Rabi A, Haris P M Mohamed, Panickal Deepu M, Ahamed Shabeer, Pulikkottil Venith J, Haris K T Muhamed
Department of Oral and Maxillofacial Surgery, Government Medical College, Kollam, Kerala, India, e-mail:
Department of Periodontics, Malabar Dental College & Research Centre, Edappal, Kerala, India.
J Contemp Dent Pract. 2017 Sep 1;18(9):807-811. doi: 10.5005/jp-journals-10024-2131.
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.
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.
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.
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.
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.
本研究旨在比较三角形瓣和信封式瓣设计在下颌阻生第三磨牙手术拔除中的应用及术后效果。
对50名参与者进行临床评估，并随机分为两组。第一组（采用三角形瓣手术的参与者）和第二组（采用信封式瓣手术的参与者），每组各25名，年龄在20至30岁之间。采用从非常满意到非常不满意的分级量表对患者满意度进行主观评估。参照视觉模拟量表（VAS）上的预定义值记录7天的疼痛程度。在术后第3天、第5天和第7天以毫米为单位评估张口受限情况。定量数据采用非配对t检验进行分析，定性数据采用费舍尔精确检验进行分析。
平均总年龄为25.5岁。研究组之间在年龄方面无统计学显著差异。患者满意度与瓣的类型之间无显著关联（p = 0.684）。观察到研究组在第4天、第5天和第6天的疼痛方面存在显著差异，其中采用三角形瓣手术的受试者报告疼痛的较少。观察到张口情况存在高度显著差异，在第7天三角形瓣组参与者的张口度高于信封式瓣组受试者。
本研究表明，与信封式瓣组参与者相比，采用三角形瓣手术的参与者术后张口情况更好，而在第三磨牙手术后第7天结束时，患者满意度和疼痛评分无显著差异。
瓣的设计是下颌阻生第三磨牙手术拔除中的一个重要因素，它会影响并发症的严重程度。此外，对于获得对阻生牙的最佳视野和操作通道以及手术创口的后续愈合也很重要。
