Discussion
swelling, alveolitis, fibrosis, pain, Dehiscence, trismus
ACUTE INFLAMMATORY RESPONSE, ALVEOLAR OSTEITIS, IMPACTION, ALVEOLITIS, FIBROSIS, SECONDARY, WOUND DEHISCENCE, ABSCESSES, DEHISCENCE, TRISMUS
The alleviation of patient discomfort from pain, swelling, and trismus following an impacted mandibular third molar removal presents a continual challenge to oral surgeons. Thus, there are many kinds of flap designs used while removing an impacted mandibular third molar with the aim of recovering the soft tissues for better healing (In this study, patients were randomized and divided into three groups: the airtight suture group, the buccal drainage group, and the no-suture group. We transferred the drainage channel from the occlusal surface to the buccal surface to decrease food impaction. The primary result of the present study is that the buccal drainage method revealed better postoperative patient satisfaction than the airtight suture method at all measured times. This could be explained by the fact that the acute inflammatory response peaks within 24 hours after the surgery and then decreases gradually (With respect to surgical incision, Shevel The primary limitation of this method is the uncertainty of whether the secondary closure would induce wound dehiscence due to one case of alveolitis in the suture-less group after surgery. Dehiscence creates a potential trap for food particles and is an excellent environment for bacterial growth, thus leading to postoperative alveolar osteitis, soft tissue abscesses, long-term discomfort, and additional treatment requirements. Further comparative studies involving larger populations are required to determine the best flap technique for a third molar surgery. In addition, we don’t have the long-term evaluation results due to the patients usually refused to hospital after the wound healed especially COVID-19 's epidemic period. In conclusion, the buccal drainage method may have more advantageous than the traditional method and no-suture method in terms of pain as well as having a better impact on QOL during the early postoperative period. The triangular flap without buccal sutures may be a simple and viable option for clinical applications, especially for some buccal mucosa tension is difficult to pull, such as mouth opening limitation and buccal mucosal fibrosis.Ackcnowledgements We are particularly grateful to all the people who have given us help on our article.Authors contributions Authors Tong-Yue Wang and Zhi-Ping Wang contributed equally to this study.
Conception and design of the research: Jin-Yuan Guo, Tong-Yue Wang.
Acquisition of data: Zhao-Qiang Zhang, Xiang-Huai Zheng.
Analysis and interpretation of the data: Xiang-Huai Zheng, Yuan Du.
Statistical analysis: Zhao-Qiang Zhang, Yuan Du.
Obtaining financing: Zhi-Ping Wang.
Writing of the manuscript: Tong-Yue Wang, Jin-Yuan Guo.
Critical revision of the manuscript for intellectual content: Zhi-Ping Wang.
All authors read and approved the final draft. All authors contributed equally to this study.Ethics The study was conducted in accordance with the Declaration of Helsinki(as was revised in 2013). The study was approved by Ethics Committee of the Stomatological Hospital, Southern Medical University. Written informed consent was obtained from all participants.(Approval No.[2021]37).
This controlled trial was approved by the Ethics Committee of Stomatological Hospital, Southern Medical University, and registered in the Chinese Clinical Trial Register website (http://www.chictr.org.cn/,ChiCTR2100051076). A written consent was obtained from each patient.Conflicts of interest The authors declare that they have no competing interests.Funding This study was supported by the Key-Area Research and Development Program of Guangdong Province (No.2019B010941002).