World Journal of Dentistry

Register      Login

VOLUME 10 , ISSUE 6 ( November-December, 2019 ) > List of Articles

ORIGINAL RESEARCH

Comparison of New Flap Design with Conventional Flap Designs on Postoperative Pain and Swelling Following Mandibular Third Molar Removal

Kamaraj Loganathan, Jayashree Mohan, Bindu Kamaraj, Sabarinathan Jaganathan, Sabitha Sengodan, Abin Varghese

Keywords : Impaction, Mandibular third molar, Modified envelop flap, Pain, Swelling

Citation Information : Loganathan K, Mohan J, Kamaraj B, Jaganathan S, Sengodan S, Varghese A. Comparison of New Flap Design with Conventional Flap Designs on Postoperative Pain and Swelling Following Mandibular Third Molar Removal. World J Dent 2019; 10 (6):422-427.

DOI: 10.5005/jp-journals-10015-1680

License: CC BY-NC 4.0

Published Online: 00-12-2019

Copyright Statement:  Copyright © 2019; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Aim: To evaluate a new flap design that is a modification of an envelope flap in reducing the postoperative complications and to compare it with the conventional flaps such as a bayonet flap and an envelope flap for the surgical removal of impacted mandibular third molars. Materials and methods: A prospective randomized control clinical study was conducted on 90 medically healthy patients who came with impacted mandibular third molars. The patients were randomly divided into group I, group II, and group III of 30 patients each. All three group patients underwent surgical removal of impacted mandibular third molars wherein for group I patients, a bayonet flap was raised, for group II a modified envelope flap (new flap design), and for group III an envelope flap was raised. Postoperative pain and swelling at day 1, 3, and 7 were assessed and compared. Data were analyzed with ANOVA, using SPSS software version 20. Results: The group II proved more successful in reducing the postsurgical sequelae of impacted third molar removal. Postoperative analysis showed increased amount of pain and swelling in groups I and III as compared to group II. Conclusion: The new design flap that is a modification of an envelope flap is more superior to other two conventional techniques. Clinical significance: The new flap design is useful in reducing postoperative pain and swelling, which is the most common sequel of surgical removal of the impacted third molar and is easy to practice.


PDF Share
  1. Rosa AL, Carneiro MG, Lavrador MA, et al. Influence of flap design on periodontal healing of second molars after extraction of impacted mandibular third molars. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2002;93(4):404–407. DOI: 10.1067/moe.2002. 122823.
  2. Kirk DG, Liston PN, Tong DC, et al. Influence of two different flap designs on incidence of pain, swelling trismus, and alveolar osteitis in the week following third molar surgery. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2007;104:1–7. DOI: 10.1016/j.tripleo.2007.01.032.
  3. Arinda PK, Indrapradana A. Comparison of three flap designs on postoperative complication after third molar surgery. Intisari Sains Medis 2018;9(2):89–94.
  4. Berge TI. The use of a visual analogue scale in observer assessment of postoperative swelling subsequent to third-molar surgery. Acta Odontol Scand 1989;47(3):167–174. DOI: 10.3109/00016358909007697.
  5. Yamaguchi A, Sano K. Effectiveness of preemptive analgesia on post-operative pain following third molar surgery, review of literatures. Jpn Dent Sci Rev 2013;49(4):131–138. DOI: 10.1016/j.jdsr.2013.07.002.
  6. Santosh BS, Shivamurthy DM, Shilpa IG, et al. Comparison of pain, swelling, and trismus in the surgical removal of impacted mandibular third molars by following two different flap techniques. J Adv Med Dent Sci Res 2016;4(1):139–142.
  7. Dolanmaz D, Esen A, Isik K, et al. Effect of two flap designs on postoperative pain and swelling after impacted third molar surgery. Oral Surg Oral Med Oral Pathol Oral Radiol 2013;116(4):244–246. DOI: 10.1016/j.oooo.2011.11.030.
  8. Sandhu A, Sandhu S, Kaur T. Comparison of two different flap designs in the surgical removal of bilateral impacted mandibular third molars. Int J Oral Maxillofac Surg 2010;39(11):1091–1096. DOI: 10.1016/j.ijom.2010.07.003.
  9. Baqain ZH, Al-Shafii A, Hamdan AA, et al. Flap design and mandibular third molar surgery: a split mouth randomized clinical study. Int J Oral Maxillofac Surg 2012;41(8):1020–1024. DOI: 10.1016/j.ijom.2012.02.011.
  10. Erdogan O, Tatlı U, Ustun Y, et al. Influence of two different flap designs on the sequelae of mandibular third molar surgery. Oral Maxillofac Surg 2011;15(3):147–152. DOI: 10.1007/s10006-011-0268-7.
  11. McCagie J. A standard procedure for the removal of unerupted wisdom teeth. Dent Prac 1957;7:150–154.
  12. Koyuncu B, Cetingul E. Short-term clinical outcomes of two different flap techniques in impacted mandibular third molar surgery. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2013;116(3):179–184. DOI: 10.1016/j.oooo.2011.12.023.
  13. van Gool AV, Ten Bosch JJ, Boering G. Clinical consequences of complaints and complications after removal of the mandibular third molar. Int J Oral Surg 1977;6(1):29–37. DOI: 10.1016/S0300-9785(77)80069-0.
  14. Alqahtani NA, Khaleelahmed S, Desai F. Evaluation of two flap designs on the mandibular second molar after third molar extractions. J Oral Maxillofac Pathol 2017;21(2):317–318. DOI: 10.4103/jomfp.JOMFP_75_17.
  15. Yolcu U, Acar AH. Comparison of a new flap design with the routinely used triangular flap design in third molar surgery. Int J Oral Maxillofac Surg 2015;44(11):1390–1397. DOI: 10.1016/j.ijom.2015.07.007.
  16. Ustad F, et al. Comparative evaluation of envelop and triangular flaps in inferior third molar surgery. Indian J Stomatol 2013;4(3):66–70.
  17. Bhargava D, Thomas S, Moghe S, et al. Review of Mucoperiosteal Flap Designs for Mandibular Third Molar Surgery. Acta Sci Med Sci 2018;2(1):7–10.
  18. Blanco G, Lora D, Marzola C. The Different Types of Flaps in the Surgical Relations of the Third Impacted Molars–Literature Review. Dentistry 2016;7:425. DOI: 10.4172/2161-1122.1000425.
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.