Can flap design influence the incidence of alveolar osteitis following removal of impacted mandibular third molars?

This study sought to evaluate the influence of flap design (that is, modified triangular flap or buccal envelope flap) on alveolar osteitis (AO) and on healing following the surgical removal of an impacted mandibular third molar. A double-blind split-mouth clinical trial examined 17 patients who were candidates for extraction of a bilaterally impacted mandibular third molar with the same difficulty index; a modified triangular flap was placed on one side and a buccal envelope flap (control) was placed on the other side. AO and healing were assessed at three and seven days after surgery. Data were analyzed with the McNemar and Wilcoxon signed-rank tests. The modified triangular flap decreased the incidence of AO and expedited healing at seven days postsurgery. In addition, statistically significant differences were observed in terms of both AO and postoperative healing.