Novel Incision Design and Primary Flap Closure Reduces the Incidence of Alveolar Osteitis and Infection in Impacted Mandibular Third Molar Surgery

Publication date: Available online 13 February 2016
Source:Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
Author(s): Jeffrey A. Elo, Ho-Hyun (Brian) Sun, Fanglong Dong, Rahul Tandon, Hardev M. Singh
PurposeTo measure the influence of flap design on alveolar osteitis (AO) and postoperative complications following mandibular third molar surgery.Patients and methodsThis study was designed as a randomized single-blind, split-mouth clinical trial. The predictor variable was flap type. Envelope flap (EF), modified triangular flap (MTF), and two related experimental flaps [second molar mesial papilla-sparing marginal incision with distobuccal release with double-pass single-layered primary closure (MPMI-2X) and single-pass single-layered primary closure (MPMI-1X)] were used. The primary outcome variable was AO. The secondary outcome variables were wound dehiscence and infection. Bivariate and logistic analyses were computed. P-value <0.05 was considered to be statistically significant.ResultsOne hundred ninety-six patients with symmetric bilateral partial bony or full bony impacted mandibular third molars participated. No sites (0/196) treated with MPMI-2X developed AO, and only two sites (2/196) treated with MPMI-2X developed post-operative infection. Both MPMI-1X and MPMI-2X were associated with decreased odds of complications compared to MTF and EF. MPMI-2X sites were significantly less likely than MTF sites to experience complications for both sides.ConclusionsMPMI-2X is a reliable technique to reduce complications such as AO, wound dehiscence, and infection in mandibular third molar surgery.



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