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Meta-Analysis
. 2020 Mar 1;25(2):e233-e239.
doi: 10.4317/medoral.23320.

Patient morbidity after impacted third molar extraction with different flap designs. A systematic review and meta-analysis

P Glera-Suárez  1 , D Soto-Peñaloza, D Peñarrocha-Oltra, M Peñarrocha-Diago
Affiliations
Meta-Analysis

Patient morbidity after impacted third molar extraction with different flap designs. A systematic review and meta-analysis

P Glera-Suárez et al. Med Oral Patol Oral Cir Bucal. .

Abstract

Background: To review the literature on the effect of different surgical flaps upon patient morbidity (pain perception, trismus, swelling and osteitis) after impacted third molar extraction.

Material and methods: An electronic and complementary search of main databases and grey literature was performed up to January 2019 to retrieve randomized clinical trials. The Cochrane risk of bias assessment tool was used for methodological appraisal. A random-effects meta-analysis was conducted of pain perception and trismus.

Results: From the initially 1314 screened studies, only 11 were included in the qualitative synthesis, and 5 in the meta-analysis. There were no statistically significant differences in pain between the envelope and triangular flap designs over time, except on the sixth postoperative day, when the envelope flap proved more painful. Regarding trismus, statistically significant differences were observed on the seventh postoperative day, with greater mouth opening in the envelope flap group than in the triangular flap group. There were no clear differences in swelling and osteitis among the flap designs.

Conclusions: Despite its limitations, the present meta-analysis found no clear differences in patient morbidity between the different flap designs.

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Conflict of interest statement

Conflicts of interest There are no conflicts of interest regarding the publication of this paper.

Figures

Figure 1
Figure 1
Cochrane´s assessment tool for risk of bias.
Figure 2
Figure 2
Triangular flap (A); envelope flap (B); pedicle flap (C); comma shpaed incision (D); reverse-L flap "RLF" (E); alternative surgical flap "ASF" (F); paramarginal triangular flap (G); lingually-based triangular flap (H).
Figure 3
Figure 3
Cummulative plot of random effects meta-analyses a week postoperative. Pain (A); Trismus (B).
See this image and copyright information in PMC

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