Int J Stomatol

Int J Stomatol ›› 2023, Vol. 50 ›› Issue (6): 718-722.doi: 10.7518/gjkq.2023105

• Reviews • Previous Articles     Next Articles

Review of classification methods for evaluating the difficulty of mandibular third molar extraction

Chai An1(),Lei Rongchang2(),Jiang Zhisheng2,Qu Binbin2,Guo Jincai3,Li He2,Shao Qi2   

  1. 1.Dept. of Oral and Maxillofacial Surgery, The Affiliated Stomatological Hospital, Hunan University of Chinese Medicine, Changsha 410208, China
    2.Dept. of Oral and Maxillofacial Surgery, Changsha Stomatological Hospital, Changsha 410006, China
    3.Dept. of Pharmacy, Changsha Stomatological Hospital, Changsha 410006, China
  • Received:2023-02-08 Revised:2023-07-12 Online:2023-11-01 Published:2023-10-24
  • Contact: Rongchang Lei E-mail:chaian123@yeah.net;leorch@163.com

RichHTML

43

PDF (PC)

1389

Abstract:

To select an appropriate extraction method, the position relationship and extraction difficulty of mandibular third molars are generally evaluated by intraoral examination and imaging examination. Now, the classification of mandi-bular third molars widely used in clinical practice mainly includes Winter classification and Pell-Gregory classification.Therefore some studies show that the evaluation results have a large deviation from the actual situation, and the clinical applicability is not strong. On this basis, the scholars combined with the anatomical characteristics of the mandibular third molar to make a more detailed classification, and proposed classification methods such as Pederson Index, Comprehensive Impacted Index, Juodzbalys and Daugela. This article summarizes the classification methods for evaluating the difficulty of mandibular third molar extraction, and provides a reference for safer and more efficient extraction of mandibular third molars.

Key words: mandibular third molars, difficulty of removal, classification method, forecast model

CLC Number: 

