Comparative Study Between Standard Ward’s Incision and Coma Shaped Incision and its Postoperative Outcome on Impacted Mandibular Third Molars Extraction in Bangladeshi Population

Mostafa Md Anisuzzaman,Alia Afrin,Mohammad Khursheed Alam

doi:10.4034/pboci.2019.191.66

Abstract

Objective: To evaluate the postoperative outcome in standard Comma Shaped incision and Ward’s incision on postoperative complications in surgical removal of impacted mandibular third molar. Material and Methods: In this study, 100 patients with impacted mandibular third molar were selected for study. The patients were divided in to two groups. Each group contains 50 patients. A standard Ward’s incision was made on one group and a Comma incision was made on another group to reflect the mucoperiosteal flap, after the common steps for removal of impacted third molars were followed. The postoperative parameters were recorded immediately on the postoperative days 1, 3 and 7. For bivariate analyses, Chi square and Student t test were used. The significance level was set at 5%. Results: The pain and swelling scores were found to be significantly lower in the surgical area with Comma incisions, which was recorded on days 1, 3 and 7 as compared to the area where standard Ward’s incision were made. In mouth opening, there was a sufficiently great difference seen between the two incisions on first postoperative day, but on day 3 and 7 there was no statistical significance. Conclusion: the Comma Shaped incision design was preferable over the standard Ward’s incision, considering the lesser degree of postoperative complications.

Highlights

Impaction is defined as cessation of the eruption of a tooth caused by a clinically or radiographically detectable physical barrier in the eruption path or by ectopic position of the tooth at least one impacted third molar will be present in 33% of the population which requires surgical removal of impacted third molar disimpaction is the one of the most frequently performed procedure [1]
Material and Methods: In this study, 100 patients with impacted mandibular third molar were selected for study
A standard Ward’s incision was made on one group and a Comma incision was made on another group to reflect the mucoperiosteal flap, after the common steps for removal of impacted third molars were followed

Summary

Introduction

Impaction is defined as cessation of the eruption of a tooth caused by a clinically or radiographically detectable physical barrier in the eruption path or by ectopic position of the tooth at least one impacted third molar will be present in 33% of the population which requires surgical removal of impacted third molar disimpaction is the one of the most frequently performed procedure [1]. Lower third molars constitute a major bulk of teeth that are impacted in the oral cavity [2]. Many series of side effects will be produced with the extraction of impacted lower third molar which including pain, swelling, inflammation, and trismus [3]. Sometimes, impacted mandibular third molar teeth don’t cause any problems, and the only way the oral surgeon knows they are impacted is from examining the routine dental x-ray. As the age of the person progresses, they can stimulate varied problems such as pain in affected side of jaw (unilateral or bilateral), swelling, pericoronitis, difficulty in mouth opening etc. Flap design is important to allow good visibility, reach to the impacted tooth, and for healing of the surgically created defect. Many different incisions have been used to raise the flap, like Ward’s incision, modified Ward’s incision, envelope, ‘S’-shaped incision (Bould Henry) etc [6]

Methods

Results

Conclusion