The Flap Recovery on the Impacted Lower Third Molar Surgery Comparing 3 Different Flap Designs: A Clinical Study

Abstract

SUMMARYAim. The purpose of the study was to analyze the healing of the deep and superficial lower first and second molars periodontium, after the surgical extraction of the contiguous impacted third molar, comparing 3 mucoperiosteal flap designs. Materials and methods. 150 patients which had to undergo a impacted lower third molar surgery were enrolled in this study. They were checked from day 0 to day 90, in order to focus on the recovery quality of the soft tissues around the lower second molar, comparing 3 different flap designs. Results. No intraoperatory incident happened. The complete recovery of the periodontium around the second molar has been shown in each patient after 90 days from surgery and each adverse reaction happened within the sixth week after surgery. Only 2 slight gengival recessions 0,5 mm have been find out. Conclusions. The impacted third molar surgery is an operation that, if rightly programmed and performed, is relatively safe. Besides, the correct handling and management of periodontium around the second molar and the choice of the flap type to be used support a correct recovery on the second molar periodontium, avoiding any long-term damage. Clinical significance. This study wanted to analyze the healing of the deep and superficial lower second molar periodontium, after the impacted lower third molar surgery. In order to improve the surgical technique used for lower third molar germectomies, we wanted to compare 3 different kind of flap designs.

Does surgical removal of mandibular third molar influence the periodontal status of the adjacent second molars? A systematic review

“…One study reported a significant increase in gingival recession at the disto-vestibular site of the second molar after surgery. The other study observed only two small recessions among the 150 patients included [47].…”

“…Gingival recession was assessed in two studies [32,47]. One study reported a significant increase in gingival recession at the disto-vestibular site of the second molar after surgery.…”

“…Unfortunately, most of the included patients in the present review were below 25 years old, making it impossible to conclude on an association between age and poorer periodontal healing after third molar avulsion. Only two other studies had a sample with a mean age greater than 30 years and four studies did not provide mean age or median age, and only specified sample boundaries [31,44,46,47], even though age seems to play a key role in PPD evolution. The presence of deep pockets preoperatively also seems to be a determining factor on the degree of healing of the distal periodontium.…”

Flapless Surgical Approach to Extract Impacted Inferior Third Molars: A Retrospective Clinical Study

“…To go into discussion, it is known that patients younger than 30 years of age have better full recovery of their M3 injury [23,24] and the risk of complications and postoperative morbidity [22], as well as the incidence of transitory lip sensitivity [25], in patients younger than 25 years old are reported to be lower compared with older patients. Therefore, our data agree well with many studies reporting the age of 25 years as a critical time, after which complications increase more rapidly.…”

Randomized clinical study comparing Piezoelectric Surgery with conventional rotatory osteotomy in mandibular third molars surgeries

“…Various methods over recent years have been suggested and utilized to minimize post-operative sequelae, such as platelet-rich fibrin administration ( Gülşen and Şentürk, 2017 ), laser application ( Kahraman et al, 2017 ), cryotherapy ( Zandi et al, 2016 ), drug injections ( Gorecki et al, 2017 ), and various flap designs ( Ottria et al, 2017 ). However, one of the most important methods has involved the use of osteotomy techniques to minimize trauma and the generation of heat associated with cutting the bone or osteotomy during surgical extraction of the lower third molars ( Al-Delayme, 2013 ).…”