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Comparison of Buccal and Lingual-Based Triangular Flap During Mandibular Third Molar Extraction for Reducing Postoperative Complications: A Randomized Controlled Trial

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Abstract

Background

Surgical removal of the mandibular third molar requires reflection of the mucoperiosteal flap. Several studies have suggested different varieties and innovative designs for flap reflection. We have designed a randomized controlled trial (RCT) to check the feasibility of two flap designs: lingual-based triangular flap (LBTF) and buccal-based triangular flap (BBTF) by calculating the duration of surgery and evaluating postoperative complications such as pain, swelling, and trismus.

Materials and Method

It was a non-inferiority parallel-group RCT. The trial was registered in the Control Trial Register of India (CTRI/2021/10/037182) and was performed according to Consolidated Standards of Registered Trial (CONSORT) guidelines. Intraoperative surgery time and postoperative pain, swelling, and trismus were measured and analyzed by a two-sample t test. The Chi-square test was used to measure gender distribution in the study.

Result

Of the total of 88 required subjects, gender distribution and performed surgical time were statistically insignificant with a p-value of 0.76 and 0.48, respectively. The pain was significantly higher in the LBTF group in the 5th and 7th postoperative days with a p-value of 0.02 and 0.028. The swelling was statistically higher during all the follow-ups except for the 28th day in the LBTF group with values of 0.006, 0.002 and 0.003, respectively. There was no significant difference in inter-incisional distance (IID) between the groups during postoperative check-ups.

Conclusion

LBTF shows no edge over BBTF during mandibular third molar disimpaction.

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Acknowledgements

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Funding

This research did not receive any grant from any funding.

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Authors and Affiliations

  1. Department of Oral and Maxillofacial Surgery, Dental Institute, Rajendra Institute of Medical Sciences, Ranchi, India

    Ajoy Kumar Shahi, V. K. Prajapati & Om Prakash

  2. Department of Oral and Maxillofacial Surgery, Rama Dental College and Research Centre, Kanpur, India

    Vishal

  3. Department of Pedodontics and Preventive Dentistry, Dental Institute, Rajendra Institute of Medical Sciences, Ranchi, India

    Swati Sharma

  4. Department of Oral Medicine and Radiology, Dental Institute, Rajendra Institute of Medical Sciences, Ranchi, India

    Tanya Khaitan

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  1. Ajoy Kumar Shahi
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  2. Vishal
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  4. V. K. Prajapati
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  5. Om Prakash
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Correspondence to Vishal.

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The authors declare that there is no conflict of interest.

Ethical Approval

The study was initiated after taking Institutional ethical clearances from RIMS, Ranchi, Memo No. 312 dated 09/07/2021.

Research Involving Human Participants and/or Animals

The research involves human participants. The research protocol had been approved by the institutional ethical committee.

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Written informed consent had been taken from all the study subjects.

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Shahi, A.K., Vishal, Sharma, S. et al. Comparison of Buccal and Lingual-Based Triangular Flap During Mandibular Third Molar Extraction for Reducing Postoperative Complications: A Randomized Controlled Trial. J. Maxillofac. Oral Surg. (2024). https://doi.org/10.1007/s12663-023-02092-2

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