Int J Stomatol

Inter J Stomatol ›› 2019, Vol. 46 ›› Issue (2): 142-148.doi: 10.7518/gjkq.2019011

• Systematic Reviews • Previous Articles     Next Articles

Flap design associated pain after the extraction of mandibular third molars: a systematic review and Meta-analysis

Weilin Pan,Yubin Cao,Chang Liu,Jiyuan Liu,Chunjie Li,Jian Pan,Chengge Hua()   

  1. State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Dept. of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
  • Received:2018-09-17 Revised:2018-12-03 Online:2019-03-01 Published:2019-03-15
  • Contact: Chengge Hua E-mail:huacg@163.com
  • Supported by:
    This study was supported by Key Research Project of Sichuan Province(2018SZ0181)

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Abstract:

Objective This review aimed to assess the effects of flap design on pain after the extraction of mandibular third molars. Methods Nine databases were searched electronically on 29 June 2018. A manual search of reference lists of included studies was conducted. Two reviewers performed quality assessment independently with tools suggested by Cochrane’s handbook, and then, they extracted data. Meta-analysis was performed using Review Manager 5.3. Results Seventeen studies with 1 033 participants and 1 421 teeth were included. Among these studies, one was at high risk of bias, whereas the risk in the other 16 was unclear. The postoperative pain of envelope flap was milder than that of standard triangular flap, and the difference was statistically significant. No significant difference was found in postoperative pain between envelope flap and Szmyd flap. Conclusion Envelope flap and Szmyd flap can be more effective in reducing the postoperative pain of patients than standard triangular flap.

Key words: third molar, tooth extraction, Meta-analysis, pain, surgical flaps

CLC Number: 

  • R782.1

TrendMD: 

Tab 1

Characteristics of included studies"

研究 方法 纳入人数（牙数） 评估人数（牙数） 干预措施 结局指标VAS
研究类型 地区
Abandansari和Foroughi[6] 口内自身对照RCT 伊朗 20（40） 20（40） 标准封套瓣;标准三角瓣 第2天VAS,没有标准差*
Baqain等[11] 口内自身对照RCT 约旦 20（40） 19（38） 标准封套瓣;Szmyd瓣 第2天VAS
Erdogan等[12] 口内自身对照RCT 土耳其 20（40） 20（40） 标准封套瓣;标准三角瓣 第3天VAS
Goldsmith等[9] 口内自身对照RCT 新西兰 57（114） 42（84） 蒂状瓣;标准封套瓣 第1~4天平均VAS*
何锦泉等[13] 平行对照RCT 中国 400（400） 372（372） 线形瓣;Szmyd瓣 第3天VAS
Kim等[14] 口内自身对照RCT 韩国 30（60） 27（54） Kruger封套瓣;无翻瓣设计 第2天VAS
Kirk等[15] 口内自身对照RCT 新西兰 35（70） 32（64） 标准封套瓣;Szmyd瓣 第2天VAS
Korkmaz等[16] 口内自身对照RCT 土耳其 28（56） 28（56） 标准封套瓣;标准三角瓣 第2天VAS
Koyuncu等[17] 平行对照RCT 土耳其 80（80） 80（80） 标准封套瓣;Szmyd瓣 第2天VAS
Koyuncu等[18] 口内自身对照RCT 土耳其 40（80） 36（72） 刺刀形瓣;Szmyd瓣 第2天VAS
Mobilio等[10] 平行对照RCT 意大利 25（25） 25（25） 标准封套瓣;标准三角瓣 最大VAS*
Nageshwar[7] 平行对照RCT 印度 100（100） 100（100） 逗号形瓣;标准封套瓣 第3天VAS,没有标准差*
乔峰和朱东望[19] 口内自身对照RCT 中国 60（120） 52（104） 标准封套瓣;Szmyd瓣 第2天VAS
Roode和Bütow[8] 口内自身对照RCT 南非 36（72） 33（66） 线形瓣;Szmyd瓣 第2天VAS,没有标准差*
Sandhu等[5] 口内自身对照RCT 印度 20（40） 20（40） 刺刀形瓣;标准封套瓣 VAS的等级资料*
Tareen等[20] 平行对照RCT 巴基斯坦 40（40） 40（40） Kruger封套瓣;标准三角瓣 第2天VAS
Yolcu和Acar[21] 口内自身对照RCT 土耳其 22（44） 22（44） 舌向瓣;Szmyd瓣 第2天VAS

Tab 2

Risk of bias summary"

研究 随机方法 分配隐藏 实施盲法 测量盲法 数据完整 报道偏倚 其他偏倚 整体评价
Abandansari和Foroughi[6] 1 1 1 2 2 2 2 1
Baqain等[11] 2 1 1 1 2 2 2 1
Erdogan等[12] 1 1 2 1 2 2 2 1
Goldsmith等[9] 1 1 1 1 0 2 2 0
何锦泉等[13] 1 1 1 1 2 2 2 1
Kim等[14] 2 1 1 2 2 2 2 1
Kirk等[15] 1 1 1 1 2 2 2 1
Korkmaz等[16] 2 1 1 2 2 2 2 1
Koyuncu等[17] 1 1 1 2 2 2 2 1
Koyuncu等[18] 1 1 1 1 2 2 2 1
Mobilio等[10] 1 1 1 1 2 2 2 1
Nageshwar[7] 1 1 1 1 2 2 2 1
乔峰和朱东望[19] 2 1 2 2 1 2 2 1
Roode和Bütow[8] 2 1 1 1 2 2 2 1
Sandhu等[5] 1 1 2 2 2 2 2 1
Tareen等[20] 1 1 1 1 2 2 2 1
Yolcu和Acar[21] 1 1 1 2 2 2 2 1

Fig 1

Envelope flap verus other flaps"

Fig 2

Szmyd flap verus non-envelope flap"

Fig 3

Flap designs"

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