Occasionally, orthodontists encounter cases where the presence of an aberrant frenum can hinder the progress and effectiveness of orthodontic therapy. This necessitates a periodontist, like the ones at Worcester Periodontics, performing a frenectomy, a surgical procedure that involves the removal or modification of the frenum to facilitate orthodontic treatment. Orthodontists often refer patients that need a frenectomy to our periodontists in Worcester. This article explores the clinical aspects of why and when a frenectomy is required in orthodontics, drawing upon existing literature to provide an evidence-based understanding of this intervention.
Meet the Frenums
Maxillary Labial Frenum: The maxillary labial frenum attaches the upper lip to the gingival tissue between the central incisors. In cases of a prominent or hypertrophic labial frenum, it can exert tension on the upper central incisors, causing diastemas (gaps between teeth) or preventing their proper alignment during orthodontic treatment. This anatomical consideration is supported by a study, which emphasized the role of the maxillary labial frenum in midline diastemas.
Lingual Frenum: The lingual frenum connects the underside of the tongue to the floor of the mouth. An excessively tight lingual frenum, often referred to as ankyloglossia or “tongue-tie,” can restrict tongue movement, affecting speech, swallowing, and oral hygiene. This frenum isn’t implicated in orthodontic issues, however.
Clinical Indications for a Frenectomy in Orthodontics
Frenectomy in orthodontics is indicated in cases where an aberrant frenum interferes with orthodontic goals.
Indications include:
- Presence of midline diastemas.
- Excessive tension preventing central incisor alignment.
Surgical Techniques:
Frenectomy procedures can be performed using various techniques, including scalpel, dental laser frenectomy (like the one we use for our LANAP procedures), or electrosurgery. The choice of technique depends on clinical factors and practitioner preference. Recent studies have explored the advantages of laser frenectomy, including reduced post-operative discomfort and faster healing times.
Post-Operative Management:
After a frenectomy, patients require meticulous post-operative care to promote healing and minimize complications. This includes instructions on oral hygiene, dietary modifications, and follow-up appointments to monitor progress. Additionally, orthodontic adjustments may resume once the surgical site has adequately healed.
If you live near Worcester and require a frenectomy, whether for treating tongue-tie or as a supplement to orthodontic treatment, our periodontists would be glad to help. Our periodotal practice makes use of the LANAP dental laser to perform frenectomies for the benefit of our patients. Call today to book your frenectomy consultation with one of our periodontists.