Marginal flap versus paramarginal flap in impacted third molar surgery: a prospective study.

A clinical prospective study was carried out to compare 2 flap designs-marginal and paramarginal-that are used during impacted third molar surgery. Twenty-seven healthy patients (ages 17 to 31 years) who underwent surgical removal of 4 impacted third molars, including 54 lower and 54 upper, were included. A marginal flap was used in 1 randomly chosen half of the jaw, and a paramarginal flap was used in the other half. The influence of these flaps on wound healing, periodontal pocket depth of the adjacent second molar, pain, trismus, and swelling was studied. Wound dehiscences developed in 8 paramarginal flap cases, whereas none occurred with the use of a marginal flap. The buccal and distal probing depths of the adjacent second molar were significantly bigger in marginal flaps at 5 and 10 days after surgery. However, the probing depth was similar with the use of both techniques at 3 months. Pain, trismus, and swelling were similar with both techniques. We found no advantages to the use of a paramarginal flap instead of a traditional marginal flap for removing impacted third molars.