How well do clinicians estimate third molar extraction difficulty?
OBJECTIVE
The goals of this study were to measure surgeons abilities to estimate third molar (M3) extraction difficulty and to identify variables associated with errors in estimates of difficulty.


METHODS
To address our research purpose, we implemented a prospective cohort study and enrolled a sample of surgeons who remove M3s. Predictor variables were categorized as either surgeon or subject specific. The primary outcome variable was the error in estimating operative difficulty. Preoperative and postoperative estimates of difficulty were obtained using a 100-mm visual analogue scale. Error was defined as the difference between preoperative and postoperative estimates of extraction difficulty. Appropriate univariate, bivariate, and multivariate statistics were computed.


RESULTS
The sample was composed of 15 surgeons who operated on 82 subjects having 250 M3s (53.2% mandibular) extracted. The mean level of surgical experience was 8.8 +/- 11.1 years. The mean age of the subjects was 26.2 +/- 10.7 years; 57.3% were female; and 72.0% were white. The mean preoperative and postoperative estimates of difficulty were 44.3 +/- 23.4 and 39.6 +/- 24.7 mm, respectively. The mean absolute and actual differences between preoperative and postoperative estimates were 15.7 +/- 13.6 and 4.8 +/- 20.2 mm, respectively. We identified several demographic and anatomic variables statistically associated ( P < or = .05) with error in estimating difficulty.


CONCLUSIONS
Our models indicate that errors in the estimates of difficulty were related to demographic (age, gender, ethnicity, snoring) and anatomic (cheek flexibility, mouth opening) variables, with little or no dependence on radiographic variables or surgical experience.
Susarla
Srinivas M
SM
Harvard School of Dental Medicine, Boston, MA 02114, USA.
Dodson
Thomas B
TB
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D002983:Clinical Competence; D015331:Cohort Studies; D005006:Ethnicity; D005260:Female; D005544:Forecasting; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D008964:Molar, Third / Q000473:pathology / Q000601:surgery*; D015999:Multivariate Analysis; D011379:Prognosis; D011446:Prospective Studies; D012307:Risk Factors; D012737:Sex Factors; D012913:Snoring; D014081:Tooth Extraction