Effect of flap design on complications after mandibular third molar extraction
10.11659/jjssx.10E024097
- VernacularTitle:翻瓣设计对下颌第三磨牙拔除术后并发症的影响
- Author:
Xiao-long FU
1
;
Min CHEN
;
Feng QIAO
Author Information
1. 天津大学海河医院口腔科,天津 300350
- Publication Type:Journal Article
- Keywords:
mandibular third molar;
flap design;
triangular flap;
envelope flap;
facial swelling;
limited mouth opening;
dry socket;
meta-analysis
- From:
Journal of Regional Anatomy and Operative Surgery
2025;34(5):425-430
- CountryChina
- Language:Chinese
-
Abstract:
Objective To compare the effects of triangular flap design versus envelope flap design in alleviating postoperative complications after mandibular third molar extraction,thereby providing a scientific basis on flap design selection for oral and maxillofacial surgeons.Methods The randomized controlled trials and controlled clinical trials published from January 1984 to April 2022 were selected by searching the CNKI,Wanfang,PubMed,Embase,Web of Science,Cochrane,and Springer databases,to analyze the effects of triangular flap and envelope flap on facial swelling,limited mouth opening,and dry socket after the extraction of lower third molars.Results The meta-analysis demonstrated that the degree of facial swelling 7 days after surgery in the triangular flap group was significantly greater than that in the envelope flap group(MD=-0.69,95%CI:-0.93 to-0.45;P<0.000 01),while there was no statistically significant difference in the degree of facial swelling 14 days after surgery between the two groups(MD=-0.07,95%CI:-0.18 to 0.04;P=0.22).Subgroup analysis indicated that in the Pell and Gregory classification A/B categories,the envelope flap was more effective than the triangular flap in improving limited mouth opening(MD=2.95;95%CI:0.11 to 5.79),but no significant difference was observed in other classification subgroups or in the overall analysis.The risk of developing dry socket by envelope flap is higher in split-side randomized controlled trials(RR=3.53,95%CI:1.67 to 7.48),whereas no significant difference was found in the parallel randomized controlled trials(RR=0.78,95%CI:0.43 to 1.43).Conclusion Compared with the triangular flap,the envelope flap has advantages in alleviating the facial swelling and improving limited mouth opening in the early postoperative period,but it has a higher risk of dry socket.
