PERNAMBUCO INDEX

& WARLINE
Oleh :
drg.Rizqan Maulana
drg. Fajar Januar Mirhard
drg. Muhammad Fuadi
drg. Tiara oktavia Saputri
 PENDAHULUAN
• Tingkat kesulitan impaksi gigi molar ketiga
merupakan indeks yang berperan dalam meprediksi
faktor risko setiap pembedahan sebelum fase
operasi.
• Berbagai indeks telah dikembangkan dalam berbagai
penelitian dengan menguji akurasi, efisiensi dan
objektifitasnya, sehingga dihasilkan indeks stratifikasi
yang lengkap dan turut mempertimbangkan aspek
bentuk, posisi gigi impaksi

Yurika, dkk. 2020

 DEFINISI
• Impaksi adalah gigi yang jalan erupsi
normalnya terhalang atau terblokir, biasanya
oleh gigi di dekatnya atau jaringan patologis

*Pedersen, 1996
 Pernambuco Index

Carvalho et al., 2018

 KLASIFIKASI
PELL AND GREGORY
•Kelas I
•Kelas II
•Kelas III

Ruslin, dkk., 2020

 KLASIFIKASI
PELL AND GREGORY
•Kelas A
•Kelas B
•Kelas C

Ruslin, dkk., 2020

 KLASIFIKASI
WINTER
•Vertikal
•Horizontal
•Inverted
•Mesioangular
•Distoangular
•Bukoangular
•linguoangular

Ruslin, dkk., 2020

 KLASIFIKASI
• WINTER

Ruslin, dkk., 2020

 WAR Lines

DIFFICULTY INDICES FOR REMOVAL

OF IMPACTED MANDIBULAR THIRD
MOLARS
 White, Amber and Red (WAR)
Lines
• To determined position and depth of impacted
mandibular third molar
• Imaginary lines drawn on the standart
radiograph with 3 different colours

Balaji,
2007
 White, Amber and Red (WAR)
Lines
• White line: Line joining the occlusal surfaces/heighest cusps tips of all erupted molars, extending
up to the ramus. It indicates the difference in occlusal level of second and third molars. Drawn
along occlusal surface of the erupted third molar and extended over third molar region posteriorly.

• Amber line: Represents the bone level distal to the 3rd molar, extended anteriorly along the crest of
interdental septum. This line denotes the alveolar bone covering the impacted tooth and the portion
of the tooth not covered. Drawn from the surface of the bone on distal aspect of third molar to the
crest of interdental septum between first and second mandibular molar.

• Red Line: Drawn perpendicular from Amber line to the imaginary point of application of elevator on
the 3rd molar. It indicates the amount that will have to be removed before elevation i.e. the depth of
the tooth in bone and the difficulty encountered in removing the tooth. Drawn perpendicular from
the amber line to an imaginary point of application of the elevator.

Balaji, 2007
 White, Amber and Red (WAR)
Lines
• White line: Corresponds to occlusal plane of molar teeth, Indicates
the difference in occlusal level of second and third molar

• Amber line: Represents the bone level, Denotes the alveolar bone
covering the impacted tooth and the portion of tooth not covered by
the bone

• Red Line: The red lines is an imaginary line drawn perpendicular

from the amber line to an imaginary point of application of an
elevator, Represent depth of the tooth in bone and the difficulty
encountered in removing the tooth, if the length of red line is more
than 5 mm then extraction is difficult, For every additional 1 mm
difficulty increases three times (3X)
 DAFTAR PUSTAKA
Balaji, SM. 2007. Textbook of Oral and Maxillofacial Surgery. New Delhi :
Elsevier Page 237
Carvalho et al., 2018, Pernambuco Index: predictablity of the complexity
of surgery for impacted lower third molars, International Journal of
Oral and Maxillofacial Surgery
Ruslin, dkk., 2020, Buku Ajar Bedah Mulut dan Maksilofasial: Teori Praktik
dan Dasar, EGC: jakarta. Hal: 333-340
Pederson G,W., 1996, Buku Ajar Praktis Bedah Mulut. EGC:Jakarta. Hal:
60
Yurika, dkk. 2020. Klasifikasi impaksi gigi molar ketiga melalui
pemeriksaan radiografi sebagai penunjang odontektomi, Jurnal
Radiology Dentomaksilofasial Indonesia, 4(1): 1-5.