OBJECTIVE: The extraction of impacted mandibular third molars (M3Ms) often lead to postoperative complications, such as pain, swelling, and trismus. Flap design during surgery plays a critical role in determining the severity of these complications. This study aimed to compare the impact of 3 surgical flap types-modified triangular flap (MTF), modified envelope flap (MEF), and distal incision flap (DIF)-on surgery duration and postoperative complications. STUDY DESIGN: Patients aged 18 to 30 years with mesially/horizontally impacted M3Ms in class I, II and positions A and B from June 2023 to June 2024 were included. The primary predictor variable was the surgical flap type (MTF, MEF, or DIF), and the primary outcome variables were surgery duration and postoperative complications, including pain, swelling, and trismus. Covariates included patient demographics and M3M positions. Descriptive statistics, one-way analysis of variance (ANOVA), and Pearson correlation analyses were used, with significance set at P <
.05. RESULTS: A total of 135 patients were included. The DIF technique resulted in the shortest surgery duration and the lowest postoperative pain, swelling, and trismus on the third and seventh days. CONCLUSIONS: Although limited in its applicability, the DIF is a safe and effective technique, reducing surgery duration and postoperative complications. Long-term studies are needed to confirm these findings. (Oral Surg Oral Med Oral Pathol Oral Radiol YEAR
VOL:page range).