Comparison of Wound Healing Using Envelope and Triangular Flap for Impacted Mandibular Third Molar Surgery

2021 ◽  
Vol 15 (10) ◽  
pp. 2811-2813
Author(s):  
Atiq ur Rahman ◽  
Muhammad Junaid Hashmi ◽  
Muhammad Shairaz Sadiq ◽  
Fareed Ahmad ◽  
Muhammad Anwaar Alam ◽  
...  
Keyword(s):  
Wound Healing ◽  
Maxillofacial Surgery ◽  
Third Molar ◽  
Surgical Removal ◽  
Post Surgery ◽  
Triangular Flap ◽  
Impacted Mandibular Third Molar ◽  
Mandibular Third Molar ◽  
Significant Difference

Objective: To compare the wound healing with triangular flap versus envelope flap techniques among patients undergoing surgical removal of the impacted mandibular third molar (IMTM). Study Design: An open label randomized controlled trial. Place and Duration of the Study: The Department of Oral & Maxillofacial Surgery, Bakhtawar Amin Medical and Dental College, Multan from January 2021 to June 2021. Material and Methods: A total of 70 patients (35 in each group) of both genders aged 20 to 50 years requiring surgical removal of IMTM were included. Patients were asked to follow up on third and seventh day while observations regarding wound healing and pain were noted on 7th day among all cases completing the final follow up. Chi square was applied to compare data between both study groups taking p-value below 0.05 as significant. Results: In a total of 70 patients, there were 42 (60.0%) female and 28 (40.0%) female. Majority of the patients, 36 (51.4%) were above 30 years of age while mean age was noted to be 32.4+9.1 years. Sixty two patients completed the follow up so they were included in the final analysis for the assessment of wound healing and pain. Overall, wound healing was observed to be in 55/62 (88.7%) patients while wound healing was found to be 30/32 (93.8%) patients in envelope flap group in comparison to 25/30 (83.3%) in triangular flap group (p=0.1953). Overall, there was no statistically significant difference in between both study group with regards to evaluation of pain (p=0.3271) Conclusion: Both envelop flap and triangular flap techniques resulted in similar outcomes regarding wound healing among patients undergoing surgical removal of IMTM. Both flap techniques resulted in relatively similar degrees of post-surgery pain. Keywords: Third molar, pain, wound healing.

scholarly journals Comparative Evaluation of Two Different Flap Designs and Postoperative Outcome in the Surgical Removal of Impacted Mandibular Third Molar

2017 ◽  
Vol 18 (9) ◽  
pp. 807-811 ◽  
Author(s):  
Shabeer Ahamed ◽  
A Rabi ◽  
PM Mohamed Haris ◽  
Deepu M Panickal ◽  
Venith J Pulikkottil ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
Third Molar ◽  
Mouth Opening ◽  
Postoperative Outcome ◽  
Study Groups ◽  
Surgical Removal ◽  
Triangular Flap ◽  
Impacted Mandibular Third Molar ◽  
Mandibular Third Molar ◽  
Significant Difference

ABSTRACT Aim The aim of this study is to compare triangular and envelope flap designs and the postoperative outcome in the surgical removal of impacted mandibular third molar. Materials and methods A total of 50 participants were assessed clinically and were divided randomly into two groups. Group I (participants operated by triangular flap) and group II (participants operated by envelope flap), with 25 participants each between the age group of 20 and 30 years. Patient satisfaction was assessed subjectively using a graded scale from very satisfied to very unsatisfied. The degree of pain was recorded for 7 days with reference to predefined values on visual analog scale (VAS). Trismus was evaluated on the day 3, day 5, and day 7 of the postoperative period in millimeters. Quantitative data were analyzed by unpaired t-test and qualitative data were by Fischer's exact test. Results The mean overall age is 25.5 years. There was no statistically significant difference between the study groups with respect to age. There was no significant association between the patient satisfaction and flap type (p = 0.684). A significant difference between the study groups on 4th, 5th, and 6th days with respect to pain was observed, wherein fewer subjects operated with triangular flap reported pain. A highly significant difference in mouth opening was observed, with triangular flap group participants having a higher mouth opening than envelope flap subjects on day 7. Conclusion The present study indicated that participants operated by triangular flap had a better mouth opening postoperatively compared with envelope flap participants, whereas there were no significant differences in patient satisfaction and pain scores at the end of the 7th day after third molar surgery. Clinical significance Flap design is a significant factor in the surgical removal of impacted third molar, and it influences the severity of complications. Furthermore, it is important for allowing optimal visibility and access to the impacted tooth and also for subsequent healing of the surgically created defect. How to cite this article Rabi A, Haris PMM, Panickal DM, Ahamed S, Pulikkottil VJ, Haris KTM. Comparative Evaluation of Two Different Flap Designs and Postoperative Outcome in the Surgical Removal of Impacted Mandibular Third Molar. J Contemp Dent Pract 2017;18(9):807-811.

