Dentists Research Articles

Medical Emergency In Dentistry By Local Anaesthetics

Justification: Local anaesthesia is widely used in various procedures in dental specialties. However, even though it is rare, a medical emergency may occur. Objective: The article aims to show the necessary care in the administration of local anaesthetic in dentistry and the medical emergencies, signs and symptoms and first procedures. Show the importance of the dental surgeon be alert to any signs and symptoms during the application of anaesthetic, and able to intercede in any risk to health or the patient's death and knowing the formula and possible side effects of anaesthetic use and their medicine interactions with legal and/or illegal drug. Methodology: research on the main electronic health platforms, BIREME, LILACS and Medline, using as descriptors: LOCAL ANAESTHETIC /+/ ODONTOLOGY and MEDICAL EMERGENCIES/AND/ODONTOLOGY, in Portuguese, French, Spanish and English, and the professional experience of the authors in First Aid and Medical Emergency in Dental Offices. Conclusion: There are risks in the administration of local anaesthetics, however they are minimal and can be predicted when there is a correct anamnesis and treatment plan and/or surgical adequate for each identified situation. Knowledge of the anatomy of irrigation and drainage, foramen, among others, besides of the physiology and neuroanatomy of the region where the anaesthetic will be applied, is important to minimise the risks. The dental surgeon should be alert to any signs and symptoms during the application of anaesthetic, and able to intercede in any risk to health or of the patient's death and knowing the formula and possible side effects of anaesthetic use and their medicine interactions with legal and/or illegal drug. The most serious side effects of a local anaesthetic focus on the central and peripheral nervous system, the cardiovascular tract and renal tract. Hence, there need to know both the physiology of the systems and the interaction of the medications with the specific anaesthetics. However, the patient may not always be able to receive anaesthetics with vasoconstrictors, and surgery is not always elective to know such medicine interactions, and not always is possible to know if there is any allergy to any specific anaesthetic without prior testing before surgery. Hence, there is needed to know emergency medical procedures in dental offices and clinics

Mycosis fungoides refractory to treatment - importance of a multidisciplinary approach.

We report a case of difficult-to-control mycosis fungoides (MF), where the role of the dental surgeon was crucial for the control and prognosis of the disease. A 62-year-old female patient diagnosed with MF had a previous record of red patches and small raised bumps on the face, along with a cancerous growth in the cervical and vulvar region. The patient was initially treated with methotrexate and local radiotherapy without resolution. Chemotherapy with cyclophosphamide, doxorubicin, vincristine, and prednisone was then started (CHOP protocol). The dental team of a reference hospital was consulted to evaluate swelling in the anterior region of the palate, which had been developing for two months, reporting discomfort when eating. The role of the dentistry team was fundamental in the differential diagnosis of oral lesions with dental infections, second neoplasia, or even a new site of disease manifestation, in addition to controlling mucosal changes resulting from chemotherapy. After ruling out dental infection, the dentistry team performed a lesion biopsy to confirm the diagnosis. The histopathological and immunohistochemical analysis showed atypical lymphoid infiltration of T cells (CD3+/CD4+/CD7-/CD8-), coexpression of CD25, and presence of CD30 cells, corresponding to the finding for MF. Identifying CD30 + allowed for a new chemotherapy protocol with brentuximab vedotin (BV) combined with gemcitabine. This protocol effectively controlled MF, which previous protocols had failed to do. The diagnosis by the dental team was essential for therapeutic change and improvement of the patient's clinical condition without the need for invasive medical procedures.

Association of Obesity and Type 2 Diabetes Mellitus With Periodontitis: A Cross-Sectional Study.

