Clasificaciones Winter y Pell-Gregory predictoras del trismo postexodoncia de terceros molares inferiores incluidos

Abstract

Winter and Pell-Gregory’s classifications allow locating and evaluating radiographically the lower third molar. Trismus is an immediate post-surgery complication after extraction. The purpose of this study was to determine the predictive value from these classifications, in relation to the post-surgery of the above mentioned molars, in patients attended at the faculty of Dentistry of the Los Andes University in Merida, Venezuela. A randomized cohort study was performed with 81 patients between 17 and 33 years old and 127 lower third molar extracted were included in the study. The procedure initiated with a clinical and radiographic (panoramic) evaluation, molars were classified according to Winter and PellGregory’s classification including an eruption degree determination. The procedure was done under truncal and mandibular infiltration anesthesia, the Winter modified and surrounded flap was designed and raised according indication with subsequent exodontias of 38, 48 or both; the effective surgery time was registered and the primary closing was effected. The retirement of suture was done in 7 days and trismus was diagnosed. Then Chi-squared were significant for trismus with Winter, Pell-Gregory, gingival and bone retention and time of effective surgery. On having applied logistic multiple regression, it had significance for trismus, with Winter (p=0,040) and Pell-Gregory according to bone deepness (p=0,021). The predictive model was estimated for trismus in mesio-angular, vertical, horizontal, disto-angular inclusions (Winter) and A, B, C (Pell-Gregory) positions, and its value was obtained. We concluded that these classifications are predictors for trismus in post-surgery of lower third molar included.