title: Surgical approach to impacted mandibular third molars--operative classification.
abstract: OBJECTIVE
  The aim of the present study is to suggest a convenient way to classify the position of the impacted third mandibular molar relative to the mandibular canal and to suggest indications for the use of each surgical approach for mandibular third molar extraction.
  
  
  METHODS
  The presented new typing system, Third Molar Classification (TMC), is a simple and easy-to-apply method for the surgical management of mandibular third molars and can be extended for any ectopic or impacted mandibular tooth. There are 3 major types of third molar positions. The second type is subdivided further into 2 subtypes. In the present study, 9 patients with high-risk mandibular third molars were treated according to the present classification and are presented and discussed. Patients typed as TMC IIb were treated with a sagittal split osteotomy approach and patients typed as TMC III were treated with an extraoral approach.
  
  
  RESULTS
  The operative classification was successfully implemented in very rare cases of deeply impacted mandibular third molars. In 3 of 9 cases (33%) minor complications included some degree of hypoesthesia using the extraoral approach; these complications resolved spontaneously without the need for any intervention.
  
  
  CONCLUSIONS
  The present study describes the use of a new surgical classification system for treatment planning in all types of mandibular third molar extractions. We believe that the present classification could help the oral and maxillofacial surgeon in decision-making and limit the possible risks that are present when attempting to extract impacted mandibular third molars.
authors.affiliation: Department of Oral and Maxillofacial Surgery, Rambam Medical Center, Haifa, Israel.
authors.forename: Imad
authors.initials: I
authors.lastname: Abu-El Naaj
authors.forename: Refael
authors.initials: R
authors.lastname: Braun
authors.forename: Yoav
authors.initials: Y
authors.lastname: Leiser
authors.forename: Micha
authors.initials: M
authors.lastname: Peled
mesh_terms: D000328:Adult; D003751:Dental Fistula / Q000601:surgery; D003803:Dentigerous Cyst / Q000601:surgery; D006801:Humans; D008297:Male; D008334:Mandible / Q000601:surgery; D008340:Mandibular Nerve / Q000033:anatomy & histology; D008875:Middle Aged; D008964:Molar, Third / Q000000981:diagnostic imaging / Q000601:surgery*; D011859:Radiography; D014081:Tooth Extraction / Q000145:classification / Q000379:methods*; D014095:Tooth, Impacted / Q000145:classification* / Q000150:complications / Q000601:surgery*