Introduction: Assessment of the surgical complexity of lower third molar extraction
is a crucial step to formulate an optimal treatment plan, balancing the advantages
and disadvantages of the surgical extraction procedure to manage intraoperative complications
and postoperative pain. Aim: This study aimed to evaluate the accuracy of
a new scale of surgical difficulty for the extraction of the impacted lower third molar.
Patients and methods: Fifty-four patients were attended for lower third molar extraction.
All patients undergoing the same surgical approach including anesthesia, incision,
and elevation of the mucoperiosteal flap, ostectomy, and tooth sectioning, elevation,
and avulsion according to the root axis, socket debridement, and suturing. The period
of this study extended for 2 years. Results: The mesio angular impaction was the most
common type of impaction, followed by horizontal impaction. There was agreement
between the preoperative and the postoperative assessment of a simple operation. 26
third molars (48.15%) were considered preoperatively medium difficulty group, and
80.77% was agreement between the preoperative and the postoperative assessments of
moderately simple (p < 0.001). Conclusion: Our scale is effective since the mandibular
third molars with the highest scores were significantly correlated to longer ostectomy
time and total surgical time.