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Case Reports
. 2024 Jan 8;16(1):e51853.
doi: 10.7759/cureus.51853. eCollection 2024 Jan.

Management of Aberrant Frenum by Z-plasty Procedure: A Case Report

Pavan Bajaj  1 , Unnati Shirbhate  1 , Chitrika Subhadaresanee  1 , Shivani Thakre  1
Affiliations
Case Reports

Management of Aberrant Frenum by Z-plasty Procedure: A Case Report

Pavan Bajaj et al. Cureus. .

Abstract

During or after the orthodontic closure, persistent diastemas are frequently the result of a high frenum attachment. A labial frenectomy is a complete removal of the frenum attachment, which typically attaches to the space between the upper two anterior teeth and the centre of the upper lip. It might be required if there is space between the teeth due to a frenulum positioned too high on the gums. Many surgical technique modifications, including Miller's technique, Z-plasty, and V-Y-plasty, have been established since the conventional classical frenectomy procedure was initially presented to cope with the difficulties associated with an aberrant labial frenum. This case report demonstrates that a Z-plasty approach was used to remove the 21-year-old female patient's high papillary-type labial frenum attachment and how orthodontic treatment led to the closure of the midline diastema. For several reasons, the frenectomy procedure with Z-plasty proved to be reliable and yielded outstanding aesthetic outcomes for the removal of the aberrant labial frenum connection. Understanding Z-plasty will enable primary intention-based tissue healing, reduce the risk of tissue contractures, shorten the patient's recovery, and enhance the patient's aesthetic outcomes.

Keywords: frenectomy; frenum; midline diastema; mucogingival problems; ortho-perio; periodontal; plastic surgery; z-plasty.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Pre-operative view of high labial papillary type frenal attachment.
Figure 2
Figure 2. Z-shaped incision was made by two lateral horizontal incisions and one vertical incision.
Figure 3
Figure 3. Diagrammatic representation of the Z-plasty frenectomy design.
Figure Credit: Author Unnati Shirbhate
Figure 4
Figure 4. Two flaps were relocated to the side opposite each flap's apex.
Figure 5
Figure 5. Sutures were placed by securing two opposing flaps.
Figure 6
Figure 6. Postoperative view after suture removal showing satisfactory tissue healing of the surgical site.
Figure 7
Figure 7. Completely satisfactory healing seen at one-month follow-up.
See this image and copyright information in PMC

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