Postoperative Pain and Swelling After Flap vsFlapless Technique For Mandibular Third Molar Surgery

Watim Medical & Dental College

Status: Enrolling

Conditions: Pain (Visceral, Somatic, or Neuropathic)

Treatments: Procedure: flapless technquie arm b; Procedure: flap technqiue for mandibular third molar extraction Arm A

Study type: Interventional

Funder types: Other

Identifiers

NCT07247929

WMC-OMFS-FLAPvsFLAPLESS-2025

Details and patient eligibility

About

This randomized controlled trial evaluates postoperative pain and facial swelling following surgical removal of partially impacted mandibular third molars using flap versus flapless techniques. The aim is to determine which method results in lower postoperative morbidity on the second postoperative day.

Full description

Impacted mandibular third molars frequently require surgical extraction, often involving mucoperiosteal flap elevation and bone removal. These steps may contribute to postoperative complications such as pain, swelling, and trismus. Minimally invasive alternatives, including flapless extraction, aim to reduce surgical trauma.

This study compares postoperative pain and swelling after flap versus flapless techniques in patients with partially impacted mesioangular mandibular third molars. Pain will be assessed using a 10-point Visual Analogue Scale (VAS), and swelling will be measured using standardized anthropometric facial measurements. A total of 160 participants will be randomized into two equal groups. All procedures will be performed by a single surgeon to reduce bias.

Enrollment: 160 estimated patients

Sex: All

Ages: 18 to 45 years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• Age 18-45 years

  • Either gender
  • Partially impacted mesioangular mandibular third molar confirmed clinically and radiographically
  • Second episode of pericoronitis
  • Swelling present on the affected side
  • No bone recession or periodontal disease on radiograph

Exclusion criteria

• HIV or HBV infection

  • Diabetes or other metabolic disorders
  • Bleeding disorders including von Willebrand disease, thalassemia, hemophilia, thrombocytosis, or thrombocytopenia
  • Periapical infection or acute pericoronitis at time of surgery
  • Severe trismus
  • Immunocompromised status

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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160 participants in 2 patient groups

flap technqiue

Experimental group

Description:

Surgical extraction with mucoperiosteal flap elevation, bone guttering, tooth sectioning, and suturing.

Treatment:

Procedure: flap technqiue for mandibular third molar extraction Arm A

flapless technquie

Experimental group

Description:

Surgical extraction without flap elevation, minimal gingival reflection, bone guttering, and no suturing.

Treatment:

Procedure: flapless technquie arm b