scholarly journals Comparing the Efficacy of Triclosan Coated Sutures versus Chlorhexidine Coated Sutures in Preventing Surgical Site Infection after Removal of Impacted Mandibular Third Molar

2020 ◽  
pp. 138-148
Author(s):  
Sneha Krishnan ◽  
Senthilnathan Periasamy ◽  
Arun Murugaiyan
Keyword(s):  
Surgical Site Infection ◽  
Maxillofacial Surgery ◽  
Third Molar ◽  
P Value ◽  
Surgical Removal ◽  
Site Infection ◽  
Impacted Mandibular Third Molar ◽  
Mandibular Third Molar ◽  
Significant Difference ◽  
Group 2

The aim of this present clinical trial study is evaluate the efficacy of triclosan coated sutures versus chlorhexidine coated sutures in preventing surgical site infection after removal of an impacted mandibular third molar. This prospective, single blind study included 30 patients divided into two groups with 15 patients each who had been referred to the Oral Surgery Clinic at Department of Oral and Maxillofacial Surgery, Saveetha Dental College, Chennai for surgical removal of impacted mandibular third molar under local anaesthesia. The patients were randomly assigned to two groups: Group 1 were treated with (3-0) antimicrobial triclosan impregnated polyglactin sutures for closure and in group 2 with (3–0) antimicrobial chlorhexidine diacetate-impregnated polyglactin sutures. Evaluation in regard to infection rate, abnormal erythema, pain and trismus between two groups was done on the 7th day postoperatively. In this study we observed that no significant difference in rates of infection between the groups. Abnormal erythema and trismus showed better results in group 2(chlorhexidine group) on 7th day postoperatively whereas incidence of pain was higher in patients treated with chlorhexidine coated sutures on the 7th day postoperatively as compared to patients treated with triclosan coated sutures. However, P value was >0.05 which was considered statistically insignificant. Within the limitations of the present study, chlorhexidine diacetate-impregnated polyglactin sutures showed reduced infection rates,erythema and trismus  as compared to triclosan impregnated polyglactin sutures in healthy patients undergoing surgical removal of third molar under local anesthesia.

scholarly journals A Noval Method for Surgical Removal of the Impacted Mandibular Third Molar: Sartawi Technique

2020 ◽  
Vol 2020 ◽  
pp. 1-5
Author(s):  
Hassan Sartawi
Keyword(s):  
Surgical Approach ◽  
Third Molar ◽  
Operation Time ◽  
Surgical Removal ◽  
Silk Suture ◽  
Third Molars ◽  
Triangular Flap ◽  
Impacted Mandibular Third Molar ◽  
Surgical Suture ◽  
Mandibular Third Molar

