The Effect of Flap Design on Wound Healing after Periapical Surgery: A Comparative Study.

Abstract

Aims: To assess the clinical effect of different flap design that used in periapical surgery and their relation to untoward postoperative sequel. Materials and methods: Forty five patients were included in the present study, they were divided randomly into three groups, each comprised of (15) patients. In the first group, apicectomy was done using intrasulcular triangular (2-sided) flap. Whereas, in the second group, a submarginal (Luebke-Ochsenbein) scalloped 2-sided flap was used. While in the third group, a new experimental (straight mucogingival) 2-sided flap was tested. Postoperative healing was evaluated clinically in regard to oedema, alteration of soft tissue colour, recession of marginal gingiva, extent of scarring, and closure of the wound site. Assessment was done at 2, 7, 15 and 30 days postoperative intervals. Results: Comparison among the three study groups was performed. Statistical analysis revealed significant differences in the results of experimental flap over the other two types in regard to oedema, colour and wound closure with the superiority of the former on the latter flaps. Both experimental and Luebke-Ochsenbein flaps showed significant differences from intrasulcular incision in their effect on gingival recession. In contrast, scarring was less evident in intrasulcular flap followed by experimental flap while in Luebke-Ochsenbein incision, this complication was significant. Conclusion: This study; however, revealed that the experimental flap allows for rapid and recession free healing following periapical surgery. In addition, inflammatory changes persist for longer time in the intrasulcular and submarginal (Luebke-Ochsenbein) incision than in experemintal incision. So it was concluded that the new flap design could provide an alternative.