title: Difficulty of impacted mandibular third molar tooth removal: predictive ability of senior surgeons and residents.
abstract: OBJECTIVE
  The present study investigated whether residents are able to estimate the degree of difficulty of mandibular third molar removal to the same extent as senior surgeons.
  
  
  METHODS
  The study included 2 residents and 2 senior surgeons, each of whom extracted 50 mandibular third molars of similar complexity. The clinical variables evaluated included patient age, gender, body size, maximal mouth opening, and tongue interference. The radiographic variables related to the third molars examined on the panoramic radiographs included spatial positioning, tooth-bone interface, root morphology, and proximity of the tooth to the inferior alveolar canal. Before each extraction, the operating surgeon estimated the level of difficulty of the surgery after considering all the variables. The predicted length of time per operation was regarded as representative of operative difficulty. At the end of each operation, its actual duration was also recorded.
  
  
  RESULTS
  The residents and senior surgeons both accurately predicted the difficulty of surgery in just more than one half of the cases. A 57% agreement (κ = 0.24) was found between the senior surgeons' preoperative estimations and actual difficulty, and the agreement was 52% (κ = 0.19) for the residents' estimations. No significant difference was found between the senior surgeons and residents in the accuracy of their estimations of operation length.
  
  
  CONCLUSIONS
  The preoperative prediction of the surgical difficulty of mandibular third molar tooth removal was unreliable, not only for the residents, but also for the senior surgeons.
authors.affiliation: Associate Professor, Department of Oral and Maxillofacial Surgery, Suleyman Demirel University Faculty of Dentistry, Isparta, Turkey.
authors.forename: Nurgul
authors.initials: N
authors.lastname: Komerik
authors.affiliation: Associate Professor, Department of Oral and Maxillofacial Surgery, Ondokuz Mayıs University Faculty of Dentistry, Samsun, Turkey. Electronic address: mehtapm@gmail.com.
authors.forename: Mehtap
authors.initials: M
authors.lastname: Muglali
authors.affiliation: Researcher, Department of Oral and Maxillofacial Surgery, Suleyman Demirel University Faculty of Dentistry, Isparta, Turkey.
authors.forename: Betul
authors.initials: B
authors.lastname: Tas
authors.affiliation: Researcher, Department of Oral and Maxillofacial Surgery, Ondokuz Mayıs University Faculty of Dentistry, Samsun, Turkey.
authors.forename: Umit
authors.initials: U
authors.lastname: Selcuk
mesh_terms: D000328:Adult; D000367:Age Factors; D000539:Alveolar Process / Q000000981:diagnostic imaging; D049628:Body Size; D001835:Body Weight; D005260:Female; D005544:Forecasting; D006801:Humans; D007396:Internship and Residency; D008297:Male; D008334:Mandible / Q000000981:diagnostic imaging / Q000601:surgery; D008964:Molar, Third / Q000000981:diagnostic imaging / Q000601:surgery*; D061646:Operative Time; D010027:Osteotomy / Q000379:methods; D011862:Radiography, Panoramic / Q000379:methods; D016059:Range of Motion, Articular / Q000502:physiology; D012307:Risk Factors; D012737:Sex Factors; D013515:Surgery, Oral / Q000193:education; D013524:Surgical Flaps; D014059:Tongue / Q000033:anatomy & histology; D019228:Tooth Crown / Q000601:surgery; D014092:Tooth Root / Q000000981:diagnostic imaging / Q000601:surgery; D014095:Tooth, Impacted / Q000000981:diagnostic imaging / Q000601:surgery*