title: Influence of flap design on periodontal healing of second molars after extraction of impacted mandibular third molars.
abstract: OBJECTIVE
  The aim of this study was to compare the influence of two mucoperiosteal flaps on periodontal healing of adjacent second molars after extraction of impacted mandibular third molars.
  
  
  METHODS
  An envelope incision with a releasing incision anterior to the second molar (3-cornered flap) was used on one side and a Szmyd flap on the other side in 14 patients with bilateral impaction of mandibular third molars. The periodontal health of the second molars was evaluated before surgery and at 3 and 6 months postoperatively. A William's periodontal probe was used to measure the pocket depth, clinical attachment level, and bone level of the buccal and mesial surfaces of the second molars. The postoperative measurements were analyzed by using analysis of covariance, with the covariables being the preoperative measurements and variation factors being the type of flap used, the surface measured, and the time since the procedure.
  
  
  RESULTS
  No statistically significant differences were found in comparing measurements of probing depth, clinical attachment level, or bone level for the 2 types of flap used or the 2 surfaces measured. However, there was a statistically significant increase in all 3 measurements from the 3-month to the 6-month postoperative time.
  
  
  CONCLUSIONS
  Independent of the design of the mucoperiosteal flap used in extracting an impacted mandibular third molar, the periodontal condition of the adjacent second molar worsened from 3 to 6 months, although it remained within normal values.
authors.affiliation: Department of Oral & Maxillofacial Surgery and Periodontology, School of Clinical Dentistry of Ribeirão Preto, University of Sao Paulo, Brazil. adalrosa@forp.usp.br
authors.forename: Adalberto Luiz
authors.initials: AL
authors.lastname: Rosa
authors.forename: Marilia Gomes
authors.initials: MG
authors.lastname: Carneiro
authors.forename: Marco Antonio
authors.initials: MA
authors.lastname: Lavrador
authors.forename: Arthur Belém
authors.initials: AB
authors.lastname: Novaes
mesh_terms: D000293:Adolescent; D000328:Adult; D016301:Alveolar Bone Loss / Q000209:etiology; D000704:Analysis of Variance; D005260:Female; D005500:Follow-Up Studies; D005888:Gingival Pocket / Q000209:etiology; D006801:Humans; D008297:Male; D008963:Molar / Q000503:physiopathology*; D008964:Molar, Third / Q000601:surgery*; D017622:Periodontal Attachment Loss / Q000209:etiology; D010514:Periodontal Pocket / Q000209:etiology; D010519:Periodontium / Q000503:physiopathology / Q000601:surgery*; D013524:Surgical Flaps / Q000009:adverse effects / Q000145:classification* / Q000473:pathology; D014081:Tooth Extraction / Q000009:adverse effects; D014095:Tooth, Impacted / Q000601:surgery*; D014945:Wound Healing