/10.4317/medoral.15.e869.CrossRefPubMed

24.

Gay-Escoda C, Sánchez-Torres A, Borrás-Ferreres J, Valmaseda-Castellón E. Third molar surgical difficulty scales: systematic review and preoperative assessment form. Med Oral Patol Oral Cir Bucal. 2022;27(1):e68-76. https://doi.org/10.4317/medoral.24951.CrossRefPubMed

25.

Komerik N, Muglali M, Tas B, Selcuk U. Difficulty of impacted mandibular third molar tooth removal: predictive ability of senior surgeons and resident. J Oral Maxillofac Surg. 2014;72(6):e1-6. https://doi.org/10.1016/j.joms.2014.01.023.CrossRef

26.

Susarla SM, Dodson TB. How well do clinicians estimate third molar extraction difficulty? J Oral Maxillofac Surg. 2005;63(2):191–9. https://doi.org/10.1016/j.joms.2004.05.220.CrossRefPubMed

27.

Ferrús-Torres E, Gargallo-Albiol J, Berini-Aytés L, Gay-Escoda C. Diagnostic predictability of digital versus conventional panoramic radiographs in the presurgical evaluation of impacted mandibular third molars. Int J Oral Maxillofac Surg. 2009;38(11):1184–7. https://doi.org/10.1016/j.ijom.2009.06.023.CrossRefPubMed

28.

Pippi R. Evaluation capability of surgical difficulty in the extraction of impacted mandibular third molars: a retrospective study from a post-graduate institution. Ann Stomatol (Roma). 2014;31(5):7–14.

29.

Macluskey M, Slevin M, Curran M, Nesbitt R. Indications for and anticipated difficulty of third molar surgery: a comparison between a dental hospital and a specialist high street practice. Br Dent J. 2005;199(10):671–5. https://doi.org/10.1038/sj.bdj.4812931.CrossRefPubMed

Title: Mandibular third molar extraction: perceived surgical difficulty in relation to professional training
Authors: María Isabel Sánchez Jorge
Rosa Acevedo Ocaña
Carolina Valle Rodríguez
Barbara Peyró Fernández-Montes
Cristina Rico-Romano
Santiago Bazal-Bonelli
Luis Sánchez-Labrador
Jorge Cortés-Bretón Brinkmann
Publication date: 01-12-2023
Publisher: BioMed Central
Published in: BMC Oral Health / Issue 1/2023
Electronic ISSN: 1472-6831
DOI: https://doi.org/10.1186/s12903-023-03131-7

2024 ASCO Annual Meeting

Springer Medicine

Mandibular third molar extraction: perceived surgical difficulty in relation to professional training

Abstract

Background

Methods

Results

Conclusions

2024 ASCO Annual Meeting

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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