Trapezoidal flap vs envelope flap in mandibular third molar extraction
Authors
N. Baldini , C. D'Elia, F. Frati , P. Cea , A. Nappo, M. Clementini , M. De Sanctis
Abstract
Objective. The primary outcome of the study was to test the periodontal healing in the distal area of the mandibular second molar using two different surgical approaches, envelope flap and trapezoidal flap.
Methods. A total number of 52 consecutive cases of mandibular third molar surgical extractions was performed using randomly either a trapezoidal flap or an envelope flap. The following parameters were recorded on the second mandibular molar: probing pocket depth (PPD), distance between bottom of the pocket and occlusal plane (OP-BP), presence of plaque in both the distolingual and the distobuccal sites. Other paramenters recorded for the study were: bleeding on probing, full-mouth plaque score, full-mouth bleeding score, total time for the surgical intervention, age of the patient, type of inclusion, ostectomy. All the patients received a questionnarie to evaluate the post-intervention discomfort. Periodontal parameters were checked at 6-month follow-up.
Results. The study failed to demonstrate statistically significant differences in PPD and OP-BP reduction between the two surgical techniques tested at 6-month follow-up. Nevertheless, a reduction in PPD values was found in both groups in distobuccal and distolingual sites. Significant lower reductions in PPD and OP-BP values were found in those sites where plaque or bleeding on probing were present at 6-month follow-up. Envelope flap showed a better result in terms of patient’s postsurgical pain and swelling. Significant correlations were also found between the following paramenters: ostectomy- time for surgical intervention, patient’s pain- ostectomy, patient’s swelling- ostectomy, time for surgical intervention- patient’s swelling, age- number of painkillers assumed.
Conclusions. This study failed to demonstrate the influence of the surgical technique on the periodontal healing of the mandibular second molar. Nevertheless envelope flap showed better outcomes in postsurgical patient’s discomfort.
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