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

Area of Science:

• Oral and Maxillofacial Surgery
• Dental Research
• Surgical Techniques

Background:

• Impacted third molar surgery is common.
• Postoperative complications can impact patient recovery.
• Flap design is a critical surgical consideration.

Purpose of the Study:

• To compare lingual-based triangular flaps versus buccal-based triangular flaps.
• To evaluate the impact on postoperative complications in impacted third molar surgery.

Main Methods:

• Thirty patients with bilateral impacted third molars were included.
• A randomized split-mouth design was used: buccal-based flap (Group 1) and lingual-based flap (Group 2).
• Postoperative pain, swelling, trismus, wound dehiscence, and alveolar osteitis were assessed.

Main Results:

• Group 2 (lingual flap) showed significantly higher postoperative pain, swelling, and trismus.
• Surgical duration was longer for the lingual-based flap (Group 2).
• Wound dehiscence occurred in 56.7% of Group 1 patients versus 20% in Group 2; no alveolar osteitis was observed.

Conclusions:

• Buccal-based triangular flaps appear superior for managing postoperative pain, swelling, and trismus.
• Lingual-based triangular flaps demonstrated a lower incidence of wound dehiscence.