Comparision of blood FLOW following two flap designs used in impacted mandibular third molar surgery

The most frequently performed procedures in oral and maxillofacial surgery are mandibular third molar operations. The use of different methods in these operations may affect wound healing and blood supply in the area. However, since they are very frequently performed operations, it is important to control postoperative complications. In our study, it was aimed to evaluate the effects of the use of envelope and trapezoidal flaps in the surgical extraction of impacted third molars on the blood supply of the adjacent second molar and the soft tissue in the operation area, and its relationship with the development of edema and trismus, which are postoperative complications. Two groups of 28 people, each consisting of 7 teeth with vertical, horizontal, mesioangular and distoangular angulations, which are the most frequently impacted positions of impacted mandibular third molar teeth, were formed. In group 1 envelope flaps and in group 2 trapezoidal flaps 2 were applied. Blood flow values were measured using laser doppler flowmeter device; It was measured at one point on the adjacent tooth and at 3 different points on the gingiva. In addition, edema and maximum mouth opening values were recorded. All measurements were performed preoperatively and on the 3rd and 7th postoperative days. According to the results of our study, no significant difference was found between the 2 groups in terms of edema and maximum mouth opening. In both groups, pulpal blood flow of adjacent teeth decreased compared to preoperative values. Although similar values were observed before the procedure, the pulpal blood flow of the adjacent tooth increased more in the envelopeflap groupthan the trapezoidal flap group on the 7th day. When the blood flow in the soft tissue was evaluated, it was observed that the blood flow increased at 3 points (Y1, Y2, Y3) in the envelope flap group and at 2 points (Y2 and Y3) in the trapezoidal flap group on the postoperative 3rd day (p<0.05), although it was not significant on the 7th day. It was decreased and remained above the preoperative values. In the trapezoidal flap group, the blood flow at the Y1 point increased slightly on the postoperative 3rd day, although it was not significant, and decreased significantly on the 7th day (p<0.05). According to the findings, we can say that the envelope flap technique is more advantageous than the trapezoidal flap technique in postoperative complications, adjacent second molar dental pulp and soft tissue blood supply. However, studies with larger sample numbers and longer follow-ups are needed to fully determine the advantages of these two flap techniques over each other and their effects on the perfusion of adjacent structures.