  • R 782

TrendMD: 
1 Vranckx M, Ockerman A, Coucke W, et al. Radiographic prediction of mandibular third molar eruption and mandibular canal involvement based on angulation[J]. Orthod Craniofac Res, 2019, 22(2): 118-123.
2 Alfadil L, Almajed E. Prevalence of impacted third molars and the reason for extraction in Saudi Arabia[J]. Saudi Dent J, 2020, 32(5): 262-268.
3 Synan W, Stein K. Management of impacted third molars[J]. Oral Maxillofac Surg Clin North Am, 2020, 32(4): 519-559.
4 Mello FW, Melo G, Kammer PV, et al. Prevalence of odontogenic cysts and tumors associated with impacted third molars: a systematic review and meta-analysis[J]. J Craniomaxillofac Surg, 2019, 47(6): 996-1002.
5 Chung KR, Noh MK, Oh SH, et al. Treatment of 2 impacted molars in a large dentigerous cyst (expan-sile cystic lesion) with combined orthodontic and surgical therapy[J]. Am J Orthod Dentofacial Orthop, 2020, 158(5): 752-758.
6 Hauer L, Seidlová P, Merglová V, et al. Complete removal of dentigerous cysts with preservation of associated teeth as an alternative to marsupialization in children and preadolescents[J]. J Craniomaxillofac Surg, 2020, 48(8): 808-814.
7 Primo FT, Primo BT, Scheffer MAR, et al. Evaluation of 1211 third molars positions according to the classification of Winter, Pell & Gregory[J]. Int J Odontostomat, 2017, 11(1): 61-65.
8 Khojastepour L, Khaghaninejad MS, Hasanshahi R, et al. Does the Winter or Pell and Gregory classification system indicate the apical position of impacted mandibular third molars[J]. J Oral Maxillofac Surg, 2019, 77(11): 2222.e1-2222.e9.
9 Santos KK, Lages FS, Maciel CAB, et al. Prevalence of mandibular third molars according to the Pell & Gregory and Winter classifications[J].J Maxillofac Oral Surg, 2022, 21(2): 627-633.
10 Gümrükçü Z, Balaban E, Karabağ M. Is there a relationship between third-molar impaction types and the dimensional/angular measurement values of posterior mandible according to Pell & Gregory/Winter Classification[J]. Oral Radiol, 2021, 37(1): 29-35.
11 Korkmaz YT, Kayıpmaz S, Senel FC, et al. Does additional cone beam computed tomography decrease the risk of inferior alveolar nerve injury in high-risk cases undergoing third molar surgery? Does CBCT decrease the risk of IAN injury[J]. Int J Oral Maxillofac Surg, 2017, 46(5): 628-635.
12 Bhansali SP, Bhansali S, Tiwari A. Review of difficulty indices for removal of impacted third molars and a new classification of difficulty indices[J]. J Maxillofac Oral Surg, 2021, 20(2): 167-179.
13 Akadiri OA, Obiechina AE. Assessment of difficulty in third molar surgery-a systematic review[J].J Oral Maxillofac Surg, 2009, 67(4): 771-774.
14 Mohanty R, Rout P, Singh V. Preoperative anatomic evaluation of the relationship between inferior alveo-lar nerve canal and impacted mandibular third molar in a population of Bhubaneswar, Odisha, using CBCT: a hospital-based study[J]. J Maxillofac Oral Surg, 2020, 19(2): 257-262.
15 Wihokrut S, Vorakulpipat C, Manosuthi P, et al. Proximity of mandibular third molar root(s) to surrounding cortical bone: cone beam computed tomo-graphy (CBCT) and panoramic findings[J]. Oral Maxillofac Surg, 2022, 26(2): 311-319.
16 Sammartino G, Gasparro R, Marenzi G, et al. Extraction of mandibular third molars: proposal of a new scale of difficulty[J]. Br J Oral Maxillofac Surg, 2017, 55(9): 952-957.
17 Koerner KR. The removal of impacted third molars.Principles and procedures[J]. Dent Clin North Am, 1994, 38(2): 255-278.
18 Akadiri OA, Obiechina AE. Assessment of difficulty in third molar surgery-a systematic review[J]. J Oral Maxillofac Surg, 2009, 67(4): 771-774.
19 Yuasa H, Kawai T, Sugiura M. Classification of surgical difficulty in extracting impacted third molars[J]. Br J Oral Maxillofac Surg, 2002, 40(1): 26-31.
20 Diniz-Freitas M, Lago-Méndez L, Gude-Sampedro F, et al. Pederson scale fails to predict how difficult it will be to extract lower third molars[J]. Br J Oral Maxillofac Surg, 2007, 45(1): 23-26.
21 Carvalho RW, do Egito Vasconcelos BC. Assessment of factors associated with surgical difficulty during removal of impacted lower third molars[J]. J Oral Maxillofac Surg, 2011, 69(11): 2714-2721.
22 Juodzbalys G, Daugela P. Mandibular third molar impaction: review of literature and a proposal of a classification[J]. J Oral Maxillofac Res, 2013, 4(2): e1.
23 徐光宙, 杨驰, 范新东, 等. 以下颌神经管为参照的下颌阻生第三磨牙的分类及临床意义[J]. 中国口腔颌面外科杂志, 2014, 12(2): 131-135.
Xu GZ, Yang C, Fan XD, et al. Classification and clinical significance of mandibular impacted third molars with reference to mandibular nerve canal[J]. Chin J Oral Maxillofac Surg, 2014, 12(2): 131-135.
24 楚德国. 下颌第三磨牙阻生类型与手术时间关系及临床分类研究[J]. 口腔医学, 2014, 34(1): 59-61.
Chu DG. Study of the relationship between the impaction types and the extraction time of mandibular third molars and clinical classification[J]. Stomatology, 2014, 34(1): 59-61.
