The extraction of impacted third molars is among the most common surgical procedures carried out in the field of Oral and Maxillofacial Surgery. For proper planning of surgical extraction, especially for impacted mandibular third molars the estimated level of surgical difficulty of the case is important. This study was conducted to evaluate the intraoperative risk factors contributing to surgical difficulty in extraction of impacted mandibular third molars and consequently the post-operative outcome. Here, we have undertaken a study in which the intraoperative variables were considered, to evaluate their contribution for surgical difficulty and postoperative complications in surgical removal of 100 impacted mandibular third molars. Three variables were found significant associated with total surgical time intervention, i.e., surgeon’s experience (p=0.006), Inter-incisal opening (p=0.032), and cheek flexibility (p=0.004). Total surgical time intervention for ‘right side’ was higher with 49.20 ± 17.94 minutes (p=0.691). Total surgical time intervention for ‘gagging reflex present’ was 50.21 ± 17.812 (p=0.674). Multiple linear regression shows that surgeon’s experience was the only predictor (p<0.001). The surgical difficulty of impacted mandibular third molar are likely to depend on the intraoperative factors like Surgeon’s time, surgeon’s experience, check flexibility, and inter incisal mouth opening.

The extraction of impacted third molars is among the most common surgical procedures carried out in the field of Oral and Maxillofacial Surgery. Both the patient and dentist must therefore have scientific evidence-based information concerning the estimated level of surgical difficulty of every case to consider in referring cases of impacted third molars for specialists’ handling. We have undertaken a study in which demographic and radiological variables were considered together to evaluate the risk factors for surgical difficulty in a cohort of 100 impacted mandibular third molars. There were 13 variables evaluated for surgical difficulty. Total surgical time intervention was noted at the end of each surgery. Each variable was analysed with total surgical time intervention with univariate and multiple linear regression. Out of 13 variables, 9 were found statistically significant. The most significant predictors for surgical difficulty were Body Mass Index, Depth of impacted tooth and Retromolar space. No postoperative complications were reported.

Third molars usually erupt within the age of 17 – 21years. Usually, due to the evolution of human jaws, the size is decreasing leading to the impacted tooth. An impacted tooth may lead to external resorption of the adjacent tooth, trismus, infection, etc. Many studies have been reported in the literature for evaluating the surgical difficulty and postoperative complications secondary to impacted third molars. This study includes a sample of 100 subjects evaluated for the surgical difficulty and postoperative complications. Various demographic, radiological, and intraoperative factors were evaluated which may lead to postoperative complications. Factors responsible for postoperative sequelae were also evaluated with complications. Postoperative pain after 4 hours and 7 days was assessed to mark the factors commonly responsible. Pain at 7th postoperative day was significant involving factors like fully impacted, horizontal impaction, level C, no/very little retromolar space, and root contact. Postoperative com­plications were not reported in this study.