Comparison of Electrocautery and Scalpel Blade Incisions of Impacted Mandibular Third Molars

Surgical extraction of impacted mandibular third molars is one of the most common procedures in oral and maxillofacial surgery. The type of incision used may influence postoperative outcomes, including pain, bleeding, and wound healing. Electrocautery offers simultaneous cutting and coagulation, potentially reducing intraoperative blood loss and improving surgical visibility, whereas scalpel incisions produce precise tissue cuts without thermal injury.

This prospective, two-arm, parallel-group, randomized controlled trial will compare electrocautery and scalpel blade incisions in patients undergoing surgical extraction of impacted mandibular third molars. Seventy-eight participants will be randomly assigned to either Arm A (scalpel blade incision) or Arm B (electrocautery incision). All other surgical and perioperative variables, including local anesthesia, flap design, irrigation, suture material, and postoperative medications, will be standardized.

The primary outcome is postoperative pain assessed using a Visual Analogue Scale at 24 hours, 48 hours, and 7 days. Secondary outcomes include intraoperative blood loss and wound healing assessed using the Landry Wound Healing Index at 1 and 4 weeks. The findings of this study will provide evidence regarding the most appropriate incision technique for impacted mandibular third-molar surgery.

Inclusion criteria

• Male and female patients.
• Age 15 to 65 years.
• Patients requiring surgical extraction of an impacted mandibular third molar. Patients classified as ASA I or ASA II.
• Patients willing to provide written informed consent, or assent with parent/guardian permission where applicable, and attend scheduled follow-up visits

Exclusion criteria

• * Patients with uncontrolled systemic disease or immuno-compromised status.

• Patients with bleeding disorders or those taking anticoagulant/antiplatelet drugs that cannot be safely withheld according to physician advice.
• Patients with pacemaker or implanted electrical cardiac device.
• Pregnant or lactating patients.
• Patients with acute infection, pericoronitis, facial space infection, or pus discharge at the surgical site at the time of surgery.
• Patients requiring bilateral third-molar extraction in the same sitting.
• Patients unwilling to participate or unable to return for follow-up.