Effect of flap design on complications after mandibular third molar extraction

FU Xiao-long; CHEN Min; QIAO Feng

doi:10.11659/jjssx.10E024097

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Effect of flap design on complications after mandibular third molar extraction

Clinical Research | 更新时间：2025-05-26

- Effect of flap design on complications after mandibular third molar extraction
- JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY Vol. 34, Issue 5, Pages: 425-430(2025)
- 作者机构：
  
  1.天津大学海河医院口腔科，天津 300350
  2.天津医科大学口腔医院牙体牙髓科，天津 300070
  3.天津医科大学口腔医院口腔颌面外科，天津 300070
- 作者简介：
- 基金信息：
- DOI：10.11659/jjssx.10E024097
  CLC： R782
- Received：24 October 2024，
  
  Published：25 May 2025
- 稿件说明：
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付晓龙,陈敏,乔峰.翻瓣设计对下颌第三磨牙拔除术后并发症的影响[J].局解手术学杂志,2025,34(05):425-430.

FU Xiao-long,CHEN Min,QIAO Feng.Effect of flap design on complications after mandibular third molar extraction[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2025,34(05):425-430.
付晓龙,陈敏,乔峰.翻瓣设计对下颌第三磨牙拔除术后并发症的影响[J].局解手术学杂志,2025,34(05):425-430. DOI： 10.11659/jjssx.10E024097.

FU Xiao-long,CHEN Min,QIAO Feng.Effect of flap design on complications after mandibular third molar extraction[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2025,34(05):425-430. DOI： 10.11659/jjssx.10E024097.

摘要

目的

比较三角瓣设计和封套瓣设计在缓解下颌第三磨牙拔除术后并发症方面的效果，为口腔颌面外科医生提供翻瓣选择的科学依据。

方法

通过检索CNKI、万方、PubMed、Embase、Web of Science、Cochrane和Springer数据库，筛选1984年1月至2022年4月发表的随机对照试验和对照临床试验，分析三角瓣和封套瓣对下颌第三磨牙拔除术后面部肿胀、张口受限和干槽症等并发症的影响。

结果

Meta分析显示，三角瓣组术后第7天的面部肿胀程度显著大于封套瓣组（

=-0.69，95%

：-0.93~-0.45；

0.000 01），但2组术后第14天的面部肿胀程度比较差异无统计学意义（

=-0.07，95%

：-0.18~0.04；

=0.22）。亚组分析表明，在Pell and Gregory A/B分类中，封套瓣在改善张口受限方面效果优于三角瓣（

=2.95，95%

：0.11~5.79），但在其他分类亚组及总体分析中未观察到显著差异。在分侧随机对照试验中封套瓣干槽症发生的风险更高（

=3.53，95%

：1.67~7.48），而在随机对照试验中未见明显差异（

=0.78，95%

：0.43~1.43）。

结论

与三角瓣相比，封套瓣在缓解术后早期面部肿胀改善张口受限方面具有优势，但其干槽症发生风险较高。

Abstract

Objective

To compare the effects of triangular flap design versus envelope flap design in alleviating postoperative complications after mandibular third molar extraction， thereby providing a scientific basis on flap design selection for oral and maxillofacial surgeons.

Methods

The randomized controlled trials and controlled clinical trials published from January 1984 to April 2022 were selected by searching the CNKI， Wanfang， PubMed， Embase， Web of Science， Cochrane， and Springer databases， to analyze the effects of triangular flap and envelope flap on facial swelling， limited mouth opening， and dry socket after the extraction of lower third molars.

Results

The meta-analysis demonstrated that the degree of facial swelling 7 days after surgery in the triangular flap group was significantly greater than that in the envelope flap group （

=-0.69，95%

：-0.93 to -0.45；

0.000 01），while there was no statistically significant difference in the degree of facial swelling 14 days after surgery between the two groups （

=-0.07，95%

：-0.18 to 0.04；

=0.22）. Subgroup analysis indicated that in the Pell and Gregory classification A/B categories，the envelope flap was more effective than the triangular flap in improving limited mouth opening （

=2.95；95%

：0.11 to 5.79），but no significant difference was observed in other classification subgroups or in the overall analysis. The risk of developing dry socket by envelope flap is higher in split-side randomized controlled trials （

=3.53，95%

：1.67 to 7.48），whereas no significant difference was found in the parallel randomized controlled trials （

=0.78，95%

：0.43 to 1.43）.

Conclusion

Compared with the triangular flap， the envelope flap has advantages in alleviating the facial swelling and improving limited mouth opening in the early postoperative period， but it has a higher risk of dry socket.

关键词

Keywords

references

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