Determination of the degree of difficulty of third molar extraction in patients seen in the Dr. René Puig Bentz dental clinic´s diagnostic area according to the Cáceres index.

Third molar extractions are the most common procedure in which retention of these teeth can
be observed due to various factors, including embryological, anatomical and functional
factors. This study aimed to determine the difficulty level of third molar extractions in patients
attending the Dr. René Puig Benz dental clinic, as measured by the Cáceres index. This
observational, cross-sectional, retrospective study will examine 256 panoramic radiographs
selected from 759. The following parameters were evaluated: mandibular height; distal angle
of the second molar; follicular size; root shape and development; molar position; bone
covering; and space between the second molar and the ascending branch. Each variable was
scored and evaluated according to Cáceres index criteria, classifying the cases as minimal,
moderate, difficult or very difficult. The results revealed the following mandibular height: 35
mm to 39 mm (79.9%), angle towards distal of the second molar: 1° to 59° (66.9%), follicular
size: 0 mm (65.7%), space from distal of the second molar to the ascending branch: larger
mesiodistal diameter of the wisdom tooth (58. 2%), a vertical position (47.8%), a shape and
root development of more than two-thirds and favourable curvature (56.4%), and bone
coverage (66.7%).The most frequent degree of difficulty was 'minimal' (54.8%), followed by
'moderate' (49.1%), 'difficult' (24.1%) and the least frequent 'very difficult' (13.6%). The study
concludes that the Caceres Index is a useful tool for predicting the difficulty of lower third
molar exodontia surgery, enabling cases to be planned and assigned accurately according to
the operator's level of experience. These findings support the implementation of the index in
academic clinical settings to improve the safety and effectiveness of surgical treatment.