Comparative study on the application effect of minimally invasive distal triangular flap and envelope flap in mandibular impacted third molar extraction
Objective To compare the application effects of minimally invasive distal triangular flap and envelope flap in mandibular impacted third molar extraction,so as to provide a basis for the clinical application of minimally invasive distal triangular flap.Methods A total of 80 patients with submucosal impacted mandibular third molar(80 impacted teeth)who were treated in the Department of Oral and Maxillofacial Surgery of West China Hospital of Stomatology,Sich-uan University from July 2020 to July 2021 were recruited and randomly divided into 2 groups with 40 cases(40 impact-ed teeth)in each group.Two groups of patients underwent mandibular impacted third molar extraction,and according to the flap methods,they were recorded as envelope group and minimally invasive distal triangular flap group respectively.The operation time,the visual analogue scale(VAS)score,swelling and mouth opening restriction on the 1st,3rd and 7th postoperative days,and the occur-rence of surgical complications were compared be-tween the two groups.Results There was no signif-icant difference in operation time between the two groups(t=0.834,P=0.408).On the first day after surgery,the VAS score[(2.37±1.31)points],facial swell-ing[(0.92±0.74)％]and mouth opening restriction[(25.00±15.04)％]in the minimally invasive distal triangular flap group were significantly lower than those in the envelope flap group[VAS score:(3.46±1.07)points,facial swelling degree:(1.98±0.98)％,and mouth opening restriction(35.83±17.17)％],and the differences were statistically signifi-cant(t values were 3.325,4.468,2.444,all P＜0.05).On the third day after surgery,the VAS score[(1.70±1.10)]and facial swelling[(0.79±0.73)％]in the minimally invasive distal triangular flap group were significantly lower than those in the envelope flap group[VAS score:(2.46±1.10)and facial swelling(1.64±1.00)％],and the differences were statistically significant(t values were 2.500 and 3.557,both P＜0.05).On the 7th day after surgery,there were no significant differences in VAS score,facial swelling or mouth opening restriction between the two groups(all P＞0.05).There were no complications such as infection or nerve injury during the operation and 7 days after surgery in the two groups.Conclusion Compared with the traditional envelope flap,the minimally invasive distal triangular flap causes less pain and facial swelling in patients during the first 3 days after surgery,and can be used as one of the flap design methods for mandibular impacted third molar extraction.
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