Introduction: Postoperative complications such as pain, swelling, trismus, and wound dehiscence are common after the surgical removal of impacted third molars, a procedure that is frequently performed by oral surgeons. The healing process does not depend only on surgical factors, but also on various patient factors. The surgical variables include flap design, bone removal, and tooth sectioning. Several studies have been conducted to compare the effect of flap design. Some authors reported no clinical significance of flaps, whereas others stated contradictory results. This study has been designed to evaluate postoperative pain, swelling, trismus, and wound dehiscence associated with impacted third molar surgery using bayonet and envelope flap design. Materials and Methods: The current study is a randomized split-mouth analysis comprising 24 subjects aged 18 to 38 years, all falling into ASA I classification, and requiring bilateral removal of mandibular third molars. Patients were blinded regarding the flap design making it a single-blind study. After the procedure, findings were recorded on postoperative day 1 and 6 for each parameter. The surgery on contralateral side was performed after one month. Results: In assessment of wound dehiscence, there was significant difference between two groups with envelope flap reporting higher incidence. For swelling and trismus, no significant difference was found between the two groups. Regarding pain, a significant difference between the two groups was observed solely on the day of the surgery. Conclusion: According to the results of this trial, employing the bayonet flap method leads to improved outcomes in terms of minimizing postoperative pain and wound dehiscence, with minor enhancements in reducing swelling and trismus.
Archana et al. (Thu,) studied this question.