Evaluating Envelope vs. Triangular Flap Techniques in Impacted Mandibular Wisdom Tooth Extraction (A Comparative Study)

Introduction: Surgical removal of impacted third molars is a commonly applied oral surgery operation. It can be quite discomforting for the patients because of postoperative complications, such as bleeding, pain, swelling, trismus, wound dehiscence, and alveolar osteitis. Many attempts have been made to reduce those complications, and the use of various flap designs have been investigated. Aim of the study: to evaluate the effect of flap designs, Envelope Flap (EF) and Modified Triangular Flap (MTF) on postoperative pain and soft tissue healing after mandibular wisdom tooth extraction. Materials and Methods Twenty patients with unilateral impacted third molars completed the study with an envelope flap and a modified triangular flap design for third molar removal. Clinical parameters, including pain and soft tissue healing, were assessed postoperatively. Results The VAS percentage decrease (%) was statistically significantly better (more decrease) in the Envelope Flap group than in the Modified triangular flap group. The Healing Index was statistically significantly higher in the Modified Triangular Flap Group compared with the Envelope Flap Group postoperatively. Conclusion The study revealed that the modified triangular flap had higher postoperative healing compared with the envelope flap, although the envelope flap had lower postoperative pain scores.