Background. The goal of this article is to present and evaluate the clinical effectiveness of a new surgical approach using a triangular flap with slight modification and a 3-0 black braided silk surgical suture as flap retractor which is later used after the surgical procedure as a normal suture, aiming to decrease procedure time, soft tissue retraction, and tools for removal of impacted mandibular third molar. Methods. Patients requiring removal of fully impacted or semi-impacted lower third molars are treated with a new approach using minimal steps and tools, a simple triangular flap, slight mucoperiosteum elevation, as the flap sides are secured and reflected with a silk suture by an assistant holding both sides of the suture from behind the patient. Results. The surgical area at the procedure was efficiently exposed, and the separation of the crown from the roots was easily done using a surgical handpiece, separation and removal of the crown, removal of the roots with a straight elevator, without the need of flap retractor or overexposure of the surgical side with a conventional triangular flap or others. After the treatment, the two sides of suture are tied together with double overhand knots, and the surgical site was fully repositioned and closed without any complications. 5- and 7-day follow-up was done on the patients, and no complications were reported. Conclusions. This preliminary study presents a new surgical approach (Sartawi technique) which can be used during extraction of impacted and semi-impacted lower third molars, the results showed that the operation time was noticeably reduced, the size of exposed mucoperiosteum tissue was minimized compared to the conventional method, the use of the mucoperiosteum elevator was eliminated, and number of suture knots and suture used to close the surgical site reduced to a single stitch.

scholarly journals Efficacy of 1% Betadine Mouthwash on the Incidence of Dry Socket after Mandibular Third Molar Surgery

2019 ◽  
Vol 3 (1) ◽  
pp. 35-38
Author(s):  
Jyoti M Biradar ◽  
Gayithri H Kulkarni ◽  
Harish Srinivas Kulkarni ◽  
Sudha Shidagauda Patil ◽  
Ashish Shrikant Satapute ◽  
...  
Keyword(s):  
Oral Hygiene ◽  
Povidone Iodine ◽  
Maxillofacial Surgery ◽  
Third Molar ◽  
Research Centre ◽  
Control Group ◽  
Dry Socket ◽  
Post Surgery ◽  
Mandibular Third Molar ◽  
Surgical Extraction

INTRODUCTION: Dry socket (syn. Alveolar osteitis, Alveolitis sicca dolorosa) is one of the most common complications after extraction of a tooth with a high incidence after a surgical extraction, particularly seen in the mandibular third molars.AIM: To assess the efficacy of 1% betadine mouthwash in prevention of dry socket.MATERIALS AND METHODS: The study included a sample of 154 patients visiting the department of Oral and Maxillofacial Surgery at Tatyasaheb Kore Dental College and Research Centre, Kohlapur, Maharashtra, India for surgical extraction of their impacted mandibular third molar and categorized as class A and B according to Pell and Gregory classification. The case group included patients who were provided with povidone iodine 1% oral antiseptic solution (Betadine), while no intervention was provided to the control group. All patients took 400 mg Ibuprofen (oral) one hour prior to the extraction. Post-surgery, patients were recalled on the third and seventh day and the data was recorded in the pre-filled proforma, data was entered in Microsoft excel, transferred into SPSS version 21.0 and the t-test was applied to analyze the data obtained.RESULTS: It was observed that 26 patients (16.89%) had a dry socket present. The presence of dry socket was slightly higher among females 14, (53.84%) as compared to males (12, 46.6%). Mostly, fair oral hygiene was observed among the study subjects. No significant correlation was observed between oral hygiene status and incidence of dry socket (p>0.05). A statistically significant correlation between the cases and control group (p=0.047) was observed.CONCLUSION: Povidone iodine 1% mouthwash reduces the incidence of dry socket following surgical extraction and hence, it use prior to surgical extraction of impacted teeth is recommended for better topical infection control.

scholarly journals Efficacy of platelet rich plasma (PRP) on mouth opening and pain after surgical extraction of mandibular third molars

2020 ◽  
Vol 27 (1) ◽  
pp. 9
Author(s):  
Maidah Hanif ◽  
Muhammad Azhar Sheikh
Keyword(s):  
Platelet Rich Plasma ◽  
Maxillofacial Surgery ◽  
Third Molar ◽  
Mouth Opening ◽  
Third Molar Surgery ◽  
Oral And Maxillofacial Surgery ◽  
Surgical Removal ◽  
Mandibular Third Molar ◽  
Surgical Extraction ◽  
Molar Teeth

