Journal of the Korean Association of Oral and Maxillofacial Surgeons

The Korean Association of Oral and Maxillofacial Surgeons (대한구강악안면외과학회)
권호 표지
DOI QR코드

DOI QR Code

Effect of a vertical incision on postoperative swelling after an impacted mandibular third molar extraction: two cases with split-mouth designed magnetic resonance imaging analysis

  • Jeong-Kui Ku (Department of Oral and Maxillofacial Surgery, Gangnam Severance Hospital, Yonsei University College of Dentistry) ;
  • Sung Hyun Baik (Department of Radiology, Seoul National University Bundang Hospital) ;
  • Jae-Young Kim (Department of Oral and Maxillofacial Surgery, Gangnam Severance Hospital, Yonsei University College of Dentistry) ;
  • Jong-Ki Huh (Department of Oral and Maxillofacial Surgery, Gangnam Severance Hospital, Yonsei University College of Dentistry)
  • Received : 2021.11.25
  • Accepted : 2022.02.11
  • Published : 2023.04.30
Download PDF
⟨ Previous Next ⟩

Abstract

This study examined the effects of a vertical incision on postoperative edema after third molar extraction. The study design was that of a comparative split-mouth approach. Evaluation was performed via magnetic resonance imaging (MRI). Two patients with homogeneous bilateral impacted mandibular third molars were enrolled. These patients underwent facial MRI within 24 hours after simultaneous extraction surgery. Modified triangular flap and enveloped flap incisions were made. Postoperative edema was evaluated by MRI and was assessed according to anatomical space. The two pairs of homogeneous extractions demonstrated that vertical incisions were associated qualitatively and quantitatively with extensive postoperative edema. The edema associated with these incisions spread toward the buccal space, beyond the buccinator muscle. In conclusion, a vertical incision with mandibular third molar extraction was related to edema in the buccal space and the fascial space, which contributed to clinical facial swelling.

Keywords

References

  1. Darawade DA, Kumar S, Mehta R, Sharma AR, Reddy GS. In search of a better option: dexamethasone versus methylprednisolone in third molar impaction surgery. J Int Oral Health 2014;6:14-7.
  2. Sortino F, Cicciu M. Strategies used to inhibit postoperative swelling following removal of impacted lower third molar. Dent Res J (Isfahan) 2011;8:162-71. https://doi.org/10.4103/1735-3327.86031
  3. Kirk DG, Liston PN, Tong DC, Love RM. Influence of two different flap designs on incidence of pain, swelling, trismus, and alveolar osteitis in the week following third molar surgery. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2007;104:e1-6. https://doi.org/10.1016/j.tripleo.2007.01.032
  4. Baqain ZH, Al-Shafii A, Hamdan AA, Sawair FA. Flap design and mandibular third molar surgery: a split mouth randomized clinical study. Int J Oral Maxillofac Surg 2012;41:1020-4. https://doi.org/10.1016/j.ijom.2012.02.011
  5. Xie Q, Wei S, Zhou N, Huang X. Modified envelope flap, a novel incision design, can relieve complications after extraction of fully horizontal impacted mandibular third molar. J Dent Sci 2021;16:718-22. https://doi.org/10.1016/j.jds.2020.06.022
  6. Blanco G, Lora D, Marzola C. The different types of flaps in the surgical relations of the third impacted molars-literature review. Dentistry 2017;7:425. https://doi.org/10.4172/2161-1122.1000425
  7. Suarez-Cunqueiro MM, Gutwald R, Reichman J, Otero-Cepeda XL, Schmelzeisen R. Marginal flap versus paramarginal flap in impacted third molar surgery: a prospective study. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2003;95:403-8. https://doi.org/10.1067/moe.2003.84
  8. Monaco G, Daprile G, Tavernese L, Corinaldesi G, Marchetti C. Mandibular third molar removal in young patients: an evaluation of 2 different flap designs. J Oral Maxillofac Surg 2009;67:15-21. https://doi.org/10.1016/j.joms.2007.05.032
  9. Anisuzzaman MM, Alam MK, Afrin A. Comparative study between standard Ward's Incision and coma shaped incision and its postoperative outcome on impacted mandibular third molars extraction in Bangladeshi population. Pesqui Bras Odontopediatria Clin Integr 2019;19:e4671.
  10. Jeong YK, Ku JK, Baik SH, You JS, Leem DH, Choi SK. Classification of postoperative edema based on the anatomic division with mandibular third molar extraction. Maxillofac Plast Reconstr Surg 2021;43:4. https://doi.org/10.1186/s40902-021-00291-w
  11. Kleinheinz J, Buchter A, Kruse-Losler B, Weingart D, Joos U. Incision design in implant dentistry based on vascularization of the mucosa. Clin Oral Implants Res 2005;16:518-23. https://doi.org/10.1111/j.1600-0501.2005.01158.x
  12. Koymen R, Karacayli U, Gocmen-Mas N, Ertugrul-Koymen C, Ortakoglu K, Gunaydin Y, et al. Flap and incision design in implant surgery: clinical and anatomical study. Surg Radiol Anat 2009;31:301-6. https://doi.org/10.1007/s00276-008-0431-5
  13. Kim JY, Yong HS, Park KH, Huh JK. Modified difficult index adding extremely difficult for fully impacted mandibular third molar extraction. J Korean Assoc Oral Maxillofac Surg 2019;45:309-15. https://doi.org/10.5125/jkaoms.2019.45.6.309
  14. Ku JK, Chang NH, Jeong YK, Baik SH, Choi SK. Development and validation of a difficulty index for mandibular third molars with extraction time. J Korean Assoc Oral Maxillofac Surg 2020;46:328-34. https://doi.org/10.5125/jkaoms.2020.46.5.328
  15. Ku JK, Jeong YK. Effectiveness of bone graft for an alveolar defect on adjacent second molar after impacted mandibular third molar extraction. J Oral Maxillofac Surg 2021;79:756-62. https://doi.org/10.1016/j.joms.2020.11.030
  16. Qiao F, Huang X, Li B, Dong R, Huang X, Sun J. A validated model to predict postoperative symptom severity after mandibular third molar removal. J Oral Maxillofac Surg 2020;78:893-901. https://doi.org/10.1016/j.joms.2020.02.007