Frenectomy: a review with the reports of surgical techniques

Abstract

The frenum is a mucous membrane fold that attaches the lip and the cheek to the alveolar mucosa, the gingiva, and the underlying periosteum. The frena may jeopardize the gingival health when they are attached too closely to the gingival margin, either due to an interference in the plaque control or due to a muscle pull. In addition to this, the maxillary frenum may present aesthetic problems or compromise the orthodontic result in the midline diastema cases, thus causing a recurrence after the treatment. The management of such an aberrant frenum is accomplished by performing a frenectomy.The present article is a compilation of a brief overview about the frenum, with a focus on the indications, contraindications, advantages and the disadvantages of various frenectomy techniques, like Miller's technique, V-Y plasty, Z-plasty and frenectomy by using electrocautery. A series of clinical cases of frenectomy which were approached by various techniques have also been reported.

Keywords: Frenectomy; Frenum; Mucogingival techniques.

[Table/Fig-1]

Pre-operative papilla type of frenal attachment

[Table/Fig-2]

Frenum held with hemostat

[Table/Fig-3]

Frenum excised

[Table/Fig-4]

Sutures placed

[Table/Fig-5]

One month post-operative

[Table/Fig-6]

Pre-operative attached type of frenal attachment

[Table/Fig-7]

Frenum excised

[Table/Fig-8]

Lateral pedicle graft obtained

[Table/Fig-9]

Graft sutured across the midline

[Table/Fig-10]

2 weeks post-operative

[Table/Fig-11]

Pre-operative attached type of frenal attachment

[Table/Fig-12]

Incision given through the frenum

[Table/Fig-13]

Incision given at both ends of the frenum to obtain 2 triangular flaps

[Table/Fig-14]

Flaps transposed across the midline sutured in the form of Z

[Table/Fig-15]

1 month post-operative

[Table/Fig-16]

Pre-operative papilla type of frenal attachment

[Table/Fig-17]

Frenum held with hemostat

[Table/Fig-18]

Frenum incised by V-shaped incision

[Table/Fig-19]

V-shaped incision sutured in the form of Y

[Table/Fig-20]

1 month post operative

[Table/Fig-21]

Pre-operative attached type of frenal attachment

[Table/Fig-22]

Frenum held with hemostat and excised with a loop electrode

[Table/Fig-23]

Excision of frenum completed with no requirement for suture placement

[Table/Fig-24]

1 month post operative