Objectives: This prospective study was performed to evaluate whether the distal-triangular flap was a practical alternative surgical approach for extracting mandibular third molars.
Methods: Sixty participants with impacted mandibular third molars were randomly divided into three groups: group A, distal-triangular flap; group B, Szmyd flap; and group C, envelope flap. The impacted third molars were extracted by the corresponding flapping method. During a three-month follow-up observation after the extraction, the postoperative pain, swelling, mouth opening, and periodontal status were recorded and analyzed by ANOVA and chi-square tests.
Results: The 60 participants had successful extraction and 3-month follow-up observation. No participant suffered from postoperative infections, lower lip disorder, or tongue sensory disorders. No statistical differences were found in the postoperative symptoms and signs of the three flap designs, such as postoperative pain, swelling, mouth opening, and periodontal status (P>0.05).
Conclusions: The distal-triangular flap was as safe and reliable as the Szmyd and envelope flaps but more advantageous because of its convenient operative field exposure and low requirement for the patient's mouth opening. Thus, the distal-triangular flap is one of the alternative flap options for extracting impacted mandibular third molars.
目的: 通过一项前瞻性研究对远中三角瓣在下颌第三磨牙拔除术中的应用效果进行研究。方法: 将60例下颌阻生第三磨牙患者随机分为远中三角瓣、近中三角瓣及封套瓣3组，分别采用相应的翻瓣方式拔除阻生第三磨牙。拔牙后随访观察3个月，记录患者术后疼痛、肿胀、张口度及邻牙牙周状况等指标，采用重复测量方差分析及卡方检验对结果进行分析。结果: 60例患者均顺利完成拔牙及3个月的随访观察，无1例出现术后感染或下唇、舌、颊黏膜感觉障碍。3组患者的术后疼痛、肿胀、张口度及邻牙牙周状况等差异均无统计学意义（P>0.05）。结论: 远中三角瓣与近中三角瓣、封套瓣一样安全可靠，但其具有方便术野暴露，对患者张口度要求不高等优势，是阻生下颌第三磨牙拔除术中可供选择的翻瓣方案之一。.
Keywords: Szymd flap; distal-triangular flap; envelope flap; mandibular third molar extraction; postoperative complication.