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NCT Number: NCT07655089

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

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

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Key information

Conditions

Post Operative Swelling

Age range

18 year–65 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

Patients aged 18-50 years. Male and female patients. Patients undergoing extraction of impacted mandibular third molars irrespective of angulation as evaluated radiographically.

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

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Exclusion criteria

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

Treatment and study plan

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

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.

Primary outcomes

  1. Postoperative Swelling

    Time frame: 48 hours after surgery

    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

  2. Postoperative Swelling

    Time frame: 48 hours after surgery

    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.

Study contacts

Contact information is provided by the study sponsor or research team.

Fatima Khattak Khattak

CONTACT

[email protected]

03315125534

Sponsors and collaborators

Lead sponsor

College of Physicians and Surgeons Pakistan

Other

Registry information

Acronym: APOSTM

Important dates

Study start
2026
Primary completion
2026
Study completion
2026
First posted
Jun 17, 2026
Registry last updated
Jun 17, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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