Postoperative morbidity after mandibular third molar surgery using two flap designs: a comparative analysis

Pain, trismus and swelling are known sequelae of surgical removal of impacted mandibular third molars. Influencing the overall surgical procedure, to ameliorate or eradicate these complications is the focus of researchers. This study aims at comparing the effect of an envelope and triangular flap incisions on postoperative morbidity following surgical extraction of impacted mandibular third molars. It was a comparative study of 104 participants (divided into two groups A and B) who had surgical extraction of impacted mandibular third molars. Group Ahad envelope flap design and Group B had triangular flap design. Pain, trismus and swelling were evaluated preoperatively and postoperatively (1st, 3rd, 5th and 7th day). A bivariate analysis comparing numerical outcomes across the two groups was done using the independent sample t-test and the relationship between nominal variables across the two groups was done using the Chi-square test. The level of significance was set at P< 0.05. The male to female ratio was 1:1.8, the mean age of subjects was 27.7 ± 6.4 years. Participants in Group A had a greater degree of pain and trismus than those in Group B though not statistically significant. There was a significant difference in swelling on the 5th (p <0.001) and 7th (p <0.001) day postoperatively with envelope flap incision resulting in more swelling than the triangular flap incision. We concluded that though pain, trismus and swelling were still observed in patients, triangular flap resulted in less degree and duration of postoperative complications than the envelope flap.Keywords: Third molar surgery, complications of third molar surgery, flap design