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. 2020 Jul 26;2020(7):CD004345. doi: 10.1002/14651858.CD004345.pub3

Mohajerani 2018.

Study characteristics
Methods Study design: split‐mouth RCT
Conducted in: Iran, 2016
Participants Inclusion criteria: adult patients had indication of impacted wisdom molar removal
Exclusion criteria: patients were excluded from the study if any of following conditions were observed
  • Presence of periapical acute or chronic inflammation

  • Presence of systemic problems

  • Pregnancy

  • Emergence of a special problem during surgery

  • Follow‐up missing during re‐examination

  • Presence of prescription for not using any particular flap

  • Presence of neurological diseases

  • Unreliable patients


Age: mean 20.1 years (between 17 and 24 years)
Number randomised: 31
Number evaluated: 28
Interventions Envelope flap versus modified triangular flap
Group A (n = 28 sites): envelope flap
Group B (n = 28 sites): modified triangular flap
All procedures performed under local anaesthesia.
All participants were given amoxicillin (500 mg/8 hours) for 7 days and codeine/paracetamol (10 mg/325 mg) every 6 hours for pain relief.
Outcomes Alveolar osteitis; healing degree
Notes 3 participants were excluded due to poor co‐operation with follow‐up.
Risk of bias
Bias Authors' judgement Support for judgement
Random sequence generation (selection bias) Unclear risk Comment: the method of randomisation is unspecified
Allocation concealment (selection bias) Unclear risk Comment: the method of allocation concealment is unclear
Blinding (performance bias and detection bias)
patient Low risk Participants were unlikely to know the differences between procedures.
Blinding (performance bias and detection bias)
assessor Low risk Comment: study is double‐blinded. The surgeon informed the examiner (evaluator) only about the area of surgery and the code of the treatment group designated to that side, and the patient and evaluator were not aware of which side had EF.
Incomplete outcome data (attrition bias)
All outcomes Unclear risk Comment: 3 participants were excluded by the research team because of their poor co‐operation
Selective reporting (reporting bias) Low risk All planned outcomes were reported.
Other bias Low risk It seems that both surgeries were done on the same day; however, pain and trismus were not considered.