Document Type : Research Paper



Aim: To estimate the importance of time in determining the difficulty of surgical removal of impacted
third molars. Materials and Methods: Two hundred medically fit patients were selected with an age
range between 18–25 years of both sexes. These patients had vertically impacted lower third molars
and indicated for surgical extraction. The diagnosis of third molar impaction was based on clinical and
standard intraoral periapical radiographs. A double–blind approach was adopted whereby two
researchers carried out a classification of the operation based on expected time of surgery and the third
researcher performed the surgery. The classification of the impaction was performed pre–operatively
according to Pell–Gregory classification, then the operation was performed following the standard
procedure for this type of surgery. Following extraction, surgical difficulty was rated according to
Garcia et al. classification and operation time from the incision till suturing of the flap. Results:
Comparison among the three classification systems was performed and the results indicated no
significant difference among the three classifications regarding simple and moderate operations, but
only a significant difference was recorded for the difficult operations. Conclusion: This study,
however, revealed the importance of time in assessing the difficulty of such operations and this, in turn,
will help surgeons in scheduling the treatment plan and taking the necessary precautions when dealing
with difficult operations