Effect of flap design on periodontal healing after impacted third molar extraction: a systematic review and meta-analysis

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• 作者：Y.-W. Chen¹ ; ² ; ³ ; C.-T. Lee⁴ ; L. Hum² ; S.-K. Chuang¹ ; ² ; ^{sungkiangchuang@gmail.com}
• 关键词：complications ; evidence-based dentistry ; impacted tooth ; periodontal pocket ; periodontal attachment loss ; third molar(s)
• 刊名：International Journal of Oral and Maxillofacial Surgery
• 出版年：2017
• 出版时间：March 2017
• 年：2017
• 卷：46
• 期：3
• 页码：363-372
• 全文大小：1110 K
• 卷排序：46

文摘

The extraction of an impacted third molar violates the surrounding soft and bony tissues. The surgeon's access to the tooth, for which there are various surgical approaches, has an important impact on the periodontium of the adjacent second molar. The aim of this review was to analyze the relationships between the different flap techniques and postoperative periodontal outcomes for the mandibular second molars (LM2) adjacent to the impacted mandibular third molars (LM3). An electronic search of MEDLINE and other databases was conducted to identify randomized controlled trials fulfilling the eligibility criteria. To assess the impact of flap design on the periodontal condition, the weighted mean difference of the probing depth reduction (WDPDR) and the weighted mean difference of the clinical attachment level gain (WDCAG) at the distal surface of LM2 were used as the primary outcomes. The results showed that, overall, the different flap techniques had no significant impact on the probing depth reduction (WDPDR −0.14 mm, 95% confidence interval −0.44 to 0.17), or on the clinical attachment level gain (WDCAG 0.05 mm, 95% confidence interval −0.84 to 0.94). However, a subgroup analysis revealed that the Szmyd and paramarginal flap designs may be the most effective in reducing the probing depth in impacted LM3 extraction, and the envelope flap may be the least effective.