Double blind randomized clinical trial comparing minimally- invasive envelope flap and conventional envelope flap on impacted lower third molar surgery

• Samuel Macedo Costa ^[1] ; Bruna Campos Ribeiro ^[1] ; Alice Soares Gonçalves ^[3] ; Laura Maria de Almeida Araújo ^[2] ; Guilherme Lacerda de Toledo ^[4] ; Marcio Bruno Figueiredo Amaral ^[5]
  1. [1] Universidade de São Paulo

     Universidade de São Paulo

     Brasil

     
  2. [2] Pontifícia Universidade Católica de Minas Gerais

     Pontifícia Universidade Católica de Minas Gerais

     Brasil

     
  3. [3] DDS. College of Dentistry of the University Center of Belo Horizonte, UNIBH, Belo Horizonte, MG, Brazil
  4. [4] DDS, OMFS. Head of the Mater Dei Hospital Oral and Maxillofacial Surgery Service, Belo Horizonte, MG, Brazil
  5. [5] DDS, OFMS, Ph.D. Head of the Oral and Maxillofacial Surgery Residency Program, Hospital João XXIII/FHEMIG, Belo Horizonte, MG, Brazil; Mater Dei Hospital Oral and Maxillofacial Surgery Service, Belo Horizonte, MG, Brazil

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• Localización: Medicina oral, patología oral y cirugía bucal. Ed. inglesa, ISSN-e 1698-6946, Vol. 27, Nº. 6 (November), 2022
• Idioma: inglés
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• Resumen

  • The latest trend in surgery is to look for minimally invasive procedures, with fewer complications and a shorter recovery time. This study aims to compare the minimally- invasive envelope flap, with smaller incision and fewer dissection and the conventional envelope flap, with a 20mm incision, on impacted mandibular third molar surgery, focusing on the hypothesis that there were no differences in postoperative outcomes.

    A double-blind randomized clinical trial was designed to compare both incisions, focused on determining the approach with minor postoperative side-effects and minor impact on quality-of-life. A total of 60 patients were enrolled for the study if their presented impacted mandibular third molar and was 18-years-old or more. Both groups were evaluated from time elapsed on the surgery, maximum mouth opening, swelling and quality of life assessment.

    The flap choice influenced facial swelling (p=0,03), pain on the first three days (p=0,037), interference with oral hygiene (p=0,019) and discomfort on speech (p=0,07). Chewing, swallowing, trismus, pain after seven days, postoperative complications and other quality-of-life arrangements were no different between groups.

    The minimally- invasive envelope flap could lead to a less painful experience for the patient, with fewer impact on the oral hygiene and speech discomfort.