Abstract
Maxillary labial frenum is capable of creating a diastema and recession, affecting aesthetics. Archer's classical frenectomy technique is an extensive procedure which causes scarring and loss of interdental papilla. This leads towards the conservative approaches like Edward's frenectomy, frenum relocation by Z-plasty and free gingival graft. Since the procedure of frenectomy was first proposed, a number of modifications have been developed to solve the problem caused by an abnormal labial frenum. But in most of the techniques the zone of attached gingiva and aesthetics are not considered. Thus, the aim of this case report is to present case series of various frenectomy techniques for management of aberrant frenum. A series of cases of an aberrant frenum were approached by various surgical frenectomy techniques like conventional (classical) technique, Miller's technique using unilateral pedicle flap and frenectomy technique using bilateral pedicle flap and results are reported. The frenectomy technique using pedicle flap gives good aesthetic results, colour match, gain in attached gingiva and no anaesthetic scar formation as healing takes place by primary intention.
Highlights
A frenum is an anatomic structure formed by a fold of mucous membrane and connective tissue and sometimes muscle fibres that attach the lip and cheeks to the alveolar mucosa and/or gingiva and the underlying periosteum [1].Depending upon the extension of attachment of fibres, frenum has been classified as follows: [2]1
The unilateral pedicle flap shows complete healing with zone of attached gingiva, no scar and colour of gingival tissue was comparable to the adjacent tissue but there is slight lateral shift of frenum from midline in cases with broad, thick, hypertrophied frenum
While cases treated with bilateral pedicle flap gave many advantages, such as gain in attached gingiva in the region previously covered by the frenum, excellent colour match, healing by primary intention, minimal scar formation, and prevention of coronal reformation
Summary
A frenum is an anatomic structure formed by a fold of mucous membrane and connective tissue and sometimes muscle fibres that attach the lip and cheeks to the alveolar mucosa and/or gingiva and the underlying periosteum [1]. Depending upon the extension of attachment of fibres, frenum has been classified as follows: [2]. 1. Mucosal- when the fibres are attached up to mucogingival junction. 2. Gingival- when fibres are inserted within attached gingiva. 3. Papillary- when fibres are extended into interdental papilla; and. 4. Papilla penetrating- when the fibres cross the alveolar process and extend up to the palatine papilla
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