The Impact of General and Local Fac-tors as Criterions of Assessment for the Difficult Lower Wisdom Tooth. A Ret-rospective Study


The aim of the study is to evaluate the relationship of the general and local factors which have an impact on the difficulty during the removal of impacted lower wisdom teeth. Several factors such as age , gender, mouth opening , chief complain, bone surrounding and radiographic appearance and sur-geon experience, will be included as factors which affect the difficulty during the removal of impacted lower wisdom teeth. Materials and methods: One hundred twenty medically fit patients were selected with an age range between 17–47 years of both sexes had impacted lower third molars and indicated for surgical extraction. Surgical removal performed by senior surgeon and junior, operation was per-formed under local anesthesia, all cases done between November 2008- June 2010, in oral and maxillo-facial surgery departmentdentistry college university of Mosul the collected data were analyzed statis-tically by using SPSS program. Results: the sample comprised of 62.5% female and 37.5% male with mean age 24.5 years, the mean of the mouth opening was 39mm, the chief complain distributed as fol-low( pain 65%, dental check up 25.8%, orthodontic reasons 6.7% and others 2.5%), according to Pell and Gregory classification the percentage were class І 44.2%, class ІІ 44.1%, class ІІІ 11.7%, while the angulations were horizontally 15.8%, mesioangular 44.2%, vertical 24.2%,distoangular 15.8%, levels position A 40%, position B 36%, position C 17%. The mean time for the experienced surgeon was 23.33 minutes while for the non experienced 53.11 minutes. There was statistically significant differ-ence between the time of the operation and the experience of the surgeon at P value =0.003. The rela-tion between the time of the operation and class, level and angulations of impaction was statistically not significant. To successfully evaluate the difficulty of lower third molar extraction prior to surgery, clinical, radiologic findings, local and general factors must be taken into account and there are special indexes used in the assessment of difficulty in lower wisdom tooth surgery with no one of them consid-ered the most reliable one because of the difference in the studies samples and in the local and general factors that had been used in the assessment of difficulty like age, gender, mouth opening , chief com-plain in addition to the clinical and radio graphical features. Conclusions: in regardless of type of diffi-culty index used in addition to local and general factors as a criteria for the assessment of lower molar