Effects of different flap designs on periodontal health of adjacent 2nd molar following partially impacted mandibular 3rd molar surgery

Third molar operations in oral and maxillofacial surgery may cause various postoperative complications such as pain, edema and periodontal problems in 2nd molars. Several different flap techniques have been developed to minimalize potential postoperatif complications. The aim of the present study is to eveluate the effects of 3 cornered laterally sliding flap for primary closure (FlepI) and envelope flap for secondary closure (FlepII) on periodontal health of adjacent second molar following third molar surgery.A total number of 30 patients (8 male and 22 female) aged between 18-28 years requiring symmetrically partially impacted mesio- vertical or vertical lower third molar surgery were included in this study. Both 3M teeth were opereted in the same visit appliying FlepI technique to one side and FlepII technique to the other side.Measurements were conducted in the pre-operatively and on 2nd, 7th, 30th and 90th post-operative days. Pain was measured by VAS, edema was recorded using certain facial points, alveolitis and infection determined using clinical parameters and wound healing was measured by WHS ( Wound Healing Scale). Gingival recession, clinical attachment level, probing depth, plaque index, gingival index and bleeding index carried out to assess the periodontal health of adjacent 2nd molars using clinical parameters. All the values were evaluated statistically by SPSS version 12,0.As a result of statistical analysis of the data, pain, edema and clinical attacment level of adjacent 2nd molars in FlepII group were significantly better than FlepI group (p<0,05). Gingival recession, probing depth, plaque index and bleeding index of adjacent 2nd molar in FlepII were significantly worse than FlepI following 3M surgery (p<0,05). Gingival index was similar for both technigues (p>0,05). There were positive correlation between plaque index and gingival index when probing depth was assessed (p<0,05).According to the results of present study 3 cornered laterally sliding flap technique is found to be an alternative surgical method for the partially impacted 3rd molar surgery to improve the periodontal health of adjacent 2nd molars.Keywords: 3 cornered laterally sliding flap, envelope flap, mandibular 3rd molar, adjacent 2nd molar, periodontal health