Background The relationship between obesity and type 2 diabetes mellitus (T2DM) is inevitable. The increase in the occurrence of obesity all around the globe has proportionally increased the occurrence of comorbidities. Periodontitis is a multifactorial inflammation of the periodontium attributed to dysbiosis in the subgingival microflora which may ultimately result in tooth loss. A triad between T2DM, periodontitis, and obesity is ascertained. Aim The present study focuses on investigating the association of obesity and T2DM with periodontal health. Methodology This cross-sectional study was conducted for a period of six months (September 2022 to February 2023) on 181 subjects, as per the sample size calculated by the statistician, who were previously diagnosed with T2DM and were either obese or overweight. The glycemic control was assessed on the basis of HbA1c values of the subjects. The subjects underwent bioelectrical impedance analysis along with an anthropometric examination. Full mouth examination including bleeding on probing, pocket probing depth, clinical attachment level (CAL), and oral hygiene index-simplified (OHI-S) was also checked to assess the status of periodontal health, and periodontitis was classified according to the new classification of 2017. Results The obtained data was statistically analyzed and p-value≤0.05 was considered statistically significant. The maximum prevalence of Stage III Grade C Periodontitis (34.73%) was observed in the diabetic obese group than in the diabetic overweight group. The overall anthropometric variable, abdominal circumference, waist-hip ratio, and basal metabolic index (BMI) were higher in the obese group as they displayed poor glycemic control. BMI and CAL also showed a positive correlation. Conclusion A significant association between obesity and T2DM with periodontitis was confirmed by this study. Hence, a syndemic approach needs to be formulated by the medical fraternity in collaboration with dental surgeons for the effective management of this triad.

Awareness and Knowledge Regarding the Concept of Shortened Dental Arches Among Dental Surgeons in Karachi, Pakistan

Awareness and Knowledge Regarding the Concept of Shortened Dental Arches Among Dental Surgeons in Karachi, Pakistan

Role of transcutaneous electrical nerve stimulation in temporomandibular joint disorders.

To co mpare the e ffica cy of transcutaneous elec trica l ner ve stimulation with commercially ava ilab le analgesics in alleviating symptoms of temporomandibular disorders. The cross-sectional, interventional study was conducted from March 11, 2020, to August 31, 2023, at the Oral and Maxillofa cial S urger y Department of the Armed Forces Institute o f Den tist r y, Rawalpindi, Pakistan, and comprised patients aged 18-65 years who were experiencing pain or distress in the temporomandibular joint region. The par ticipants were divided into intervention group A and control group B. Group A treatment involved applying electrodes near the temporomandibular joint, with parameters adjusted as per the treatment guidelines. Group B subjects received only analgesics along with basic care recommendations. Pain intensit y was assessed using visual analogue scale, while functional impairment and adverse effects were monitored. Data was analysed using SPSS 24. Of the 130 patients initially assessed, 100(77%) were included; 50(50%) in each group. In group A, there were 33(66.0%) fema les and 17(34.0 %) male s wit h overal l mean age 42.8±10.12 years. In group B, there were 30(60%) females and 20(40%) males with overall mean age 46.98±14.09 years. Pain intensity was significantly lower in group A compared to group B post-inter vention (p=0.009). Group A sub jec ts also showed significant post-intervention improvement in terms of mouth opening compared to group B patients (p<0.05). There was no significant intergroup difference with respect to adverse effects (p>0.05). Transcutaneous electrical nerve stimulation was significantly more effective than commercially available analgesics in alleviating symptoms of temporomandibular disorders.

Acupuncture: Chinese therapeutic technique and its applications in dentistry

Objective: The objective of this article is to talk about acupuncture, showing its origin and history, showing how it works, creating an interface between this practice and dentistry, addressing the benefits of this technique in dental treatments. Methodology: To compose this review article, searches were carried out for studies, articles, monographs and gray literature books that could contain a large amount of information, enriching the manuscript, bringing more scientific and current basis, thus, these searches were carried out on the basis data such as: Science Direct, Web of Science, DeCs, Scielo, PROSPERO, The Brazilian Journal of Health Review, VHL/BIREME, CAPES Journal Portal, The Cochrane Library, PUBMED and Google Academy. Results: Acupuncture is an ancient technique, created in China and which has spread throughout the planet, being something that has great use within medicine and dentistry, in treating problems such as: orofacial pain, TMD, neuralgia of the trigeminal and having anesthesia and analgesia function. Conclusion: It was seen that acupuncture is a Chinese technique that has great utility within dentistry, with a range of benefits within problems that are commonly seen in the clinical life of a dental surgeon and that affect the health of several people during the throughout life, thus being a powerful tool when used appropriately by dentists who are trained in this technique.

