Flap design: Comparison of ward’s flap versus modified ward’s flap in surgical extraction of impacted mandibular third molar.

摘要

To compare the Ward’s Flap Versus Modified Ward’s flap in relation to access,healing & postoperative complications in surgical extraction of mandibular third molar impaction.Study Design: Comparative Cross Sectional. Setting: Department of Oral & MaxillofacialSurgery LUMHS Jamshoro/Hyderabad: Period: March 2017 to November 2017. Materials andMethods: The history, clinical examination and radiographs (OPG and periapical) had doneby team of researchers and recorded on proforma. After selection of patient into either group(Group A=Wards Flap, Group B Modified Wards), the surgical extraction was carried out underlocal anesthesia. For group A, a standard full thickness mucoperiosteal flap (ward’s flap) wasraised. The incision was given mesial to the impacted lower third molar. For group B, a standardfull thickness mucoperiosteal flap (Modified ward’s flap) was given mesial to second molar. Atthe end of the surgery, the flap design used for the extraction of impacted lower third molartooth and the duration of each operation (from the first extraction maneuver to the completionof the last suture), Pain, Swelling and Trismus13 were recorded on the proforma. Every patientwas called for follow up on the 3rd day and 7th day. Results: Mean age was found 27.93 years,with range of minimum 20 years and maximum 35 years. Male were found in the majority 72.3%.Majority of the cases 51.5% were found with class B, in class A 37.5% and 10.9% were foundwith class C. According to the impaction position 50% cases were in class I, and 50% caseswere in class II. Preoperative pain measurement was done according VAS, 71.9% patientswere found with mild pain, 9.4% were with moderate pain while 18.8% patients were withoutpain. Modified Wards flap showed good efficacy regarding duration of third molar extractionas compare to Ward’s flap P-value 0.018. Modified ward’s flap had showed less postoperativepain as compare to ward’s flap p-value 0.022. No significant difference was found between bothgroups on 3rd and 7th postoperative day in Mouth opening. Conclusion: This study concludedthat both ward’s flap and modified ward’s flaps showed good efficacy, while duration of surgeryand postoperative pain were significantly less in the modified ward’s flaps as compare to ward’sflap. More large sample size studies are required to evaluate more accurate findings.