The present study aimed to assess the effect of different flap designs on pain, swelling and trismus following surgical removal of impacted mandibular third molar. The study was carried out in Oral and Maxillofacial Department, Dental Teaching Hospital of Dentistry College, Mosul University. Sixty patients were included in the research where they were divided into 4 groups, each comprised of 15 patients. In the first group, the impacted teeth were removed using an envelope flap. In the second

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... oup, a standard flap was used for the removal of impacted teeth. For the third group, the impacted teeth were removed using modified standard flap. While in the fourth group, S-shaped flap was used. Pain, swelling and trismus were assessed clinically post-operatively at 1 day, 3 days and 7 days intervals. Pain and swelling were evaluated subjectively while trismus was evaluated by measuring the maximum mouth opening ability (in mm) between the right upper and right lower central incisors using a vernier. The results showed no significant effect among the 4 flap designs on post-operative complaints. It was concluded that the type of incision appears to have no effect on the degree of pain, swelling and trismus following surgical removal of impacted lower third molar.