Uticaj dizajna režnja na otok, trizmus i bol posle hirurgije trećih donjih molara: bukalni triangularni režanj vs. „envelop” režanj

  • Stevo Matijević University of Defence, Faculty of Medicine of the Military Medical Academy, Belgrade, Serbia; Military Medical Academy, Dental Clinic, Department of Oral Surgery, Belgrade, Serbia
  • Filip Djordjević University of Priština in Kosovska Mitrovica, Faculty of Medicine, Department of Oral Surgery, Kosovska Mitrovica, Serbia
  • Mila Vukašinović University of Priština in Kosovska Mitrovica, Faculty of Medicine, Department of Oral Surgery, Kosovska Mitrovica, Serbia
  • Zoran Bukumirić University of Belgrade, Faculty of Medicine, Belgrade, Serbia
  • Dejan Dubovina University of Priština in Kosovska Mitrovica, Faculty of Medicine, Department of Oral Surgery, Kosovska Mitrovica, Serbia
DOI: https://doi.org/10.2298/VSP231201007M
Ključne reči: edem;, molar, treći;, hirurgija, oralna, procedure;, bol;, postoperativne komplikacije;, režnjevi, hirurški;, zub, impakcija;, trizmus

Sažetak


Uvod/Cilj. Otok, trizmus i bol (OTB) su najčešće komplikacije nakon  hirurške ekstrakcije impaktiranih donjih trećih molara (DTM). Bukalni triangularni i „envelop“ režanj su dva najčešće primenjivana mukoperiostalna režnja u hirurgiji DTM. Cilj istraživanja bio je da se uporedi mogući uticaj te dve vrste korišćenih mukoperiostalnih režnjeva na intenzitet OTB nakon hirurške ekstrakcije impaktiranih DTM. Metode. Studijom je obuhvaćeno 30 odraslih pacijenata oba pola, sa potpuno impaktiranim DTM u vertikalnoj poziciji prema Winter-ovoj klasifikaciji i klase I ili II i pozicije A ili B, prema klasifikaciji Pell-a i Gregory-a. Svi pacijenti su nasumično podeljeni u dve grupe, u zavisnosti od primenjenog mukoperiostalnog režnja (triangularni ili „envelop“ tip). Stepen prisutnog otoka, interincizalno rastojanje i nivo bola određivani su preoperativno i pri svakoj kontrolnoj poseti (prvog, drugog i sedmog postoperativnog dana). Rezultati. Nije utvrđena statistički značajna razlika između ispitivanih grupa u pogledu smanjenja OTB u postoperativnom periodu (p > 0,05). Zaključak. Izbor vrste mukoperiostalnog režnja, bukalni triangularni ili „envelop“ tip, prilikom hirurške ekstrakcije impaktiranih DTM nema uticaja na  stepen inteziteta postoperativnog OTB.

Biografija autora

Stevo Matijević, University of Defence, Faculty of Medicine of the Military Medical Academy, Belgrade, Serbia; Military Medical Academy, Dental Clinic, Department of Oral Surgery, Belgrade, Serbia

VMA, Odeljenje za oralnu hirurgiju. 

Docent dr sc stom.

Reference

Yolcu Ü, Acar AH. Comparison of a new flap design with the routinely used triangular flap design in third molar surgery. Int J Oral Maxillofac Surg 2015; 44(11): 1390–7.

Dolanmaz D, Esen A, Isik K, Candirli C. Effect of 2 flap de-signs on postoperative pain and swelling after impacted third molar surgery. Oral Surg Oral Med Oral Pathol Oral Radiol 2013; 116(4): e244–6.

Kirk DG, Liston PN, Tong DC, Love RM. Influence of two dif-ferent 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(1): e1–6.

Monaco G, Daprile G, Tavernese L, Corinaldesi G, Marchetti C. Mandibular third molar removal in young patients: an evalua-tion of 2 different flap designs. J Oral Maxillofac Surg 2009; 67(1): 15–21.

Djordjević F, Bubalo M, Perić D, Mihailović Dj, Bukumirić Z, Dubovina D. Effectiveness of submucosal, oral, and intramus-cular routes of dexamethasone administration in trismus, swelling, and pain reduction after the third lower molar sur-gery. Vojnosanit Pregl 2023; 80(4): 337–42.

Pell GJ, Gregory GT. Impacted mandibular third molars: Classi-fication and modified technique for removal. Dent Dig 1933; 39(9): 330–8.

