A Comparison of Postoperative Healing between Two Different Flaps for 3rd Molar Surgery in Controlled Diabetic Patients

Background: A flap is a unit of tissue that is transferred from donor site to recipient site while maintaining its own blood supply. Flaps are of various shapes and forms. They can be simple advancements of skin and range up to composites of many different types of tissue. Diabetes Mellitus is a metabolic disease where there is significant elevation of blood glucose level from the normal range for prolonged periods of time. The common signs and symptoms are, frequent urination, increased thirst, increased appetite, lethargy, infections, delayed healing of wounds. The complications of surgical procedures on diabetic patients are: delayed healing, wound dehiscence and decreased immunity, thus increased incidence of infection in the surgical site. Complications of intra-oral surgical procedures include delayed healing, wound dehiscence, bone loss, periodontal derangement of teeth, infection, xerostomia causing more caries, failure of flap due to decreased vascularity.

Aims and Objectives: The study aimed to answer whether Envelope Flap is better than Triangular Flap or vice versa for a mandibular 3rd molar surgery. To examine the complications of choosing a specific flap design in a minor oral surgery in patients with higher susceptibility to infection due to systemic condition, which is controlled Diabetes Mellitus.

Materials and Methods: This study was conducted on 20 patients, who were taken from the out-patient of Department of Oral and Maxillofacial Surgery, Sree Balaji Dental College and Hospital, Chennai. On one side which was picked randomly for all patients, the Triangular flap was used. On the other side, the Envelope flap was used.

Conclusion: The statistical analysis P value > 0.05, which shows that the difference in post operative healing between the two flaps discussed is statistically insignificant. Thus, statistically both flaps are a viable option and both show similar results, although clinically envelope flap shows better overall results.