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

NCT ID: NCT07247929

Last Updated: 2025-11-25

Basic Information

• Recruitment Status: RECRUITING
• Clinical Phase: NA
• Total Enrollment: 160 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2024-08-15
• Study Completion Date: 2026-04-15

Brief Summary

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.

Detailed 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.

Conditions

Pain (Visceral, Somatic, or Neuropathic)

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: TREATMENT
• Blinding Strategy: NONE

Study Groups

flap technqiue

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

Group Type: EXPERIMENTAL

flap technqiue for mandibular third molar extraction Arm A

Intervention Type: PROCEDURE

Surgical extraction performed using a mucoperiosteal flap. A Ward's or modified Ward's incision is placed with a No. 15 blade. The flap is elevated to expose bone, followed by bone guttering with a straight fissure bur under saline irrigation. Tooth sectioning is carried out and fragments are removed. The socket is irrigated with saline and the flap is repositioned and sutured with 3-0 black braided silk.

flapless technquie

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

Group Type: EXPERIMENTAL

flapless technquie arm b

Intervention Type: PROCEDURE

Surgical extraction of partially impacted mandibular third molar without raising a mucoperiosteal flap. Only minimal gingival reflection is performed using a periosteal elevator. Bone guttering and tooth sectioning are carried out using a bur under saline irrigation. Tooth fragments are removed. The socket is irrigated with saline and 0.2% chlorhexidine. No sutures are placed, and the site is allowed to heal by secondary intention

Interventions

flap technqiue for mandibular third molar extraction Arm A

Surgical extraction performed using a mucoperiosteal flap. A Ward's or modified Ward's incision is placed with a No. 15 blade. The flap is elevated to expose bone, followed by bone guttering with a straight fissure bur under saline irrigation. Tooth sectioning is carried out and fragments are removed. The socket is irrigated with saline and the flap is repositioned and sutured with 3-0 black braided silk.

Intervention Type: PROCEDURE

flapless technquie arm b

Surgical extraction of partially impacted mandibular third molar without raising a mucoperiosteal flap. Only minimal gingival reflection is performed using a periosteal elevator. Bone guttering and tooth sectioning are carried out using a bur under saline irrigation. Tooth fragments are removed. The socket is irrigated with saline and 0.2% chlorhexidine. No sutures are placed, and the site is allowed to heal by secondary intention

Intervention Type: PROCEDURE

Eligibility Criteria

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

• Minimum Eligible Age: 18 Years
• Maximum Eligible Age: 45 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: Yes

Sponsors

Watim Medical & Dental College

OTHER

Sponsor Role: lead

Responsible Party

Huma Bajar

prinicpal investigator

Responsibility Role: PRINCIPAL_INVESTIGATOR

Locations

Watim Medical College&Dental Hospital

Islamabad, Islamabad, Pakistan

Site Status: RECRUITING

Countries

Pakistan

Central Contacts

dr huma bajar huma bajar, bds

Role: CONTACT

humabajar@yahoo.com

00923243322292

Facility Contacts

dr huma bajar huma bajar, bds

Role: primary

humabajar@yahoo.com

00923243322292

Other Identifiers

WMC-OMFS-FLAPvsFLAPLESS-2025

Identifier Type: -

Identifier Source: org_study_id