Removal of impacted teeth can be either extremely difficult or relatively straightforward and easy. To determine the degree of difficulty preoperatively, the surgeon should examine the patient methodically. The primary factor determining the difficulty of the removal is accessibility.
Accessibility is determined by the case of exposing the tooth, of preparing a pathway tor its delivery, and of preparing a purchase point (or taking advantage of a natural purchase point). With careful classification of the
impacted teeth using a variety of systems, the surgeon can approach the proposed surgery in an orderly fashion and predict whether any extraordinary surgical approachesappraches will be necessary or if the patient will encounter any postoperative problems. ‘ The majority of the classifying results from analysis of the radiograph. For most situations the periapical radiograph provides adequate detail and should be the radiograph most commonly used. The panoramic radiograph
shows a more accurate picture of the total anatomy of the
region and can be used as an adequate substitute. For each patient the dentist should carefully analyze the factors discussed in this section. By combining these factors, the dentist can assess the difficulty of the surgery
and elect to extrat the impacted teeth that are within his skill level. However, for ‘the patient’s sake the dentist should refer the patient to a specialist if a tooth presents a difficult surgical problem.



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