Influence of a pedicle flap design on acute postoperative sequelae after lower third molar removal.
Pain, swelling, trismus, and alveolar osteitis often occur after removal of impacted third molar teeth. To minimize these complications a number of mucoperiosteal flap designs have been advocated, but, to date, a pedicle flap design has not been evaluated. In a randomized prospective split mouth study, 52 participants had bilateral symmetrically impacted mandibular third molars removed over two sessions. A buccal envelope or pedicle flap was randomly assigned to the left or right third molar site. Pre-and postoperative pain and swelling were recorded using a standardized visual analogue scale, trismus was measured as the maximum inter-incisal opening distance in millimetres and dry socket was assessed clinically. Greater continuous pain, pain on maximum opening, and oro-facial swelling were recorded with the pedicle flap design. Continuous pain resolved significantly faster with this flap design (p<0.05). Trismus was similar for both flap designs (p>0.05). Five cases of alveolar osteitis occurred with the envelope flap whilst no cases developed with the pedicle flap, but the incidence was too small for statistical analysis. The pedicle flap improved some aspects of postoperative pain experience and reduced the incidence of alveolar osteitis, but further investigation with a larger sample size is required to evaluate its significance.
Department of Oral Diagnostic and Surgical Sciences, University of Otago, Dunedin, New Zealand.
Sam M
SM
Goldsmith
Rohana Kumara
RK
De Silva
Darryl C
DC
Tong
Robert M
RM
Love
D000293:Adolescent; D000328:Adult; D004368:Dry Socket / Q000209:etiology; D004487:Edema / Q000145:classification / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008334:Mandible / Q000601:surgery*; D008964:Molar, Third / Q000601:surgery*; D010147:Pain Measurement; D010149:Postoperative Pain / Q000209:etiology; D010497:Pericoronitis / Q000209:etiology; D011183:Postoperative Complications; D011446:Prospective Studies; D013524:Surgical Flaps / Q000145:classification* / Q000473:pathology; D013529:Surgical Wound Dehiscence / Q000209:etiology; D013530:Surgical Wound Infection / Q000209:etiology; D014081:Tooth Extraction / Q000379:methods*; D020390:Tooth Socket / Q000601:surgery; D014095:Tooth, Impacted / Q000601:surgery; D014313:Trismus / Q000209:etiology; D055815:Young Adult