Laser doppler flowmetry evaluation of gingival and pulpal blood flow alterations in mandibular second molars following the mandibular third molar surgery using two different flap techniques

The aim of this study was to evaluate the effects of envelope flap and triangle flap techniques on gingival blood flow and pulpal blood flow of neighboring second molar tooth with laser doppler flowmeter. Sixty patients (53 females, 7 males) aged between 20-30 years with fully embedded mandibular mesioangular right third molar teeth participated in the study. Two separate flap groups of 30 people were formed. Blood flow measurements to be made with laser doppler flowmeter in triangle and envelope flap groups were made at one point on the tooth and 3 points on the gingival tissues before surgery and on the postoperative 7th day. Acrylic plaque was applied to the patients prior to measurements for standardization. Thus, pre-op and post-op 7 day measurements were performed from the same points. The obtained data were analyzed statistically. As a result of the study, in the envelope flap group after the mandibular third molar tooth extraction, in the 7th day measurements, the pulp blood flow of the adjacent tooth and gingival blood flow of the 3 different points of the flap were significantly higher (p <0.05). In the triangular flap group, the postoperative 7th day measurements showed a significant increase in adjacent pulpal blood flow (p <0.05). Significant decrease was observed in gingival 1st and 2nd point measurements in which blood flow of triangular flap was measured (p <0,05) and significant increase was found in gingival 3rd point (p <0,05). It can be said that the envelope flap technique used in the surgical extraction of the impacted mandibular third molar tooth is a more advantageous and preferable method in terms of blood supply of the flap in the postoperative period compared to the triangular flap technique. However, more studies requiring longer follow-up are needed in order to determine this precisely.