25 Zhang XY, Wang LX, Gao ZH, et al. Development of a new index to assess the difficulty level of surgical removal of impacted mandibular third molars in an Asian population[J]. J Oral Maxillofac Surg, 2019, 77(7): 1358.e1-1358.e8.
26 Yoo JH, Yeom HG, Shin W, et al. Deep learning based prediction of extraction difficulty for mandi-bular third molars[J]. Sci Rep, 2021, 11(1): 1954.
27 Susarla SM, Dodson TB. Risk factors for third molar extraction difficulty[J]. J Oral Maxillofac Surg, 2004, 62(11): 1363-1371.
28 Peñarrocha-Diago M, Camps-Font O, Sánchez-Torres A, et al. Indications of the extraction of symptomatic impacted third molars. A systematic review[J]. J Clin Exp Dent, 2021, 13(3): e278-e286.
29 Almendros-Marqués N, Berini-Aytés L, Gay-Escoda C. Evaluation of intraexaminer and interexami-ner agreement on classifying lower third molars according to the systems of Pell and Gregory and of Winter[J]. J Oral Maxillofac Surg, 2008, 66(5): 893-899.
30 Chuang SK, Perrott DH, Susarla SM, et al. Risk factors for inflammatory complications following third molar surgery in adults[J]. J Oral Maxillofac Surg, 2008, 66(11): 2213-2218.
31 雷飞, 倪菁, 王丹杨. 微创拔牙技术在下颌埋伏阻生智齿拔除过程中的应用研究[J]. 临床口腔医学杂志, 2020, 36(6): 338-341.
Lei F, Ni J, Wang DY. Application of minimally invasive tooth extraction technology in extraction of mandibular unerupted-impacted wisdom teeth[J].J Clin Stomatol, 2020, 36(6): 338-341.
[1] Xia Weiyao,Jia Zhonglin. Research progress on the relationship between vitamin and oral clefts [J]. Int J Stomatol, 2023, 50(6): 632-638.
[2] Lu Lei,Wang Xin,Kang Zebiao,Xie Fuqiang. Research progress on the application of computer-assisted navigation surgery in complex maxillofacial fractures [J]. Int J Stomatol, 2023, 50(6): 696-703.
[3] Yu Dongyang,Li Shaodong,Han Lei,Shan Ben,Liu Yong,Zhao Zhengyu. Differentiation of pleomorphic adenoma and adenolymphoma of parotid gland by CT morphological features, gender and radiomics [J]. Int J Stomatol, 2023, 50(5): 506-513.
[4] Li Yijun, Xu Ziang, Li Yi.. Research progress on the sentinel lymph nodes in the detection of head and neck squamous cell carcinoma [J]. Int J Stomatol, 2023, 50(5): 521-527.
[5] Liu Ting,Wu Xiuping.. Research progress on oral-craniomaxillofacial features and treatment of Down syndrome [J]. Int J Stomatol, 2023, 50(5): 618-622.
[6] Jiang Yueying,He Yutian,Li Ting,Zhou Ronghui.. Research progress on the application of near infrared fluorescence probe in the diagnosis of oral cancer [J]. Int J Stomatol, 2023, 50(4): 407-413.
[7] Tang Xiaojuan, Liu Xiaojing, Sun Yongheng, Zhang Jingxia. Efficacy of narrow-spectrum intense pulsed light in the treatment of scar after surgery of primary unilateral cleft lip [J]. Int J Stomatol, 2023, 50(4): 433-437.
[8] Wu Yifan,Lu Hao,Liu Shengwen,Xu Wanlin,Yang Wenjun.. Gorham-Stout disease in maxillofacial bone: a case report and literature review [J]. Int J Stomatol, 2023, 50(4): 445-451.
[9] Wang Chunyi,Li Jingtao.. A case of rare mandible and lower lip duplication and literature review [J]. Int J Stomatol, 2023, 50(4): 452-456.
[10] Fan Lin,Sun Jiang.. Application of microneedles in stomatology [J]. Int J Stomatol, 2023, 50(4): 472-478.
[11] Liu Yuntong,Liu Chang,Gao Lichao,Luo Yuxue,Cao Yubin,Hua Chengge.. Research progress on the postoperative inferior alveolar neurosensory disturbance [J]. Int J Stomatol, 2023, 50(4): 479-484.
[12] Zhu Keshi,Liao Anqi,Yu Youcheng.. Research progress on the application of machine learning in dental implantology [J]. Int J Stomatol, 2023, 50(4): 491-498.
[13] Chen Zhuo,Shi Bing,Li Jingtao.. Characterizing the nasal growth among patients with cleft lip and palate [J]. Int J Stomatol, 2023, 50(3): 279-286.
[14] Xia Weiyao,Luo Yankun,Jia Zhonglin. Review of the precise diagnosis and genetic etiology of Pierre Robin sequence [J]. Int J Stomatol, 2023, 50(3): 287-292.
[15] Li Peiran,Bi Ruiye,Wang Min,Wang Ruiyu,Liu Yao,Jiang Nan,Cao Pinyin,Zhu Songsong.. Soft tissue changes of the maxillary region in patients after anterior maxillary osteotomy setback and Le Fort Ⅰ osteotomy advancement [J]. Int J Stomatol, 2023, 50(3): 293-301.
Viewed
Full text


Abstract

Cited
  Shared   
  Discussed   
[1] . [J]. Foreign Med Sci: Stomatol, 1999, 26(06): .
[2] . [J]. Foreign Med Sci: Stomatol, 1999, 26(06): .
[3] . [J]. Foreign Med Sci: Stomatol, 1999, 26(06): .
[4] . [J]. Foreign Med Sci: Stomatol, 1999, 26(06): .
[5] . [J]. Foreign Med Sci: Stomatol, 1999, 26(06): .
[6] . [J]. Foreign Med Sci: Stomatol, 1999, 26(06): .
[7] . [J]. Foreign Med Sci: Stomatol, 1999, 26(06): .
[8] . [J]. Foreign Med Sci: Stomatol, 1999, 26(06): .
[9] . [J]. Foreign Med Sci: Stomatol, 1999, 26(06): .
[10] . [J]. Foreign Med Sci: Stomatol, 1999, 26(06): .