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Ab s t r Ac t Aim: To evaluate a new flap design that is a modification of an envelope flap in reducing the postoperative complications and to compare it with the conventional flaps such as a bayonet flap and an envelope flap for the surgical removal of impacted mandibular third molars. Materials and methods: A prospective randomized control clinical study was conducted on 90 medically healthy patients who came with impacted mandibular third molars. The patients were randomly divided into group I, group II, and group III of 30 patients each. All three group patients underwent surgical removal of impacted mandibular third molars wherein for group I patients, a bayonet flap was raised, for group II a modified envelope flap (new flap design), and for group III an envelope flap was raised. Postoperative pain and swelling at day 1, 3, and 7 were assessed and compared. Data were analyzed with ANOVA, using SPSS software version 20. Results: The group II proved more successful in reducing the postsurgical sequelae of impacted third molar removal. Postoperative analysis showed increased amount of pain and swelling in groups I and III as compared to group II. Conclusion: The new design flap that is a modification of an envelope flap is more superior to other two conventional techniques. Clinical significance: The new flap design is useful in reducing postoperative pain and swelling, which is the most common sequel of surgical removal of the impacted third molar and is easy to practice.

Comparison of New Flap Design with Conventional Flap Designs on Postoperative Pain and Swelling Following Mandibular Third Molar Removal