COMPARISON BETWEEN THE LINGUALLY BASED AND THE BUCCALLY BASED TRIANGULAR FLAP DESIGN IN THE SURGICAL REMOVAL OF IMPACTED MANDIBULAR THIRD MOLARS (CLINICAL TRIAL)

Said, Nesma M.; Osman, Saeeda M.; Sweedan, Ahmed O.

doi:10.21608/adjalexu.2021.144852

	COMPARISON BETWEEN THE LINGUALLY BASED AND THE BUCCALLY BASED TRIANGULAR FLAP DESIGN IN THE SURGICAL REMOVAL OF IMPACTED MANDIBULAR THIRD MOLARS (CLINICAL TRIAL)
Alexandria Dental Journal
Article 6, Volume 46, Issue 1, April 2021, Page 36-42 PDF (572.83 K)
Document Type: Original Article
DOI: 10.21608/adjalexu.2021.144852
View on SCiNiTO
Authors
Nesma M. Said ¹; Saeeda M. Osman²; Ahmed O. Sweedan³
¹Oral and Maxillofacial Surgery department ,faculty of dentistry,Alexandria university
²Professor of Oral and Maxillofacial Surgery, Department of Oral and Maxillofacial Surgery Faculty of Dentistry, Alexandria University, Egypt.
³Lecturer of Oral and Maxillofacial Surgery, Department of Oral and Maxillofacial Surgery Faculty of Dentistry, Alexandria University, Egypt.
Abstract
INTRODUCTION: Removal of wisdom teeth could be challenging owning to limited accessibility, the tooth’s structural location and probable nerve damage especially to the inferior alveolar nerve and the lingual nerve. OBJECTIVES: The primary goal of this study is to make a comparison between the lingually based triangular flap and the buccally based triangular flap in terms of post-operative healing and complications. METHODS: 20 patients between the age of 21 and 30 years were randomly selected for mandibular third molar removal from clinic of the Oral and Maxillofacial Department, Faculty of Dentistry, Alexandria University. They were divided into two groups the study group (n=10) was operated using the lingually based triangular flap design and the control group (n=10) was operated using the buccally based triangular flap design. The patients were recalled on the 2nd, 7th and 14th days postoperatively in order to evaluate postoperative pain ,swelling ,wound dehiscence , the incidence of dry socket formation and lingual nerve injury. RESULTS: The lingually based triangular flap showed inferior levels of pain and was statistically significant in the 3rd and 7th day postoperatively . The lingually based triangular flap design showed less amount of facial swelling and lower incidence of wound dehiscence, dry socket formation and lingual nerve injury but the difference between the groups was all statistically insignificant. CONCLUSION: Lingually based triangular flap design revealed better postoperative healing than buccally based triangular flap design.
Keywords
Lingual Triangular Flap; Buccal Triangular; Impaction; Mandibular Molar


