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Clinical Wound Healing After Lower 3rd Molar Fully-impacted Surgery With 2 Types of Flap

Not Applicable
Conditions
Quality of Life
Wound Heal
Dehiscence
Interventions
Procedure: lower third molar extraction
Registration Number
NCT04314765
Lead Sponsor
University of Roma La Sapienza
Brief Summary

The dehiscence distal to the second molar after lower third molar extraction is very common because the access flap for surgical extraction cannot be repositioned on a portion of healthy bone to guarantee suture support. The healing process is therefore delayed and the possible accumulation of food and debris is often responsible for bad smell and pain with the consequent occurrence of an overlapping infection.

The main aim of the study is to evaluate whether healing is significantly different using two different flaps for surgical access. Clinical assessment and a quality of life questionnaire are used for the evaluation.

Detailed Description

Not available

Recruitment & Eligibility

Status
UNKNOWN
Sex
All
Target Recruitment
56
Inclusion Criteria
  • fully-impacted lower third molar
  • patients aged between 18 and 35
Exclusion Criteria
  • patients undergoing drug treatment for systemic diseases that can influenced the healing process,
  • pregnant women,
  • smoking habits
  • patients with disabilities
  • all interventions in which intraoperative accidents involving the soft tissues occurred (laceration of the mucosa / flap).

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
envelope flaplower third molar extractionEnvelope flap is performed to extract the the lower third molar
bayonet flaplower third molar extractionBayonet flap is performed to extract the the lower third molar
Primary Outcome Measures
NameTimeMethod
wound healing day 1414 days after surgery

a clinical chart is complete to evaluate if in the group of lower third molar extracted with a bayonet flap the proportion of healing without dehiscence (good healing index) is significant greater than in the group of third molar extracted with an envelope flap.

wound healing day 22 days after surgery

a clinical chart is complete to evaluate if in the group of lower third molar extracted with a bayonet flap the proportion of healing without dehiscence (good healing index) is significant greater than in the group of third molar extracted with an envelope flap.

wound healing day 77 days after surgery, at suture removal

a clinical chart is complete to evaluate if in the group of lower third molar extracted with a bayonet flap the proportion of healing without dehiscence (good healing index) is significant greater than in the group of third molar extracted with an envelope flap.

Secondary Outcome Measures
NameTimeMethod
quality of life day 22 days after surgery

the patient complete a HRQOL questionnaire (modify from Shugars DA et al 1996) to evaluate if differences exist in the patient's quality of post-operative life in relation with two types of flap; we use visual analog scales (VAS) for post-operative pain and five-points Likert-Type for swelling, chewing, speaking, sleeping, sport and daily routine activity; higher scores mean a worse outcome.

quality of life day 1414 days after surgery

the patient complete a HRQOL questionnaire (modify from Shugars DA et al 1996) to evaluate if differences exist in the patient's quality of post-operative life in relation with two types of flap; we use visual analog scales (VAS) for post-operative pain and five-points Likert-Type for swelling, chewing, speaking, sleeping, sport and daily routine activity; higher scores mean a worse outcome.

Pell & Gregory classintra-operative

on orthopantomography

tooth positionpre-operative

on orthopantomography

quality of life day 55 days after surgery

the patient complete a HRQOL questionnaire (modify from Shugars DA et al 1996) to evaluate if differences exist in the patient's quality of post-operative life in relation with two types of flap; we use visual analog scales (VAS) for post-operative pain and five-points Likert-Type for swelling, chewing, speaking, sleeping, sport and daily routine activity; higher scores mean a worse outcome.

quality of life day 77 days after surgery, at suture removal

the patient complete a HRQOL questionnaire (modify from Shugars DA et al 1996) to evaluate if differences exist in the patient's quality of post-operative life in relation with two types of flap; we use visual analog scales (VAS) for post-operative pain and five-points Likert-Type for swelling, chewing, speaking, sleeping, sport and daily routine activity; higher scores mean a worse outcome.

dehiscence14 days after extraction

a clinical chart is complete to evaluate if the presence of the dehiscence makes differences in surgical wound healing

pre-operative symptomspre-operative

the presence or not of pre operative Symptoms

interincisive heightpre-operative

the distance between upper and lower central incisors

type of impactionpre-operative

on orthopantomography

Partial Plaque Scorepre-operative

Partial plaque score was recorded dichotomously (presence/absence of plaque) on six sites per tooth in the arch of extraction and was then calculated as the percentage of total tooth surfaces that revealed the presence of plaque; an higher percentage means higher presence of plaque

Full Mouth Plaque Scorepre-operative

Full-mouth plaque score was recorded dichotomously (presence/absence of plaque) on six sites per tooth and was then calculated as the percentage of total tooth surfaces that revealed the presence of plaque; higher percentage mean higher presence of plaque

depth of impactionpre-operative

on orthopantomography

description root morphologypre-operative

on orthopantomography; apical anomalies yes/no

description of relationship with the second molarpre-operative

on orthopantomography; no contact/contiguity/overlap

duration of surgeryintra-operative

extraction and suture

description number of rootspre-operative

on orthopantomography; 1/2/3/more than 3

quantity of keratinized gingivapre-operative
maximum diameter of the bone cavityintra-operative
probing depth distal to the second molarpre-operative
position of the gingiva with respect to the CEJ (cemento-enamel junction) of the second molarpre-operative
maximum depth of the bone cavityintra-operative

maximum depth of the bone cavity with respect to the CEJ of the second molar

position of the gingivaintra-operative

position of the gingiva after the suture with respect to the CEJ (cemento-enamel junction) of the second molar

Trial Locations

Locations (1)

Pippi Roberto

🇮🇹

Roma, Italy

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