Comparison of two different flap designs for bilateral impacted mandibular third molar surgery

We compared the effect of lingual-based triangular flap with buccal-based triangular flap on postoperative complications in impacted third molar surgery.

Thirty patients aged between 18 and 36 (mean age 19.65±2.14) were included. They all had bilateral impacted third molars. We used buccal-based triangular flap on a randomly selected side (Group 1) and lingual-based triangular flap on the other side (Group 2). We evaluated pain during 7 days after the surgery; swelling and trismus on postoperative 2., 7. and 14. days; wound dehiscence and alveolar osteitis incidence on postoperative 7. and 14. days.

Pain was significantly higher in Group 2 during 7 days postoperatively (P<.05). Trismus and swelling were also more prominent in Group 2 on postoperative days 2 and 7. In Group 2, the duration of the surgery in was longer than Group 1 (P<.05). In Group 1, 17 patients (56.7%) had wound dehiscence and 6 patients (20%) in Group 2 (P<.05). No alveolar osteitis developed in either groups.

The buccal-based triangular flap seems better with regard to postoperative pain, swelling and trismus. On the other hand, the lingual-based triangular flap had a lesser incidence for wound dehiscence.