Universitat de València Clínica Odontológica, Unidad de Cirugía Bucal Gascó Oliag 1, 46021. Valencia, Spain
Med Oral Patol Oral Cir Bucal. 2020 Mar 1;25(2):e233-e239. doi: 10.4317/medoral.23320.
To review the literature on the effect of different surgical flaps upon patient morbidity (pain perception, trismus, swelling and osteitis) after impacted third molar extraction.
An electronic and complementary search of main databases and grey literature was performed up to January 2019 to retrieve randomized clinical trials. The Cochrane risk of bias assessment tool was used for methodological appraisal. A random-effects meta-analysis was conducted of pain perception and trismus.
From the initially 1314 screened studies, only 11 were included in the qualitative synthesis, and 5 in the meta-analysis. There were no statistically significant differences in pain between the envelope and triangular flap designs over time, except on the sixth postoperative day, when the envelope flap proved more painful. Regarding trismus, statistically significant differences were observed on the seventh postoperative day, with greater mouth opening in the envelope flap group than in the triangular flap group. There were no clear differences in swelling and osteitis among the flap designs.
Despite its limitations, the present meta-analysis found no clear differences in patient morbidity between the different flap designs.
回顾关于不同手术皮瓣对阻生第三磨牙拔除后患者发病率（疼痛感知、张口困难、肿胀和骨髓炎）影响的文献。
截至 2019 年 1 月，通过电子和补充方式对主要数据库和灰色文献进行了检索，以检索随机临床试验。采用 Cochrane 偏倚风险评估工具进行方法学评估。对疼痛感知和张口困难进行了随机效应荟萃分析。
从最初筛选出的 1314 项研究中，仅 11 项被纳入定性综合分析，5 项被纳入荟萃分析。除了在术后第 6 天，信封瓣组更疼痛外，在时间上，信封瓣和三角瓣设计之间在疼痛方面没有统计学上的显著差异。关于张口困难，术后第 7 天存在统计学上的显著差异，信封瓣组的张口度大于三角瓣组。在肿胀和骨髓炎方面，各皮瓣设计之间没有明显差异。
尽管存在局限性，但本次荟萃分析发现不同皮瓣设计之间在患者发病率方面没有明显差异。
