Novel incision design and primary flap closure reduces the incidence of alveolar osteitis and infection in impacted mandibular third molar surgery

The effect of triangular and reversed triangular flap designs to post third molar odontectomy complications (a pilot study)

“…In contrast to this study is that all research subjects had IA impaction classification which has bigger gap between third and second molar. All subject of the triangular flap group experienced dehiscence could be due to lack of mucosa used to close the extraction socket so that there was tension when suturing the buccal flap with the lingual part of partially impacted third molar (3,20). Several other studies (2,17) found that dehiscence in triangular flap design was less than envelope flap design, but we found no studies comparing triangular flap with reversed triangular flap design.…”

“…Reversed triangular flap could reduce tension and dehiscence from wider dissection of the flap to the distal and inferior. Another type of pedicle flap, the mesial papilla-sparing marginal incision, was also considered as a desirable surgical technique that gave less dehiscence compared with triangular and envelope flap (3). Bleeding observed in this study was local bleeding (oozing) which caused from local factor such as flap design.…”

“…Morbidites that occur after odontectomy such as pain, swelling, trismus, alveolar osteitis, dehiscence, bleeding and compromised periodontal status of the preceding second molar are still haunting both the surgeon and patient. Flap design to expose the impacted tooth is one of the important determining factor (2)(3)(4)(5)(6). Triangular flap is the most common approach used by many surgeons.…”

“…The disadvantage is that the triangular flap has difficulty to achieve primary wound closure on healthy bones, making it possible for dehiscence and complications such as alveolar osteitis. Some researchers still find the incidence of dehiscence in as much as 29.2 -68% of the cases and alveolar osteitis as much as 10.8% using triangular flap design (3,7). Occurrence of oozing after odontectomy using triangular flap design is quite common (8).…”

The Comparison of Anti-Inflammatory Effect in Two Methods of Topical Dexamethasone Injection and Topical Application of Ginger Aqua-Alcoholic Extract after Removing Mandibular Wisdom Teeth

“…The complications of removing these teeth and surgical pain that occurs in 90% of patients with moderate to severe severity and the effect on the daily activities of the patient, has turned the removal of pain and discomfort into one of the important goals in dentistry. And for many years, science has sought to find ways to reduce pain (10,11).…”