Background: Nowadays, various standards have been proposed for the impacted inferior 3rd molar extraction. However, there are conflicting data on the effect of the surgical removal of Ms3, with varying outcomes for post-operative re-injury and patient comfort.

Objective: To compare the innovative surgical technique for the removal of impacted inferior third molars (iMs3).

Methods: This strategy was evaluated using a randomised, split-mouth controlled clinical trial, adhering to the CONSORT standards. We compared the revolutionary single incision access (SIA) with flapless surgical approach (FSA). The main objective of the study was to assess the rate at which the 3rd molar extraction site healed. The secondary outcomes included the measures of gum health such as pocket probing depth (PPD) and attached gingiva as well as the occurrence of discomfort (pain) and edoema. The research was conducted on a sample of 74 teeth extracted from 37 individuals who presented with bilateral impaction of the third molars.

Results: The cohort consisted of 47% Caucasian males and 53% Caucasian females, with an average age of 31.5±8.1 years. A notable disparity in the rate of recovery and wound healing was seen between the side treated with SIA (29.4±3.7 days) and the side treated with FSA (40.5±4.5 days; p<0.05). PPD was substantially lower on day 45 after surgery compared to baseline (p<0.05). Likewise, attached gingiva substantially increased from baseline to comparison (p<0.05). Both the single incision access strategy and the flapless surgical procedure had similar effects. Oedema and pain were comparable in both the surgery groups.

Conclusion: FSA and SIA techniques were comparable in improving the healing time following 3rd molar extraction. The data suggested the early post-surgical enhancements in connected gingiva, as well as the reduction in oedema and discomfort.