Effects of Flap Design on the Periodontal Health of Second Lower Molars after Impacted Third Molar Extraction

Abstract

The purpose of this study was to compare the envelope flap and triangular flap for impacted lower third molar (M3) extraction and their effects on the periodontal health of adjacent second molars (M2). A population of 60 patients undergoing M3 extraction with the envelope flap (Group A) or triangular flap (Group B) was analyzed, comparing probing pocket depth (PPD), clinical attachment level (CAL), and gingival recession (REC) recorded at six sites (disto-lingual, mid-lingual, mesio-lingual, disto-vestibular, mid-vestibular, and mesio-vestibular) before (T0) and 6 months after extraction (T1). There was a statistically significant mean difference in PPD and CAL at two sites, disto-vestibular (dv) and disto-lingual (dl), between values recorded before and 6 months after surgery for either Group A or Group B. Furthermore, for the same periodontal records, at 6 months after surgery, a statistically significant difference was recorded between younger and older patients, implying that the healing process was more beneficial for younger patients. No significant differences were found between the two groups (A and B) in PPDdl, PPDdv, CALdl, and CALdv, confirming that the mucoperiosteal flap design does not influence the periodontal healing process of second molars.

Marginal and Para-Marginal Technique in Late Germectomy of Lower Third Molars

“…Furthermore, the formation of a periodontal pocket distal to the adjacent second molar is the most common and well-known post-operative complication, as described by many authors. Although a direct correlation between pain, tumefaction, probing depths, and bleeding on probing was not established, it appears that younger patients are less prone to develop periodontal pockets, and generally, the probing depths are significantly lower compared to adult patients [ 19 , 20 , 21 , 22 , 29 ]. In our study, a higher probing depth was observed in patients treated with a marginal approach.…”

Six-Month Soft Tissues Healing after Lower Third Molar Extraction: Comparison of Two Different Access Flaps

“…Extraction of third molars represents a frequently invasive surgical procedure for both hard and soft tissues, particularly in the lower jaw. As the design of the access flap, gingival detachment included, often implicates a considerable damage for the entire periodontium, periodontal healing seems to depend on the chosen surgical technique [1]. Additional factors influencing the quality and course of the healing process must be taken into consideration, including the patient's age, patient's systemic conditions and eventual medications taken, periodontal conditions of the adjacent second molar, position of the third molar and inclination of its roots, relationship between the third molar and the inferior alveolar nerve, relationship between the third molar and the second molar, and the degree of openness of the patient's mouth [1][2][3][4][5][6].…”