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Abstract
Background: The removal of impacted third molars from the mandible is often accompanied by postoperative facial swelling, pain and soft tissue manipulation, which is attributed to inflammation in the soft tissues and exposure of the alveolar bone. Flapless extraction has been suggested as a less invasive means of extraction that may minimize postoperative morbidity.
Objective: To compare the mean postoperative outcomes in terms of mean pain and swelling with flap and flapless surgical removal of partially impacted mandibular third molar.
Methods: This was randomized controlled trial was conducted at Oral Surgery Department, Watim Medical College & General Hospital, Rawalpindi from August 2024 to December 2024. One hundred and sixty patients with partially impacted mesioangular third molars were randomly divided into two groups with 80 patients in each: Group A (flap; n=80) and Group B (flapless; n=80). A 10-point Visual Analogue Scale (VAS) was used to assess pain and the distances between 5 facial reference points were summed to measure facial swelling. Evaluations were made on the second postoperative day. SPSS version 25.0 was used to analyze data with an independent-samples Student's t-test at a significant level of p≤0.05.
Results: The mean postoperative pain score was significant lower in the flapless group than in the flap group (1.62±0.95 vs. 5.18±0.88; p<0.001). However, the swelling of the face after flapless extraction was also significantly lower (10.12 ± 0.75 cm vs. 10.45 ± 0.78 cm, p<0.001).
Conclusion: The use of flapless extraction resulted in less pain and swelling on the second postoperative day and may be a more desirable minimal invasive technique for the appropriate partially impacted mandibular third molars.