title: An alternative surgical flap design for impacted third molars: a comparison of two different surgical techniques.
abstract: BACKGROUND
  A major concern of patients who need surgery for impacted third molars is the occurrence of pain and swelling. The damage done during the incision and retraction of soft tissue to expose the impacted teeth, contribute to the above-mentioned.
  
  
  OBJECTIVE
  The study was done to prove a hypothesis that an alternative surgical flap (ASF) is effective in limiting pain and swelling when compared to the standard reverse L-flap (RLF).
  
  
  METHODS
  A prospective randomized cross-over study was done, which included 33 healthy patients. Patients with mirror-image impacted mandibular third molars were selected. Evaluation of pain and swelling was done by Visual Analogue Scale (VAS), implemented for the first seven days after surgery.
  
  
  RESULTS
  The results indicated on average that patients experience less pain with the ASF, although this was not statistically significant. The patients also indicated that they experienced a significant reduction (p < 0.05) in swelling for days one through three, compared to the RLF.
  
  
  CONCLUSIONS
  The hypothesis that the ASF will result in less swelling, has been proven. It is therefore recommended that surgeons use this flap method for removal of impacted third molars to enhance post-operative patient comfort.
authors.affiliation: Department of Maxillo-Facial- and Oral Surgery, Faculty of Health Sciences, University of Pretoria, P O Box 1266, Pretoria 0001, South Africa. giel.roode@up.ac.za
authors.forename: G J
authors.initials: GJ
authors.lastname: Roode
authors.forename: K
authors.initials: K
authors.lastname: Bütow
mesh_terms: D000293:Adolescent; D000328:Adult; D018592:Cross-Over Studies; D004487:Edema / Q000517:prevention & control; D005260:Female; D006801:Humans; D008297:Male; D008964:Molar, Third / Q000601:surgery*; D019647:Oral Surgical Procedures / Q000379:methods*; D010147:Pain Measurement; D010149:Postoperative Pain / Q000517:prevention & control*; D011446:Prospective Studies; D013524:Surgical Flaps; D011795:Surveys and Questionnaires; D014095:Tooth, Impacted / Q000601:surgery*; D055815:Young Adult