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"Effects of flap modification on third molar extraction outcomes"-A randomised split mouth study.
Geetha Sridharan1, Komagan Prabhu Nakkeeran1, Gnanam Andavan1
1Department of Oral and Maxillofacial Surgery, SRM Dental College and Hospital, Ramapuram Campus, Ramapuram, Chennai, 600089, Tamil Nadu, India.
Journal of Oral Biology and Craniofacial Research
|September 23, 2020
Summary
Modifications to the conventional Ward's flap design for third molar surgery did not significantly impact pain, swelling, or healing. However, the vertical anterior releasing incision offered poorer surgical accessibility compared to the oblique incision.
Area of Science:
- Oral and Maxillofacial Surgery
- Surgical Techniques
- Dental Research
Background:
- Third molar surgery is a common procedure with potential post-operative complications.
- Flap design is a critical factor influencing surgical outcomes and patient recovery.
- Optimizing flap design can potentially minimize morbidity and improve surgical efficiency.
Purpose of the Study:
- To compare the influence of modified flap designs on post-operative outcomes in third molar surgery.
- To evaluate the effect of different anterior releasing incisions on pain, swelling, and wound healing.
- To assess the impact of flap design modifications on surgical accessibility and periodontal health.
Main Methods:
- A randomized, single-blinded, split-mouth cross-over study involving 25 patients with impacted mandibular third molars.
- Comparison of Conventional Ward's flap with oblique anterior releasing incision (control) versus vertical anterior releasing incision (study group).
- Primary outcome measures included pain (VAS), swelling, mouth opening, periodontal probing depth, wound healing (Landry's score), and surgical accessibility.
Main Results:
- No statistically significant differences were observed in pain, swelling, mouth opening, or periodontal probing depth between the two flap designs.
- Surgical accessibility was significantly better in the control group (oblique incision) compared to the study group (vertical incision) (p=0.00184).
- Moderate swelling was noted in the study group, but it was not statistically significant.
Conclusions:
- Modifications in conventional Ward's flap design can influence swelling and surgical accessibility.
- The vertical anterior releasing incision in the modified Ward's flap design offers no discernible advantage over the oblique anterior releasing incision in terms of the evaluated outcomes.
- Surgical accessibility is a key consideration when modifying flap designs for third molar extraction.
