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Clinical evaluation of the effect of four flap designs on the post–operative sequel (pain, swelling and trismus) following lower third molar surgery

Author: Mohammad S Sulieman
Journal: Al-Rafidain Dental Journal مجلة الرافدين لطب الأسنان ISSN: 18121217 Year: 2005 Volume: 5 Issue: 1 Pages: 24-32
Publisher: Mosul University جامعة الموصل

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Abstract

The present study aimed to assess the effect of differentflap designs on pain, swelling and trismus following surgicalremoval of impacted mandibular third molar. The study wascarried out in Oral and Maxillofacial Department, DentalTeaching Hospital of Dentistry College, Mosul University.Sixty patients were included in the research where theywere divided into 4 groups, each comprised of 15 patients. Inthe first group, the impacted teeth were removed using an envelopeflap. In the second group, a standard flap was used forthe removal of impacted teeth. For the third group, the impactedteeth were removed using modified standard flap.While in the fourth group, S–shaped flap was used. Pain,swelling and trismus were assessed clinically post–operativelyat 1 day, 3 days and 7 days intervals. Pain and swellingwere evaluated subjectively while trismus was evaluated bymeasuring the maximum mouth opening ability (in mm) betweenthe right upper and right lower central incisors using avernier. The results showed no significant effect among the 4flap designs on post–operative complaints.It was concluded that the type of incision appears tohave no effect on the degree of pain, swelling and trismusfollowing surgical removal of impacted lower third molar.


Article
A comparative double–blind study among two universal systems of classification of impacted lower wisdom tooth and duration of surgery

Authors: Mohammad S Sulieman --- Wa’el T Al–Wattar --- Karam H Jazrawi
Journal: Al-Rafidain Dental Journal مجلة الرافدين لطب الأسنان ISSN: 18121217 Year: 2006 Volume: 6 Issue: 1 Pages: 42-47
Publisher: Mosul University جامعة الموصل

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Abstract

Aim: To estimate the importance of time in determining the difficulty of surgical removal of impactedthird molars. Materials and Methods: Two hundred medically fit patients were selected with an agerange between 18–25 years of both sexes. These patients had vertically impacted lower third molarsand indicated for surgical extraction. The diagnosis of third molar impaction was based on clinical andstandard intraoral periapical radiographs. A double–blind approach was adopted whereby tworesearchers carried out a classification of the operation based on expected time of surgery and the thirdresearcher performed the surgery. The classification of the impaction was performed pre–operativelyaccording to Pell–Gregory classification, then the operation was performed following the standardprocedure for this type of surgery. Following extraction, surgical difficulty was rated according toGarcia et al. classification and operation time from the incision till suturing of the flap. Results:Comparison among the three classification systems was performed and the results indicated nosignificant difference among the three classifications regarding simple and moderate operations, butonly a significant difference was recorded for the difficult operations. Conclusion: This study,however, revealed the importance of time in assessing the difficulty of such operations and this, in turn,will help surgeons in scheduling the treatment plan and taking the necessary precautions when dealingwith difficult operations

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