Introduction: The extraction of the erupted upper third molars (EUTMs) may be required in different clinical conditions (i.e. orthodontic treatment, periodontal disease). This study evaluates a new anatomical–radiological–surgical classification for the extraction of EUTMs.

Materials and methods: 166 EUTMs were enrolled and were randomly allocated in two groups according to two different extraction techniques: Group 1 (G1 – 97 teeth) was treated according to the proposed extraction protocol; Group 2 (G2 – 69 teeth) was treated according to the experience of the surgeon. The proposed classification divides EUTMs according to the root radiographic image into 4 classes: Multiple Roots (M), Simple (S), Tapered (T), Rounded (R); only one instrument is recommended for each class: molar forceps (DG117/DG118) for M; DG250 for S; Ogden Felsch DG 270 for T; Apexo “A” for R. Operating time and complications were the main outcomes.

Results: Differences were detected between G1 and G2 for operating time (146.8 s vs. 225.6 s – p < 0.05) and for operative complications (G1 = 37.1% vs. G2 = 47.8% – p < 0.05); operating time (odds ratio (OR) = 1.04 – p < 0.001) and smoking habit (OR = 31.27 – p < 0.001) were risk factors for complications in a multiple regression model; extraction protocol was a risk factor for complication, but did not reached the statistical significance (OR = 2.67 – p = 0.09).

Conclusions: The proposed anatomical–radiological–surgical classification seems to help the surgeon in diminishing the operating time and complications during the extraction of the erupted upper third molars.

Conflict of interest: None declared.