Winter GB. Principles of exodontia as applied to the impacted mandibular third molar: a complete treatise on the operative technic with clinical diagnoses and radiographic interpreta-tions. St. Louis, USA: American Medical Book Company; 1926. p. 835.

Schultze-Mosgau S, Schmelzeisen R, Frölich JC, Schmele H. Use of ibuprofen and methylprednisolone for the prevention of pain and swelling after removal of impacted third molars. J Oral Maxillofac Surg 1995; 53(1): 2–7; discussion 7–8.

Royal College of Surgeons of England – Faculty of Dental Surgery. Parameters of care for patients undergoing mandibular third molar surgery [Internet]. The Royal College of Surgeons of England; 2020 [accessed on: 2023 December 25]. Available from: https://www.rcseng.ac.uk/-/media/files/rcs/fds/guidel

ines/3rd-molar-guidelines--april-2021.pdf

Sifuentes-Cervantes JS, Carrillo-Morales F, Castro-Núñez J, Cun-ningham LL, Van Sickels JE. Third molar surgery: Past, pre-sent, and the future. Oral Surg Oral Med Oral Pathol Oral Radiol 2021; 132(5): 523–31.

Mohajerani H, Esmaeelinejad M, Jafari M, Amini E, Sharabiany SP. Comparison of envelope and modified triangular flaps on incidence of dry socket after surgical removal of impacted mandibular third molars: a double-blind, split-mouth study. J Contemp Dent Pract 2018; 19(7): 836–41.

Glera-Suárez P, Soto-Peñaloza D, Peñarrocha-Oltra D, Peñarrocha-Diago M. Patient morbidity after impacted third molar extrac-tion with different flap designs. A systematic review and meta-analysis. Med Oral Patol Oral Cir Bucal 2020; 25(2): e233–9.

Koyuncu BÖ, Cetingül E. Short-term clinical outcomes of two different flap techniques in impacted mandibular third molar surgery. Oral Surg Oral Med Oral Pathol Oral Radiol 2013; 116(3): e179–84.

Tareen MK, Hamad J, Saleem SM, Ahmad S. To compare the triangular flap to envelope flap for the removal of impacted mandibular last molar. Pak J Med Health Sci 2015; 9: 434–6.

Alqahtani NA, Khaleelahmed S, Desai F. Evaluation of two flap designs on the mandibular second molar after third molar ex-tractions. J Oral Maxillofac Pathol 2017; 21(2): 317–8.

Erdogan O, Tatli U, Ustün Y, Damlar I. Influence of two differ-ent flap designs on the sequelae of mandibular third molar surgery. Oral Maxillofac Surg 2011; 15(3): 147–52.

Borgonovo AE, Giussani A, Grossi GB, Maiorana C. Evaluation of postoperative discomfort after impacted mandibular third molar surgery using three different types of flap. Quintessence Int 2014; 45(4): 319–30.

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(8): 1020–4.

Rabi A, Haris PMM, Panickal DM, Ahamed S, Pulikkottil VJ, Haris KTM. Comparative Evaluation of Two Different Flap Designs and Postoperative Outcome in the Surgical Removal of Impacted Mandibular Third Molar. J Contemp Dent Pract 2017; 18(9): 807–11.

Lopes da Silva BC, Machado GF, Primo Miranda EF, Galvão EL, Falci SGM. Envelope or triangular flap for surgical removal of third molars? A systematic review and meta-analysis. Int J Oral Maxillofac Surg 2020; 49(8): 1073–86.

Abandansari SA, Foroughi R. The effect of releasing incision on the postoperative complications of mandibular third molar surgery. Int J Adv Biotechnol Res 2016; 7: 1144–51.

Chen YW, Lee CT, Hum L, Chuang SK. Effect of flap design on periodontal healing after impacted third molar extraction: A systematic review and meta-analysis. Int J Oral Maxillofac Surg 2017; 46(3): 363–72.

Sandhu A, Sandhu S, Kaur T. Comparison of two different flap designs in the surgical removal of bilateral impacted mandibu-lar third molars. Int J Oral Maxillofac Surg 2010; 39(11): 1091–6.

Zhu J, Yuan X, Yan L, Li T, Guang M, Zhang Y. Comparison of Postoperative Outcomes Between Envelope and Triangular Flaps After Mandibular Third Molar Surgery: A Systematic Review and Meta-Analysis. J Oral Maxillofac Surg 2020; 78(4): 515–27.

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2024/03/29
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Vol. 81 Br. 03 (2024): Vojnosanitetski pregled
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