title: Does laterally rotated flap design influence the short-term periodontal status of second molars and postoperative discomfort after partially impacted third molar surgery?
abstract: OBJECTIVE
  To assess the influence of the surgical removal of partially impacted third molars (3Ms) and compare the effects of a 3-cornered laterally rotated flap (LRF) with primary closure (flap 1) and an envelope flap with secondary closure (flap 2) on the short-term periodontal status of the adjacent second molars (2Ms). We also assessed the postoperative complications after removal of the partially impacted 3M.
  
  
  METHODS
  A split mouth, randomized clinical study was designed. The study sample included patients with bilateral partially impacted 3Ms. The primary predictor variable was the type of flap design (flaps 1 and 2). The primary outcome variable was periodontal status (gingival recession [GR], probing depth [PD], plaque index [PI], and gingival index) of the 2Ms measured preoperatively and 90 days postoperatively. The secondary outcome variables were postoperative complications, including pain, facial swelling, alveolitis, and local wound infection. The other variables included gender, position of the 3Ms, and surgical difficulty. We performed descriptive, comparative, correlation, and multivariate analyses.
  
  
  RESULTS
  The sample included 28 patients aged 18 to 28 years. The GR, PD, and PI values with the flap 2 design were greater than those with the flap 1 design (P < .05). Facial swelling with the flap 1 design was significantly greater than with the flap 2 design on the second postoperative day (P < .05). The pain levels with the flap 1 design were significantly greater than those with the flap 2 design on the first and second postoperative days (P < .05). According to the multivariate regression analyses, flap design was closely related to the periodontal status of the 2Ms and postoperative discomfort.
  
  
  CONCLUSIONS
  The results of the present clinical study have shown that the flap design in partially impacted 3M surgery considerably influences the early periodontal health of the 2Ms and postoperative discomfort. However, although the 3-cornered LRF design might cause more pain and swelling, it could be the method of choice for partially impacted 3M surgery because of the early periodontal healing.
authors: Assistant Professor, Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Karadeniz Technical University, Trabzon, Turkey. Electronic address: ytkorkmaz@hotmail.com.
authors: Yavuz Tolga
authors: YT
authors: Korkmaz
authors: Professor, Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Gazi University, Ankara, Turkey.
authors: Nur
authors: N
authors: Mollaoglu
authors: Professor, Department of Periodontology, Faculty of Dentistry, Gazi University, Ankara, Turkey.
authors: Nurdan
authors: N
authors: Ozmeriç
mesh_terms: D000293:Adolescent; D000328:Adult; D003774:Dental Plaque Index; D004368:Dry Socket / Q000209:etiology; D004487:Edema / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D005889:Gingival Recession / Q000209:etiology; D006801:Humans; D008297:Male; D008963:Molar / Q000473:pathology*; D008964:Molar, Third / Q000601:surgery*; D010027:Osteotomy / Q000379:methods; D010149:Postoperative Pain / Q000209:etiology*; D010512:Periodontal Index; D010514:Periodontal Pocket / Q000209:etiology; D010519:Periodontium / Q000473:pathology / Q000601:surgery*; D011183:Postoperative Complications; D013524:Surgical Flaps / Q000145:classification / Q000601:surgery*; D013530:Surgical Wound Infection / Q000209:etiology; D019228:Tooth Crown / Q000601:surgery; D014081:Tooth Extraction / Q000379:methods*; D014095:Tooth, Impacted / Q000601:surgery*; D016896:Treatment Outcome; D055815:Young Adult