Management of High Maxillary Labialis Frenulum in Interdental Papil with Frenectomy Procedure

• Main Authors: Mercia Sharon Kandou, -, Shafira Kurnia, -
• Format: Book Section PeerReviewed
• Language: Indonesian; English; Indonesian
• Published: Program Pendidikan Dokter Gigi Spesialis Periodonsia FKG Unair 2019
• Subjects: R Medicine; RK Dentistry
• Online Access: http://repository.unair.ac.id/98153/1/15.%20Management%20of%20High%20Maxillary%20Labials.pdf; http://repository.unair.ac.id/98153/2/15.%20Turnitine%20Management%20of%20High%20Maxillary%20Labialis%20Frenulum%20in%20Interdental%20Papil%20with%20Frenectomy%20Procedure.pdf; http://repository.unair.ac.id/98153/6/16_Management%20of%20High%20Maxillary%20Labialis%20Frenulum%20in%20Interdental.pdf; http://repository.unair.ac.id/98153/
• Institution: Universitas Airlangga

Background: The frenum is a mucous membrane fold that attaches the lip and the cheek to the alveolar mucosa, the gingiva, and the underlying periosteum. Maxillary labialis frenulum often attaches to the center of the upper lip and between the upper two front teeth. This can cause a large gap and gum recession by pulling the gums off the bone because of the muscle pull and also can cause aesthetic deformities. If the maxillary labialis frenulum is attached closely to gingival margin,plaque removal will be more difficult and affect the health of gingiva. If the maxillary labialis frenulum is attached closely to interdental papil, it will be more difficult to insertion crown for front teeth. Frenectomy is one of periodontal plastic surgery to removal the high frenulum(aberrant frenulum) attachment and enhance a beautiful aesthetic and gingival health. Case: A-33-years-old female patient referred to Periodontics Clinic Dental Hospital Airlangga University with the chief complaint have trouble in plaque removal and felt her gums more rider than before. She also complain about her midline gap between maxillary central incisor . She also want to make crowns on 11 and 21 after endodontic treatment. On ekstraoral examination, There is no abnormality. There is a high Maxillary labialis frenulum in interdental papil and the tissue around the frenulum is healthy and normal on intraoral examination. Blanche test examination is positif.Case management: The patient first received phase-I therapy, which included oral-hygiene instructions, scaling, and root planning, and polishing. She was instructed to use a desensitizing tooth paste and a modified Stillman brushing technique and to avoid techniques that could cause damage to the marginal tissues (e.g., a scrub technique or bass technique). After 1 week of phase I therapy, patient was examined again and if the condition of gingiva and periodontal tissue is considered healthy, frenectectomy surgery can be done. Before surgery, Patient must be explained about the procedure of frenectomy and if the patient is understand the procedure, patient have to sign the inform consent. Discussion. Due to a high maxillary frenulum labialis in interdental papil, Insertion of the crown on central incisor will be more difficult. Frenectomy is the complete removal of the frenum, including its attachment to the underlying bone so that the insertion of the crown will be easy and matched.Conclusion: The continuing presence of a diastema between the maxillary central incisors has often been considered as an aesthetic problem. The presence of an aberrant frenum in interdental papil being one of the aetiological factors for the persistence of a midline diastema and difficulty for inserting crown so that the focus on the frenum has become essential. Frenectomy is one of periodontal plastic surgery to removal the high frenulum(aberrant frenulum) attachment and achieve a better aesthetic result.