Analysis of Shape of Lingula in Dry Adult Human Mandible in a Bangladeshi Population

The lingula is an important anatomical landmark used in oral and dental surgeries and to block the inferior alveolar nerve. Our study aims to analyze different types of lingula found in mandibles of Bangladeshi individuals. This cross-sectional, descriptive study was done on 150 fully ossified dry human mandibles in the Department of Anatomy, Mymensingh Medical College, Mymensingh, Bangladesh between July 2019 and June 2020. A non-random purposive sampling technique was adopted. The lingula was classified into four types: triangular, truncated, nodular and assimilated. The triangular shape was most commonly found (67%), followed by truncated (19.33%), nodular (9.66%) and assimilated (4%). On right side of the mandible, the triangular shape was present in 61.33% samples and on left side, in 59.33% samples. Truncated shape was found 25.33% on right side and 26.66% on left. Nodular shape was present in 10% on right side and 9.33% on left. Assimilated shape was observed in 3.33% on right side and 4.66% on left. Knowledge of various morphological shapes helps dental and maxillofacial surgeons to preserve important structures like inferior alveolar nerve and vessels during surgical interventions of mandible. Our data is expected to increase the information pool, which will be useful for further anthropological studies. CBMJ 2024 July: vol. 13 no. 02 P: 223-226

CUIDADOS PALIATIVOS NA UNIDADE DE TERAPIA INTENSIVA: VISANDO A EQUIPE MULTIDISCIPLINAR

Palliative care is essential in the intensive care unit (ICU) to promote patient well-being in situations of serious and terminal illness. The multidisciplinary team plays a fundamental role in the implementation of palliative care in the ICU, as each professional has specific skills that contribute to comprehensive patient care. General objective: Explore palliative care in the intensive care unit and its importance for the multidisciplinary team. This study was a literature review in the Scielo and Google Scholar databases with a time frame from 2020 to 2024, using the following keywords: palliative care, nurse, dental surgeon; intensive care unit and multidisciplinary team. This study was a literature review in the Scielo and Google Scholar databases with a time frame from 2020 to 2024, using the following keywords: palliative care, nurse, dental surgeon; intensive care unit and multidisciplinary team. The inclusion criteria used in this literature review were: complete scientific articles published between 2020 and 2024 and available in databases (Google Scholar and Scielo). Duplicate articles published outside the chosen period and which did not address the topic were excluded. Results and discussions: The nurse and the dental surgeon play important roles as members of the multidisciplinary team in the ICU. The nurse is responsible for coordinating care and ensuring the patient's well-being, while the dental surgeon contributes to the prevention and treatment of oral problems that can affect the patient's quality of life. It is concluded that palliative care in the ICU is effective in improving patients' quality of life, but they still face challenges such as lack of knowledge and difficulties in communication.

Contemporary dentistry in the perception of dental surgeons: a qualitative analysis

Contemporary dentistry in the perception of dental surgeons: a qualitative analysis

CONDUTA DO ESPECIALISTA EM ENDODONTIA FRENTE AO RETRATAMENTO ENDODÔNTICO

Failure cases represent a significant percentage within endodontic practice. It is then necessary, in most cases, to carry out endodontic retreatment, which requires the search for a quick, safe and efficient technique. The objective of this study was to analyze the clinical conduct of the Endodontic Specialist in relation to endodontic retreatment through the completion of a questionnaire. To this end, 40 dental surgeons specializing in Endodontics, registered with CRO-PE, were selected. The results demonstrated that 97.5% of those surveyed indicated retreatment in the presence of a periapical lesion with symptoms, 50% in the absence of a periapical lesion with symptoms. Both in root canals treated endodontically and exposed to the oral environment for 30 days (75%) and in canals exposed for 40 days (82.5%) Specialists recommended retreatment in teeth that required a restoration with the presence of an intra-radicular post. 90%. Still in relation to how they use the Association of K, H and Gates-glidden files. The most used solvent was Eucalyptol (62.5%), followed by orange peel oil (55%), Xylol (7. 5%) and chloroform (7.5%). 5% do not use any solvent. 56.4% of those surveyed introduce the solvent up to the middle third in cases of overfilling of the root canal. 62.5% of those surveyed recommend a limit for canal preparation and filling of 1mm below the radiographic vertex. Using foraminal patency in 97.5% of cases. The most used irrigating solution was Chlorinated Soda (60%), followed by labarraque solution (25.0%), Dankin's liquid (17.5%) and saline solution (7.5%). 97.5% stated that they performed retreatment in two sessions and in these cases they used Callen (45.0%) and Callen associated with PMCC (42.5%) as intra-canal medication. The products tricresol formalin, calcium hydroxide P.A and formocresol were mentioned respectively by 15.0%, 12.5% ​​and 5.0%, 80% of those surveyed responded that in cases of flare-up they would not leave the tooth open to the oral environment . And 20% responded that they would leave it. Still in relation to flare-up, the intra-canal medication of choice when not leaving the canal open to the mouth was Callen (37.5%), followed by tricresol formalin (31.1%), callen + PMCC (25% ), calcium hydroxide P.A. (9.4%) and formocresol (3.1%). The drug of choice in cases of acute endodontic treatment was Amoxicillin associated with Clavulanate (92.5%).

