Assessment of Post Operative Swelling Among Patients Following Extraction of Impacted Third Molars

NCT07655089 | Not Yet Recruiting

• 1 other identifier: DSG-2022-024-4359
• Study Type: interventional
• Target: 116
• Locations: 0 countries
• Sites: N/A

Brief Summary

This randomized controlled trial aims to compare Ward's incision and Comma incision regarding postoperative swelling following extraction of impacted mandibular third molars. Secondary outcomes include pain and bleeding assessed 48 hours after surgery. The findings will help identify the incision technique associated with better postoperative outcomes

Conditions

Post Operative Swelling

Keywords

Impacted Mandibular Third Molar; Swelling,; Oral Surgery

Outcome Measures

Primary Outcomes (2)

• Postoperative Swelling

  Degree of postoperative swelling assessed using a Visual Analog Scale (VAS) ranging from 0 to 5, where 0 indicates no swelling and 5 indicates extremely severe swelling following extraction of impacted mandibular third molars

  48 hours after surgery

• Postoperative Swelling

  Degree of postoperative swelling assessed 48 hours after extraction of impacted mandibular third molars using a Visual Analog Scale (VAS) ranging from 0 to 5, where 0 indicates no swelling and 5 indicates extremely severe swelling.

  48 hours after surgery

Study Arms (2)

Ward's Incision Group

EXPERIMENTAL

Standard Ward's incision with mucoperiosteal flap elevation for extraction of impacted mandibular third molar.

Procedure: Ward's Incision; Procedure: Comma Incision

Comma Incision Group

ACTIVE COMPARATOR

Comma incision flap design for extraction of impacted mandibular third molar.

Procedure: Ward's Incision; Procedure: Comma Incision

Interventions

Ward's Incision PROCEDURE

Patients allocated to Group A will undergo extraction of impacted mandibular third molars using Ward's incision. Depending on the degree of impaction, a sulcular incision will be made from the mesiobuccal aspect of the first or second molar extending distally. A relieving incision will be placed mesially without severing the interdental papilla, followed by a distal releasing incision on the mandibular ramus. A full-thickness mucoperiosteal flap will then be elevated to facilitate tooth extraction.

Comma Incision Group; Ward's Incision Group

Comma Incision PROCEDURE

Patients allocated to Group B will undergo extraction of impacted mandibular third molars using the Comma incision technique. The incision will begin below the second molar and extend to its distobuccal line angle, then curve smoothly upward to the gingival crest. The incision will continue as a crevicular incision around the distal aspect of the second molar. A distolingually based flap will be elevated to provide adequate exposure for extraction of the impacted third molar.

Comma Incision Group; Ward's Incision Group

Eligibility Criteria

• Age: 18 Years - 65 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Patients with no periodontal pathology related to the involved tooth on clinical examination.

You may not qualify if:

• Patients with congenital or acquired bleeding disorders. Patients with any bony lesion adjacent to the impacted third molar. Medically immunocompromised patients.

Sponsors & Collaborators

• College of Physicians and Surgeons Pakistan: lead

Related Publications (1)

• Sayed N, Bakathir A, Pasha M, Al-Sudairy S. Complications of Third Molar Extraction: A retrospective study from a tertiary healthcare centre in Oman. Sultan Qaboos Univ Med J. 2019 Aug;19(3):e230-e235. doi: 10.18295/squmj.2019.19.03.009. Epub 2019 Nov 5.

  PMID: 31728221 RESULT

Central Study Contacts

Fatima Khattak Khattak

CONTACT

03315125534; fatimakhattak32@gmail.com

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: CARE PROVIDER
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Principal investigator, Department of Operative Dentistry

Study Record Dates

• First Submitted: June 6, 2026
• First Posted: June 17, 2026
• Study Start: July 5, 2026
• Primary Completion (Estimated): August 5, 2026
• Study Completion (Estimated): August 5, 2026
• Last Updated: June 17, 2026

Record last verified: 2026-06