This randomized controlled trial evaluates postoperative pain and facial swelling following surgical removal of partially impacted mandibular third molars using flap versus flapless techniques. The aim is to determine which method results in lower postoperative morbidity on the second postoperative day.

Impacted mandibular third molars frequently require surgical extraction, often involving mucoperiosteal flap elevation and bone removal. These steps may contribute to postoperative complications such as pain, swelling, and trismus. Minimally invasive alternatives, including flapless extraction, aim to reduce surgical trauma.

This study compares postoperative pain and swelling after flap versus flapless techniques in patients with partially impacted mesioangular mandibular third molars. Pain will be assessed using a 10-point Visual Analogue Scale (VAS), and swelling will be measured using standardized anthropometric facial measurements. A total of 160 participants will be randomized into two equal groups. All procedures will be performed by a single surgeon to reduce bias.

Inclusion Criteria:

• Age 18-45 years

  • Either gender
  • Partially impacted mesioangular mandibular third molar confirmed clinically and radiographically
  • Second episode of pericoronitis
  • Swelling present on the affected side
  • No bone recession or periodontal disease on radiograph

Exclusion Criteria:

• HIV or HBV infection

  • Diabetes or other metabolic disorders
  • Bleeding disorders including von Willebrand disease, thalassemia, hemophilia, thrombocytosis, or thrombocytopenia
  • Periapical infection or acute pericoronitis at time of surgery
  • Severe trismus
  • Immunocompromised status