EFFECT OF SURGICAL FLAP DESIGNS ON POSTOPERATIVE COMPLICATIONS FOLLOWING MANDIBULAR THIRD MOLAR SURGERY: A SYSTEMATIC REVIEW
DOI:
https://doi.org/10.33279/jkcd.v16i03.1037Keywords:
Impacted Third Molar; Pain; Postoperative Complications; Surgical Flaps; Tooth Extraction; Trismus; Wound HealingAbstract
Objectives: To evaluate the results following various surgical flaps designs for mandibular third molar surgery to determine surgical flap designs are associated with better postoperative recovery.
Materials and Methods: In this systematic review, different flap designs were analyzed based on postoperative symptoms, following the PRISMA guidelines. We systematically reviewed comparative studies analyzing flap designs based on postoperative symptoms. Main flap designs included the envelope flap, triangular flap, modified envelope flap, modified triangular flap, Szmyd flap, triangular transposition flap and flapless design.
Results: Twenty-one studies comprising 1346 patients were analyzed, and the least satisfactory results were observed with conventional flaps (i.e., envelope and triangular flaps), whereas most studies reported more favorable postoperative outcomes with flapless designs. Apart from the flapless design, the Szmyd flap and the triangular transposition flap showed the best results among the flaps.
Conclusion: Minimally invasive and flap-preserving procedures have shown lower postoperative morbidity than conventional flaps, although there are significant clinical and methodological variability and design of a universally superior procedure is not recommended.
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