Double blind randomized clinical trial comparing minimally- invasive envelope flap and conventional envelope flap on impacted lower third molar surgery

Med Oral Patol Oral Cir Bucal. 2022 Nov 1;27(6):e518-e524. doi: 10.4317/medoral.25425.

Abstract

Background: The latest trend in surgery is to look for minimally invasive procedures, with fewer complications and a shorter recovery time. This study aims to compare the minimally- invasive envelope flap, with smaller incision and fewer dissection and the conventional envelope flap, with a 20mm incision, on impacted mandibular third molar surgery, focusing on the hypothesis that there were no differences in postoperative outcomes.

Material and methods: A double-blind randomized clinical trial was designed to compare both incisions, focused on determining the approach with minor postoperative side-effects and minor impact on quality-of-life. A total of 60 patients were enrolled for the study if their presented impacted mandibular third molar and was 18-years-old or more. Both groups were evaluated from time elapsed on the surgery, maximum mouth opening, swelling and quality of life assessment.

Results: The flap choice influenced facial swelling (p=0,03), pain on the first three days (p=0,037), interference with oral hygiene (p=0,019) and discomfort on speech (p=0,07). Chewing, swallowing, trismus, pain after seven days, postoperative complications and other quality-of-life arrangements were no different between groups.

Conclusions: The minimally- invasive envelope flap could lead to a less painful experience for the patient, with fewer impact on the oral hygiene and speech discomfort.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adolescent
  • Edema
  • Humans
  • Mandible / surgery
  • Molar, Third* / surgery
  • Pain, Postoperative / etiology
  • Pain, Postoperative / prevention & control
  • Postoperative Complications / epidemiology
  • Postoperative Complications / etiology
  • Postoperative Complications / prevention & control
  • Quality of Life
  • Tooth Extraction / adverse effects
  • Tooth Extraction / methods
  • Tooth, Impacted* / complications
  • Tooth, Impacted* / surgery
  • Trismus