Influence of Surgical Flap Design (Envelope and Szmyd) for Removal of Impacted Mandibular Third Molars on Clinical Periodontal Parameters: A Clinical Trial

Muhtada Ahmad, Zafar Ali Khan, Tahir Ullah Khan, Montaser N. Alqutub, Sameer A. Mokeem, Abdulrahman M. AlMubarak, Mehmood Haider, Mansour Al-Askar, Naseer Ahmed, Nada Aldahiyan, Fahim Vohra and Tariq Abduljabbar
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Muhtada Ahmad: Department of Oral & Maxillofacial Surgery, Dow Dental College, Dow University of Health Sciences, Karachi 74200, Pakistan
Zafar Ali Khan: Department of Oral Maxillofacial Surgery and Diagnostic Sciences, College of Dentistry, Jouf University, Sakaka, Al Jouf 72345, Saudi Arabia
Tahir Ullah Khan: Department of Oral & Maxillofacial Surgery, Lady Reading Hospital Medical Teaching Institute, Peshawar 25000, Pakistan
Montaser N. Alqutub: Department of Periodontics and Community Dentistry, College of Dentistry, King Saud University, Riyadh 11545, Saudi Arabia
Sameer A. Mokeem: Department of Periodontics and Community Dentistry, College of Dentistry, King Saud University, Riyadh 11545, Saudi Arabia
Abdulrahman M. AlMubarak: Department of Periodontics and Community Dentistry, College of Dentistry, King Saud University, Riyadh 11545, Saudi Arabia
Mehmood Haider: Department of Oral & Maxillofacial Surgery, Abbasi Shaheed Hospital, Karachi 75300, Pakistan
Mansour Al-Askar: Department of Periodontics and Community Dentistry, College of Dentistry, King Saud University, Riyadh 11545, Saudi Arabia
Naseer Ahmed: Department of Prosthodontics, Altamash Institute of Dental Medicine, Karachi 75500, Pakistan
Nada Aldahiyan: Department of Restorative Dental Science, College of Dentistry, King Saud University, Riyadh 11545, Saudi Arabia
Fahim Vohra: Department of Prosthetic Dental Science, College of Dentistry, King Saud University, Riyadh 11545, Saudi Arabia
Tariq Abduljabbar: Department of Prosthetic Dental Science, College of Dentistry, King Saud University, Riyadh 11545, Saudi Arabia

IJERPH, 2021, vol. 18, issue 9, 1-11

Abstract: The aim of the study was to assess the influence of flap designs (Envelope flap (EF) and Szmyd flap (SF)) for impacted mandibular third molar extraction, on periodontal pocket depth (PPD), clinical attachment loss (CAL) and bone levels (BL) of second molar. Sixty patients indicated for third molar extractions with healthy second molars were allocated into two groups: EF and SF ( n = 30). Third molars were assessed for angulation, root patterns, depth of impactions and relation with ramus (Pell and Gregory classification). Extraction of third molars was performed and PPD, CAL and BL around second molars at 0, 3 and 6 month (mon) follow-ups (FU) were assessed clinically and radiographically. ANOVA, Chi-square and Fisher’s exact test were employed to compare periodontal factors between EF and SF groups, considering p ? 0.05 as significant. Sixty participants with a mean age of 23.22 ± 3.17 were included in the study. Based on angulation, the most common impaction in the EF and SF groups was mesio-angular (EF, 50%; SF, 36.7%). Buccal and distal PPD showed a significant increase ( p < 0.001) in both EF and SF patients from baseline to 6 mon. EF patients showed significantly higher distal and buccal CAL (6.67 ± 0.18 mm; 6.91 ± 0.17 mm) and BL (7.64 ± 0.16 mm; 7.90 ± 0.15 mm) as compared to SF patients (CAL, 6.76 ± 0.26 mm; 6.91 ± 0.17 mm-BL, 7.42 ± 0.38 mm; 7.34 ± 0.34 mm) at 6 mon FU. SF showed better soft tissue attachment (PPD and CAL) and bone stability (less bone loss) around second molars compared to EF after third molar extractions regardless of the patient, tooth and operator factors.

Keywords: periodontal attachment loss; periodontal pocket; bone loss; third molar; surgical flaps (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
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