Desenho da incisão na exodontia terceiros molares

: uma revisão sistemática

Abstract

Introduction: The extraction of mandibular third molars (3MM) is one of the most frequently performed procedures in oral surgery, often requires due to lack of space, pain, infection, orthodontic or preventive reasons. Incision design is a fundamental technical factor and choosing the appropriate technique might influence the postoperative outcome. The main objective of this systematic review is to evaluate the influence of incision design on postoperative outcomes following 3MM extraction. Specific objectives include the analysis of intra- and postoperative variables such as surgical time, pain, swelling, trismus, healing, periodontal status of the adjacent second molar (2M) and quality of life, according to the type of incision used. Materials and Methods: A search was conducted in the PubMed, Scopus, and Web of Science databases using the MeSH terms: “third molar,” “third molars,” and “surgical wound,” in accordance with PRISMA guidelines. The risk of bias was assessed using the Cochrane RoB2 tool. Only randomized clinical trials published in English, French, or Portuguese since 2004 were included. Results: A total of 460 articles were identified in the scientific databases. After a rigorous screening process, 15 studies met the inclusion criteria and were analyzed. Data on pain, swelling, trismus, periodontal status of the 2M, healing, surgical time, and quality of life were extracted and compared across different incision designs. Conclusion: The incision design in 3MM extraction influences postoperative complications, especially in the first days after surgery. Less invasive techniques, such as the MIEF, comma-shaped, or para-marginal incisions, are often associated with reduced pain, improved healing, and less impact on the periodontal status of the adjacent 2M and on patient quality of life. However, methodological variability and the influence of other clinical factors highlight the need for individualized approaches and further studies with standardized protocols.

Date of Award	11 Jul 2025
Original language	Portuguese
Awarding Institution	Universidade Católica Portuguesa
Supervisor	Bruno Almeida (Supervisor) & Tiago Borges (Co-Supervisor)