title: Primary wound healing after lower third molar surgery: evaluation of 2 different flap designs.
abstract: OBJECTIVE
  Wound dehiscences after lower third molar surgery potentially extend the time of postsurgical treatment and may cause long-lasting pain. It was the aim of this prospective study to evaluate the primary wound healing of 2 different flap designs.
  
  
  METHODS
  Sixty completely covered lower third molars were removed. In 30 cases, the classic envelope flap with a sulcular incision from the first to the second molar and a distal relieving incision to the mandibular ramus was used, whereas the other 30 third molars were extracted after preparation of a modified triangular flap first similarly described by Szmyd. Wound healing was controlled on the first postoperative day, as well as 1 and 2 weeks after surgery.
  
  
  RESULTS
  The overall result was a total of 33% wound dehiscence. In the envelope-flap group, wound dehiscences developed in 57% of the cases. This represents a relative risk ratio of 5.67, with a 95% CI from 1.852 to 12.336. With the modified triangular-flap technique, only 10% of the wounds gaped during wound healing.
  
  
  CONCLUSIONS
  This study confirms evidence that the flap design in lower third molar surgery considerably influences primary wound healing. The modified triangular flap is significantly less conducive to the development of wound dehiscence.
authors.affiliation: The Department for Oral Surgery and Radiology, Dental School, Karl-Franzens University Graz, Austria. norbert.jakse@uni-graz.at
authors.forename: Norbert
authors.initials: N
authors.lastname: Jakse
authors.forename: Vedat
authors.initials: V
authors.lastname: Bankaoglu
authors.forename: Gernot
authors.initials: G
authors.lastname: Wimmer
authors.forename: Antranik
authors.initials: A
authors.lastname: Eskici
authors.forename: Christof
authors.initials: C
authors.lastname: Pertl
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D020209:Cranial Nerve Injuries / Q000517:prevention & control; D005260:Female; D006801:Humans; D061222:Lingual Nerve Injuries; D008297:Male; D008334:Mandible; D008875:Middle Aged; D011446:Prospective Studies; D012907:Smoking; D013524:Surgical Flaps; D013529:Surgical Wound Dehiscence / Q000209:etiology* / Q000517:prevention & control; D014081:Tooth Extraction / Q000009:adverse effects* / Q000379:methods*; D014945:Wound Healing / Q000502:physiology*