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Figs. 9a–c Figs. 10a–c a a E v a l u a t i o n o f s u r g i c a l d i f f i c u l t y o f e x t r a c t i o n b b c c Figs. 9a–c Coronal area: (a) 20–75 mm2 (1); (b) 75–90 mm2 (2); and (c) 90–130 mm2 (3). Figs. 10a–c Root length: (a) 3.0–8.0 mm (1); (b) 8.0–9.5 mm (2); and (c) 9.5–13.0 mm (3). and coronal area to the classical variables of Pell and Gregory,1 producing the predictive scale with the largest number of variables to date, and add- ing ostectomy time as an indicator of surgical dificulty.5 These authors recorded longer ostec- tomy times in those cases predicted to be the most dificult extractions according to their clas- sification.5 This is consistent with the findings of the present study, in which the variables me- siodistal diameter of the third molar and root radiolucency were added to the classification of Peñarrocha et al.,5 and ostectomy time, tooth sectioning time and total surgical time were also considered. The relationship between the dificulty of extraction and the parameters evaluated by the various presurgical scales is usually appraised on the basis of the total surgical time. The results obtained in the present study point to a linear relationship between the surgical dificulty score and the total surgical time and ostectomy time. Santamaría and Arteagoitia demonstrated a re- lationship between the dificulty of extraction and the depth of impaction, the width of the periodontal ligament, the inclination of the third molar, its relation to the second molar, and the distance between the mandibular ramus and the second molar.11 According to Yuasa et al., the most important variables for assessing the dificulty of mandibular third molar extraction are depth level C, Class 3 and large roots, or the combination of these three factors—all of which can be record- ed from the panoramic radiographs.12 López Arranz underscored the importance of evaluating the adjacent teeth: The presence of the first and second molars, their anatomical integrity and separate roots constitute important support for extraction of the third molar.13 In the present study, the mesiodistal dia- meter of the third molar and the distance between the mandibular ramus and the second molar were the parameters most closely cor- related to total surgical time. This was in con- trast to Carvalho and do Egito Vasconcelos, who identified the number of roots and their morpho- logy, the position of the tooth, the periodontal space, and the relation to the second molar as the only significant predictors.14 These authors associated the greatest surgical dificulty with Class 3 cases on the scale of Pell and Gregory.1 The observations of Yuasa et al.12 and those of the present study indicate that long distances Journal of Oral Science & Rehabilitation Volume 3 | Issue 1/2017 57