Risk factors for medication-related osteonecrosis of the jaws in menopausal women

Aim: This study aimed to identify risk factors for medicationrelated osteonecrosis of the jaw (MRONJ) by carrying out clinical and radiographic evaluations of patients with osteopenia and osteoporosis using bisphosphonates (BFs). Methods: After approval by the CCS/UFES Ethics Committee (registration number 2,738,749), consultations were undertaken, and data were collected from medical records in cooperation with sectors from UFES and the University hospital. A total of 50 patients, 29 with osteoporosis and 21 with osteopenia were selected. Patients underwent a clinical and a panoramic dental x-ray examination to assess risk factors associated with oral health and dental interventions. Results: All patients had at least one local risk factor, the most frequent being tooth extraction (100%) and periodontal disease (50%) which, if associated with the use of BFs, could lead to MRONJ. Among the systemic risk factors, the most common were diabetes and corticosteroid therapy. The most used BF was alendronate, administered orally. Conclusion: The dental surgeon should evaluate all patients with osteopenia and osteoporosis using BFs to determine whether there are other risks. Whether there may be other potential risks, acknowledging upon key risks factors surrounding MRONJ are critical for early diagnosis and successful dental treatment.

DIFFICULTIES FOR DENTAL SURGEONS REGARDING THE EARLY DIAGNOSIS OF MOUTH CANCER IN PRIMARY HEALTH CARE

Introduction: In Brazil, oral cancer disease is considered a malignant neoplasm of the lip, tongue, gums, floor of the mouth, hard palate and other parts of the mouth. It represents a serious public health problem due to the high rates of late diagnoses and, consequently, the significant rates of morbidity and mortality. General objective: This is a research developed through an opinion article focusing on the dental surgeon’s approach to diagnosis in Primary Health Care (PHC). Methods: This is an opinion article survey, developed from February to June 2024, through the reflection of the texts published in the area as well as through the guidelines of the dental surgeon in PHC. Results: In the end, it can be seen that associated factors evidence this difficulty, such as the lack of materials for biopsy performance. Another important point is the non-implementation of family health strategies as an approach to the prevention of oral cancer. Final considerations: It can be stated that the training of professionals is an important factor for early diagnosis, as well as the expansion of resources.

Lingual Fasciculation as a Point of Call for the Diagnosis of Amyotrophic Lateral Sclerosis: A Literature Review.

Dental surgeons often play a pivotal role in the initial detection of lingual fasciculations (LFs). These involuntary micro-movements of the tongue can serve as early clinical indicators of neurodegenerative diseases, with amyotrophic lateral sclerosis (ALS) being the most concerning. Therefore, it is imperative to educate dental surgeons on identifying LF and understanding the potential underlying pathologies. This study aimed to pinpoint the pathologies in which LFs could emerge as an early clinical marker. Our review focused on articles delineating patient populations exhibiting LF within broader pathological contexts, encompassing neurological and other conditions, with the aim of elucidating their etiologies. We conducted a comprehensive literature review across four databases (PubMed, Embase, Web of Science, and Scopus). Two authors independently extracted data, with consultation from a third author when necessary. Eligible articles included those describing patients with LFs, detailing the methods of detection, diagnosis, and associated pathologies. Our review identified 22 articles encompassing 153 patients with LF, with an average age of 45.8 years and a female prevalence of 43%. Electromyography and ultrasound emerged as the predominant detection methods. ALS constituted the primary diagnosis in the majority of cases (91%). Additionally, other conditions diagnosed included Machado-Joseph disease (0.046%), familial transthyretin amyloid neuropathy (0.013%), Brown-Vialetto-Van-Laere syndrome (0.006%), chronic inflammatory demyelinating polyneuropathy (0.006%), bulbospinal amyotrophy or Kennedy's disease (0.006%), and osmotic demyelination syndrome (0.006%). LF secondary to organophosphate poisoning was also documented. Symptoms associated with LF encompassed taste alterations, dysphagia, difficulty swallowing, and slurred speech. While primarily indicative of ALS, LFs may also signal diverse underlying pathologies. Healthcare practitioners should be vigilant in their detection and expedite patient referrals to facilitate early integration into care protocols.

