Lingual Based Four Cornered Flap for Third Molar Surgery.

PURPOSE: The aim of this prospective randomized clinical study was to compare the efficacy of lingual based four cornered flap with the commonly used triangular flap for impacted third molar surgery.

METHODS: Ten patients with bilateral impacted third molars were randomly treated under local anaesthesia, one side with triangular flap and single layer closure (with 3-0 silk) and other side by raising lingual based four cornered flap and double layer closure, subcutaneously with 5-0 vicryl and mucosa with 3-0 silk. All patients were operated by single surgeon (A. Rai) and suture removal was done after 7 days.

RESULTS: Healing by primary intension takes place when lingual flap and double layer suturing was done, also the patients had less pain, swelling and alveolar osteitis. The visibility was excellent with lingual flap and pocket formation distal to second molar was also less. The only drawback with lingual flap is that it required little less time in comparison to triangular flap.

CONCLUSION: The lingual based four cornered flap is better than the triangular flap.