Intuitive recording

Sir, I would like to share with your readers a suggestion for a simple method to record the preoperative evaluation of the impacted third molar. It combines Pell-Gregory's ramus classification and Pell-Gregory's occlusal classification with Winter's classification in a table. It is intuitive, which would be helpful in communication with patients, and it can be used both in clinical judgement and statistical research.

First we locate Pell-Gregory's ramus classification (marked I II III) and Pell-Gregory's occlusal classification (marked A B C) in a table. For different sides of a dentition, the orientations are opposite (Figs 1, 2). The horizontal tables indicate Pell-Gregory's ramus classification and the vertical tables indicate Pell-Gregory occlusal classification. Background images show the position of each blank in the dentition; teeth in the images are C7 or D7.

Figure 1

A simple method to record the preoperative evaluation of the impacted third molar

Figure 2

A simple method to record the preoperative evaluation of the impacted third molar

Then we transform Winter's classification into arrows by marking the vertical impaction as ↑, the mesioangular impaction as ↖ or ↗, the distoangular impaction as ↖ or ↗, the buccoangular impaction as ⊕, the linguoangular impaction ⊙, the horizontal impaction as ← or → and the inverted impaction as ↓.

Figure 3

A simple method to record the preoperative evaluation of the impacted third molar

For example, if a C8 is impacted and its preoperative evaluation is class II, middle-position, mesioangular impaction, it could be recorded as in Figure 3. Similarly, if a D8 is impacted and its preoperative evaluation is Class III, low-position, buccoangular impaction, it could be recorded as in Figure 4.

Figure 4

A simple method to record the preoperative evaluation of the impacted third molar

The table also has another benefit in that it can be used to evaluate impacted teeth with direct scores. If we give value to blanks (Fig. 5) and arrows to assess the difficulty of extraction M3, we can get the total score of each impacted tooth conveniently. This could be of benefit both to clinical judgement and statistical research.

Figure 5

A simple method to record the preoperative evaluation of the impacted third molar

If the vertical impaction (↑) is worth 1, the mesioangular impaction and the distoangular impaction (↖ or ↗) are both worth 2, the buccoangular impaction (⊕) is worth 3, the linguoangular impaction (⊙) is worth 4, the horizontal impaction (← or →) is worth 5 and the inverted impaction (↓) is worth 6, then Fig. 3 is worth: 2(II) + 2(b) + 2(↖) = 6 and Fig. 4 is worth: 3(III) + 3(C) + 3(⊕) = 9.