COMPARISON OF POSTOPERATIVE OUTCOME OF TRIANGULAR FLAP AND ENVELOPE FLAP AFTER IMPACTED LOWER THIRD MOLAR SURGERY

Abstract

Background: Surgical extraction of impacted mandibular third molars is commonly associated with postoperative complications such as pain, trismus, swelling, and alveolar osteitis. Flap design is an important modifiable factor that may influence these outcomes. This study aimed to compare postoperative outcomes between triangular flap and envelope flap after impacted lower third molar surgery.

Methodology: This randomized controlled trial was conducted in the Department of Oral and Maxillofacial Surgery, Bolan Medical College/Hospital Quetta over a period of 3 months. A total of 60 patients meeting inclusion criteria were randomly divided into two equal groups: Group A (envelope flap) and Group B (triangular flap). Postoperative pain, trismus, alveolar osteitis, and operating time were assessed. Data were analyzed using independent t-test and chi-square test, with p < 0.05 considered significant.

Results: The mean age was comparable between Group A (30.22 ± 5.7 years) and Group B (29.9 ± 5.9 years). Postoperative pain was observed in 40% vs 33.3%, trismus in 76.7% vs 70%, and alveolar osteitis in 10% vs 6.7% in Group A and B respectively, with no statistically significant differences (p > 0.05). However, the mean operating time was significantly higher in the envelope flap group (24.6 ± 4.2 min) compared to the triangular flap group (21.8 ± 3.9 min) (p = 0.01).

Conclusion: Both envelope and triangular flap designs are comparable in terms of postoperative pain, trismus, and alveolar osteitis. However, the triangular flap technique is associated with significantly reduced operative time, suggesting better surgical efficiency.