Comparative Evaluation of Surgical Difficulty of Impacted Maxillary and Mandibular Third Molars: An Observational Study

Abstract

Introduction Extraction of the third molar is the surgical intervention most frequently performed by dental professionals. Notwithstanding a meticulously designed surgical strategy, complications may arise during extraction of the lower third molars. The primary objective of this study was to evaluate and compare the surgical difficulties encountered when managing impacted maxillary and mandibular third molars. The secondary objective was identifying the predictors of surgical difficulty in extracting the third molars from both arches. Materials and methods This study included 30 systemically healthy patients requiring upper and lower third molar extractions on the same side. The Pederson index was used to assess surgical difficulty in such patients on pre-treatment orthopantomograms. The time interval between upper and lower extraction was one week for all patients, and all extractions were performed by an experienced oral and maxillofacial surgeon. An independent t-test was performed to determine the significance of the differences between group variables. Predictors of surgical difficulty, such as sex, type of impaction, duration of surgical procedure, type of surgical procedure, fused roots, and root curvature, were assessed using multivariate analysis. Results The mean patient age was 29.93 ± 2.81 years. The mean mouth opening was 41.25 ± 3.5 mm. Chi-square test results revealed no significant differences between the maxillary and mandibular groups across all variables (p > 0.05). The independent t-test results revealed significant differences between the maxillary and mandibular groups in procedure duration (p < 0.05). The duration of the procedure was significantly longer in the mandibular group (44.13 ± 15.20 minutes) than in the maxillary group (33.33 ± 13.96 minutes). Root curvature, duration of the surgical procedure, type of surgical technique employed, and patient sex were all identified as significant predictors. Conclusion The surgical difficulty for impacted third molars was similar in both arches. The duration of the surgical procedure was longer in the mandibular arch.