References
1.Lopes V, Mumenya R, Feinmann C, Harris M. Third molar surgery: an audit of the indications for surgery, post-operative complaints and patient satisfaction. Br J Oral Maxillofac Surg.1995;33:33-5. 2. Shevel E, Koepp WG, Bütow KW. A subjective assessment of pain and swelling following the surgical removal of impacted third molar teeth using different surgical techniques. SADJ. 2001;56:238-41. 3.Bello SA, Adeyemo WL, Bamgbose BO, Obi EV, Adeyinka AA. Effect of age, impaction types and operative time on inflammatory tissue reactions following lower third molar surgery. Head Face Med. 2011;28:7-8. 4.Amin MM, Laskin DM. Prophylactic use of third molars indomethacin for prevention of postsurgical complications after removal of impacted third molars. Oral Surg Oral Med Oral Pathol. 1983;55:448-51. 5. Sortino F, Cicciu M. Strategies used to inhibit postoperative swelling following removal of impacted lower third molar. Dent Res J (Isfahan). 2011;8:162-71. 6.Kirk DG, Liston PN, Tong DC, Love RM. 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:e1-6. 7. Suarez-Cunqueiro MM, Gutwald R, Reichman J, Otero- Cepeda XS, Schmelzeisen R, Compostela S. Marginal flap versus paramarginal flap in impacted third molar surgery: a prospective study. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2003;95:403-8. 8.Roode GJ, Butow K. An alternative surgical flap design for impacted third molars: a comparison of two different surgical techniques. SADJ. 2010,65: 246,248-51. 9.Briguglio F, Zenobio EG, Isola G, Briguglio R, Briguglio E, Farronato D, et al. Complications in surgical removal of impacted mandibular third molars in relation to flap design: clinical and statistical evaluations. Quintessence Int. 2011;42:445-53. 10.Yolcu Ü, 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;44:1390-7. 11.Baqain ZH, Al-Shafi A, Hamdan A, Sawair A. Flap design and mandibular third molar surgery: a split mouth randomized clinical study. Int J Oral Maxillofac Surg. 2012;41:1020-4. 12.Ryabko BY, Stognienko VS, Shokin YI. A new test for randomness and its application to some cryptographic problems. J Stat Plan Infer. 2004;123:365-76. 13.Koymen R, Ortakoğlu K, Okcu KM, Altuğ HA, Aydıntuğ YS. Wound closure by skin traction. Turk J Med Sci. 2002;32:179-81. 14.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;6:29-37. 15.Azaz B, Shteyer A, Piamenta M. Radiographic and clinical manifestations of the impacted mandibular third molar. Int JOral Surg. 2017;5:153-60. 16.Monaco G, Daprile G, Tavernese L, Corinaldesi G, Marchetti C. Mandibular third molar removal in young patients: an evaluation of 2 different flap designs. J Oral Maxillofac Surg. 2009;67:15-21. 17.Seymour RA, Walton JG. Pain control after third molar surgery. Int J Oral Surg. 1984;13:457-85. 18.Erdogan O, Tatlı U, Ustun Y, Damlar I. Influence of two different flap designs on the sequelae of mandibular third molar surgery. Oral Maxillofac Surg. 2011;15:147-52. 19.Mangla M, Rajput L, Kumar A, Rathi V, Jain H, Kumar S. Lingual Triangular Flap vs Triangular Flap: A pilot study. Int J Oral Health Med Res. 2017;4:62-4. 20.Garcia AG, Sampedro FG, Rey JG, Torreira MG. Trismus and pain after removal of impacted lower third molars. J Oral Maxillofac Surg. 1997;55:1223-6. 21.Conard SM, Blakey GH, Shugars DA, Marciani RD, Phillips C, White RP. Patients’ perception of recovery after third molar surgery. J Oral Maxillofac Surg. 2017;57:1288-94. 22.Dolanmaz D, Esen A, Isik K, Candirli C. Effect of 2 flap designs on postoperative pain and swelling after impacted third molar surgery. Oral Surg Oral Med Oral Pathol Oral Radiol. 2013;116:244-6. 23.Bouloux GF, Steed MB, Perciaccante VJ. Complications of third molar surgery. Oral Maxillofac Surg Clin North Am. 2007;19:117-28. 24.Kumar B S, T S, M V, Raman U. To Compare Standard Incision and Comma Shaped Incision and Its Influence on Post–Operative Complications in Surgical Removal of Impacted Third Molars. J Clin Diagn Res. 2013;7:1514-8. 25.Mansuri S, Mujeeb A, Hussain SA, Hussain MA. Mandibular third molar impactions in male adults: Relationship of Operative time and Types of impaction on inflammatory complications. J Int Oral Health. 2014;6:9-15. 26.Suarez-Cunqueiro MM, Gutwald R, Reichman J, Otero-Cepeda LS, Schmelzeisen R, de Compostela S. Marginal flap versus paramarginal flap in impacted third molar surgery: a prospective study. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2003: 95: 403– 408. 27.Kirk DG, Liston PN, Tong DC, Love RM. 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: e1–e6 28.Al-Samman AA. Can Flap Design Affects Patient Morbidity Following Mandibular Third Molar Surgery? Smile Dent J. 2016;11:18-21. 29.Menziletoglu D, Guler A, Basturk F, Isik B, Erdur E. Comparison of two different flap designs for bilateral impacted mandibular third molar surgery. Journal of Stomatology, Oral and Maxillofacial Surgery. 2019.
Statistics Article View: 365 PDF Download: 722