Botox: Current and Emerging Trends for Dental Practitioners in Esthetic Dentistry.

There are numerous medical and dental disorders for which there are no effective traditional therapy options. For various medical and dental disorders, botulinum toxin (BT) can be employed as an alternate therapeutic option that uses the chemodenervation approach. The range of dentistry treatment choices is expanding quickly. Applications of non-traditional therapy alternatives, such as the use of BT, are becoming more and more common in this situation. Although BT has been shown to be effective in a number of circumstances, its application in esthetic operations, such as the treatment of facial wrinkles, has gained widespread acceptance. This research is especially interested in applications of BT related to dentistry in the craniofacial region. For many diseases that a dentist would be interested in treating, BT provides a temporary, reversible, and generally safe therapy option. Due to their extensive knowledge of the anatomy of the faciomaxillary region, dental surgeons are a potential pool of operators who, with a small amount of skill enhancement, can use BT in their toolkit. This broadens the scope of minimally invasive alternatives to invasive protocols or refractory conditions. An online search was conducted for the use of BT in dentistry; all studies and articles pertaining to the subject were chosen, and dental-related content was removed and summarized. The fundamentals of BT and some of its applications in dentistry are covered in this article. The comprehensive details of its application in dentistry will be covered in the upcoming sections.

Differences in dental care for pregnant women in the public sector after the creation of Previne Brasil

Aim: To compare performance differences among dental surgeons in the public sector of the state of Minas Gerais regarding prenatal dental care before and after the establishment of Previne Brasil. Methods: A cross-sectional study was conducted, gathering data through a structured questionnaire. The sample consisted of dental surgeons working in the public sector of municipalities in MG and utilizing the snowball effect. Data analysis was performed using the IBM-SPSS® version 29.0, employing Pearson’s Chi-square statistical test (P&lt;0.05). Results: Out of the 28 State Health System (SRS) present in MG. A total of 1696 responses were collected, but after applying the exclusion criteria, 1001 responses remained, specifically related to dental surgeons working in MG public sector. 78.6% comprised professionals who graduated before 2019, while 20.1% graduated after that year. The morning and the second or other gestational trimesters were the most common periods considered optimal for caring for pregnant women. A significant portion of the professionals had not undergone any specific courses or training on this topic, reporting an average satisfaction level of 5.52 regarding the accessibility of information during their education aimed at this audience. Conclusion: Variances were observed in the care provided to pregnant women by dental surgeons working in the public sector of Minas Gerais, distinguishing those trained before and after the implementation of Previne Brasil. The debunking of myths and taboos stands as crucial for enhancing the acceptance of prenatal dentistry.

Major functions and importance of dental surgeons in the hospital environment and intensive care units: a concise systematic review

Major functions and importance of dental surgeons in the hospital environment and intensive care units: a concise systematic review

Evaluation of Burnout among Medical Officers and Dental Surgeons in State Health Services using Maslach's Burnout Inventory during COVID-19: A Cross Sectional Study.

The Coronavirus disease 2019 (COVID-19) pandemic became a worldwide public health crisis. It leads to raised levels of burnout and anxiety among the people of the medical and dental fraternity, especially those involved in various duties related to COVID-19. The present research focused on evaluating the prevalence and predictors of burnout among medical officers and dental surgeons in Haryana's state dental health services. A cross-sectional study was conducted to assess burnout among medical officers and dental surgeons involved in COVID-19-related duties in state health services. Maslach's burnout scale was used to evaluate burnout. It is a prevalidated and self-administered questionnaire with three domains, that is, emotional exhaustion (EE), personal accomplishment (PA) assessment, and depersonalization (DP). The Chi square test, Student's t test (unpaired), and analysis of variance (ANOVA) with post hoc analysis were done wherever applicable. Pearson's correlation analysis was used to check the relationship among EE, DP, and PA. A total of 200 study participants responded to the online survey. Nearly half of them (51%) were aged 25-34 years. The majority had service experience of up to 20 years (90%). Almost three-fourths (72%) of study participants performed duties for >8 h a day. Up to 86% reported that the second wave of COVID-19 caused increased burnout. Moderate-to-high degrees of occupational exhaustion (OE) and DP were reported among approximately 42% of study participants. Medical officers were reported to have statistically significantly higher levels of burnout compared to dental surgeons (P < 0.05). Moderate levels of burnout were reported among half of the study participants, suggestive of the need to address the issues related to mental health of healthcare providers.

