Purpose: The purpose of this study was to compare the effect of two different flap designs on surgical removal of impacted mandibular third molars.

Methods: Four hundred patients who required removal of impacted mandibular third molars were included in the study. They were divided into group A and group B randomly. Patients in group A received distal incision flap and group B underwent angular incision flap. The effect of flap design on surgical time, incidence of dry socket, pain, swelling and trismus was evaluated postoperatively. Data analysis was carried out with SPSS 13.0 software package.

Results: The surgical time was longer in group A than in group B 3 days postoperatively. Facial swelling and trismus were less in group A than in group B 3 days postoperatively. There was no significant difference in two groups 7 days postoperatively.

Conclusions: The distal incision flap design can release facial swelling and trismus in surgical removal of impacted mandibular third molars.

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