Introduction: Surgery of mandibular third molar teeth for removal is one of the most common procedures undertaken in oral and maxillofacial surgery departments. The complications created by the post extraction wound healing and physiological consecution of third molar surgery can affect patients' quality of life. Platelet rich plasma (PRP) is an autologous concentrate of platelets suspended in the Plasma that accelerates healing by concentration of growth factors which lessen the inflammation and as a result pain and trismus. Materials and methods: A Study was conducted on 130 patients at the department of Oral and Maxillofacial Surgery, FUCD Islamabad, for a period of 6 months after ethical approval. The patients with impacted mandibular wisdom teeth were selected and divided equally into two equal groups. The pain score was measured using the visual analogue scale (VAS) and trismus was measured using Vernier caliper before the surgery, immediately after surgery, on 3rd and 7th follow up visits. Results: The mean postoperative pain on 7th day was significantly lower in the PRP group with statistically significant P-value <0.0001. Trismus was also less reported in the PRP group with P-value <0.00065. Conclusion: Platelet Rich Plasma is effective to lessen trismus and pain after surgical removal of mandibular third molar teeth.

scholarly journals Assessment of Incidence and Risk Factors of Dry Socket Formation after Surgical Removal of Impacted Mandibular Third Molar

2019 ◽  
Vol 04 (12) ◽  
pp. 814-818
Author(s):  
Dr. Revati Singh ◽  
Dr. Rohit Singh ◽  
Dr. Supriya Singh ◽  
Dr. Amit Kumar ◽  
Dr. Shahi Kunar ◽  
...  
Keyword(s):  
Risk Factors ◽  
Third Molar ◽  
Surgical Removal ◽  
Dry Socket ◽  
Impacted Mandibular Third Molar ◽  
Mandibular Third Molar

Impact of Mesioangular Mandibular Impacted 3rd Molar on Peridontal Health of Adjacent Tooth

2021 ◽  
Vol 15 (11) ◽  
pp. 3488-3491
Author(s):  
Samar Nazir ◽  
Nousheen Khan ◽  
Athar Khan ◽  
Asif Noor ◽  
Naima Jabeen
Keyword(s):  
Statistical Significance ◽  
Maxillofacial Surgery ◽  
Third Molar ◽  
Root Caries ◽  
Second Molar ◽  
Impacted Mandibular Third Molar ◽  
Adjacent Tooth ◽  
Mandibular Third Molar ◽  
The Creation ◽  
The Impact

Objective: The aim of this study is to determine the impact of mesioangular mandibular 3rd molar impaction on periodontal health of adjacent tooth in patients. Study Design: Retrospective/observational study Place and Duration: Department of Oral & Maxillofacial Surgery, MMDC Multan, during from Oct 2020 to September 2021. Methods: Total of seventy patients of both genders was presented in this study. Detailed demographic data of enrolled cases age, sex, body mass index, symptoms and complications were recorded after taking informed written consent. All the patients had mesioangular impactions of mandibular third molars. The impaction depth, relationship with ramus, and angulation of 70 IMTMs and their association with 2nd molar distal caries and root resorption, pathological states, and closeness to the mandibular canal were assessed on panoramic radiographs. Pell and Gregory classification was used to determine position of impacted third molar. The odds ratio (OR) and 95% confidence interval (CI) of IMTM's position on the related complications (credible interval for Bayesian models). Statistical significance was defined as a two-tailed p-value 0.05. SPSS 24.0 version was used to analyze complete data. Results: There were 42 (60%) males and 28 (40%) females with mean BMI 23.13±6.46 kg/m2. Most of patients 31 (44.3%) were aged between 20-35 years. Mean attachment level was 3.03±2.34 and probing depth was 3.34±3.35. Caries, pain and swelling were the most common symptoms found among cases. Distal second molar root caries 21 (30%) and pocket formation 17(24.3%) were the most common pathologies. As per histological findings periapical inflammation was majority found in 37 (52.9%) cases followed by dental follicle in 19 (27.1%) and cyst in 11 (15.7%). Conclusion: In this study, we found that the impacted mandibular third molar was most linked with distal second molar root caries and the creation of a pocket between the impacted tooth and the second molar tooth. The most common pathology associated with the impacted molar was distal second molar root caries and the creation of a pocket between the affected tooth and the second molar. Keywords: Mesioangular, Impacted mandibular third molar, Pathology, Complication

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