What is a Frenum?
A frenum is a fold of mucous membrane, usually with enclosed muscle fibers, that attaches the lips and cheeks to the alveolar mucosa and /or gingiva and underlying periosteum. It is corrected with a Frenectomy surgical procedure. A frenum becomes a problem if the attachment is too close to the marginal gingiva. Tension on the frenum may pull the gingival margin away from the tooth. This condition may be conductive to plaque accumulation and inhibit proper toothbrushing.
Treatment with a Frenectomy or Frenotomy
A frenectomy is a surgical procedure that removes the frenum, including its attachment to underlying bone, and may be required in the correction of an abnormal diastema between maxillary central incisors. The procedure includes a initial incision that encompasses the frenum, removal of the triangular portion of the frenum, separating the attachment fibers from the underlying bone, and suturing the labial mucosa to gain primary closure. Frenotomy is incision of the frenum. Both procedures are used, but frenotomy generally suffices fro periodontal purposes, that is, relocating the frenal attachment so as to create a zone of attached gingiva between the gingival margin and the frenum.
Frenectomy and frenotomy are usually performed in conjunction with other periodontal treatment procedures but occasionally are done as separate operation. Frenal problems occur most often on the facial surface between the maxillary and mandibular central incisors and in the canine and premolar areas. They occur less often on the lingual surface of the mandible.
Criteria for selection of techniques includes surgical site free of plaque, calculus, and inflammation, adequate blood supply, anatomy of the recipient and donor sites, stability of the grafted tissue to the recipient site, and minimal trauma to the surgical site.
The current case demonstrates a frenectomy procedure that I completed on a patient. Healing is complete in approximately 4 weeks with minimal pain.