What comes first: teeth or face? Recommendations for an interdisciplinary collaboration between facial esthetic surgery and dentistry

AbstractObjectiveThe aim of the present study was to provide recommendations in order to facilitate communication between dental professionals and surgeons who are collaborating in the field of dentofacial esthetics.Clinical ConsiderationsSmile esthetics are beyond the scope, both of the surgeons who are collaborating with facial esthetics and of the dentists, as a wide range of treatment options from both sides is available. It can be difficult for the surgeon or the dentist that first comes in contact with the patient to conduct an individualized global treatment plan, in order to find out how the various phases of the treatment can be sequenced, as a workflow for an efficient interaction between facial surgery and dentistry still does not exist in the scientific literature.ConclusionsFacial cosmetic procedures and dental treatment have to be planned as individual elements of the whole dentofacial esthetic rehabilitation. The treatment has to be initiated with the design of the smile and the intraoral mock‐up, followed by the required surgical interventions, and to be finished with the delivery of the definitive dental restoration.Clinical SignificanceDentofacial esthetics require comprehensive communication between surgeons and dentists. Following the proposed recommendations, an individualized interdisciplinary treatment plan can be conducted, defining the role of each specialty.

Homeopathy applied to Dentistry

Objective: To research, through literature review, the use of homeopathy as an alternative treatment for many pathologies involved in ​​dentistry field. Methodology: online searches using databases available at PUBMED Central and VHL/BIREME. Other platforms such as Web of Science, Science Direct and Google Academy. Results: Our search resulted in 25 articles. Conclusion: Despite the mysticism that surrounds it, the use of homeopathic medicines in dental treatments is, in fact, a scientifically proven alternative treatment, which helps in various pre and post surgical procedures, which has a low financial cost and great effectiveness, enabling a contribution to dental care. Scientific study in this area requires more research and clinical evidence, so that this practice is more widespread and used by dental surgeons, in addition to the application of homeopathy as a discipline in dentistry.

Comparative assessment of difficulty scales for removal of the third molar of the lower jaw depending on its position

Retention (delayed eruption) of the third molar is one of the most common pathologies in the outpatient practice of a dentist-surgeon. Such a pathology can very often be complicated by inflammatory diseases, such as pericoronitis, periostitis and other more serious diseases. Therefore, early warning and most gentle removal of the causative tooth determines the professionalism of the dental surgeon. A large number of indexes of difficulty of removal of the third molar have been proposed by different authors, but none of them is considered universal and optimal for different clinical cases. The level of complexity is most clearly characterized by a scale that takes into account not only radiological but also clinical and demographic indicators. Such scales exist in modification or in more recent literary sources. Having chosen the most clear and correct scale, it is possible for the surgeon to clearly assess the entire level of complexity and responsibility for surgical intervention on removing the third molar, thereby obtaining the most effective result, minimizing complications both during the operation and after a while. The purpose of the study: justification of the selection of the difficulty rating scale for the removal of the third molar of the lower jaw, depending on its position. The study analyzed and compared 18 basic scales of complexity that are most often used by surgeons before removing the impacted third molar of the lower jaw. Data sources that were used for the search were taken from Medline, PubMed, Google Scholar, Minerva library databases. Each of the difficulty scales was presented and translated into Ukrainian for convenient use in the practice of a dental surgeon. A general table was provided where a comparative analysis of the difficulty scales was made according to thirty parameters. It is shown that the Cosme Gay-Escoda C. scale has the most indicators for preoperative assessment of complexity. There are many difficulty scales for preoperative assessment for the removal of impacted third molars of the lower jaw. Some of them have radiological evaluation criteria, some have clinical criteria, and only the Pernumbuco index (2017), Zhang X. (2019), and Cosme Gay-Escoda C. (2022) scales also have demographic indicators. However, the latter has the largest number of criteria, according to which the difficulty of removing the third molar of the lower jaw is calculated.