Comparative Evaluation of the Flap and Flapless Techniques for the Extraction of Impacted Third Molars Using a Split-Mouth Prospective Randomized Control Research

A BSTRACT Aim: Comparative evaluation of the flap and flapless techniques for the extraction of impacted third molars using a split-mouth prospective randomized control research. Material and Methods: The research comprised 120 healthy individuals. Every patient having surgery was separated into two locations and then randomly allocated to two groups: Group I (control, n = 60) had surgical extraction of the lower third molar by elevating a buccal flap, and Group II (study group, n = 60) had surgical extraction of the lower third molar without the need to raise a buccal flap. Results: The flap group had a preoperative swelling measurement of 12.4 ± 1.2 cm. By the second day after the surgery, the edema grew to 14.6 ± 1.5 cm and gradually reduced to 13.0 ± 1.3 cm by the seventh day after the surgery. The preoperative edema in the flapless group was assessed at 12.5 ± 1.3 cm. By the second day after the operation, the swelling measured 13.2 ± 1.4 cm, and it dropped to 12.7 ± 1.2 cm by the seventh day after the operation. The evaluation of pain levels was done using a visual analog scale (VAS). By the second day after the operation, the group with flaps reported a pain score of 6.5 ± 1.1, which then declined to 4.3 ± 0.9 by the seventh day. The pain score in the group without flaps was 5.1 ± 1.0 on the second day after surgery and dropped to 3.2 ± 0.8 on the seventh day. Patients had a considerable reduction in discomfort when the flapless approach was used on both the second and seventh days after the surgery. The pocket depth was assessed by using a calibrated periodontal probe on the distal surface of the second molar. At the 1-month postoperative milestone, the flap group exhibited a pocket depth of 3.4 ± 0.5 mm, which marginally decreased to 3.2 ± 0.4 mm by the second month. In the group without flaps, the depth of the pocket was measured to be 3.1 ± 0.4 mm after 1 month and 3.0 ± 0.3 mm after 2 months. Conclusion: The flapless approach led to reduced postoperative edema, discomfort, and trismus as well as a shorter surgical time. Despite small variations in pocket depth, the flapless method resulted in a more favorable overall postoperative recovery.