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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.

A comparative double–blind study among two universal systems of classification of impacted lower wisdom tooth and duration of surgery