Lip frenuloplasty

The lower labial frenulum is often the cause of malocclusion, diction problems and recurrent oral diseases. Conservative therapy is powerless here. The only effective treatment method in such cases is plastic surgery of the frenulum of the lower lip (and often the tongue).
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Indications for labial frenuloplasty

Plasty of the fold of the lower lip (surgical correction of the tissue connecting the lip to the gum) is performed when the attachment to the lower gum is too close - less than 5 mm from the neck of the tooth. This can interfere with proper tooth growth and gum contour formation. Other indications:

  • Excessive thickening in normal location. This thickening creates discomfort and aesthetic problems
  • Disturbance of the chewing process in a child when solid complementary foods are introduced. Incorrect location of the frenulum makes it difficult to chew food
  • Diastema (gap between the front teeth). Correction helps eliminate this defect
  • The need to correct the bite. It is recommended to trim the film before starting orthodontic treatment
  • Excessive tension, causing the formation of peri-gingival pockets (spaces between the gum and teeth) and recession (recession) of the gums. This leads to exposure of the roots of the teeth and an increased risk of damage
  • The need for dentures with a complete removable denture. The correction improves the fixation of the prosthesis

The intervention can be carried out at any age. However, the optimal age is 5-8 years - it is at this time that the formation of a permanent bite occurs.

Indications for labial frenuloplasty

Contraindications

Surgery on the frenulum of the lower lip has a number of contraindications. These include:

  • Chronic recurrent and acute diseases of the oral cavity (infections, frequent inflammation of the gums and mucous membrane)
  • Osteomyelitis (inflammation of bone tissue)
  • Poor blood clotting (hemophilia and other coagulopathies). Such conditions lead to serious bleeding during and after surgery
  • Caries of anterior teeth (with complications)
  • Oncological formations in the oral cavity
  • Diseases of the nervous system (uncontrolled nervous disorders complicate both the operation and the rehabilitation process)
  • Blood diseases (anemia, leukemia and other diseases affecting overall homeostasis and healing ability)

Systemic diseases of the body at the active stage are also a contraindication to intervention. Such pathologies include, in particular, diabetes mellitus in the stage of decompensation.

Types of labial frenuloplasty

Operations on the labial frenulum are performed in 2 ways. In most cases, the laser method is used. Laser frenulum removal is characterized by precision and a short rehabilitation period. The surgical method involves the use of a scalpel and is more traumatic.

There are three main types of lip frenulum correction:

  • Frenotomy This procedure helps eliminate discomfort when chewing and correct the bite.
  • Frenuloplasty During this operation, the edge of the film is transferred to a new location (usually slightly higher).
  • Frenectomy This is the most radical method, involving resection (removal) of the wide frenulum of the upper lip. In this case, the interdental papilla and part of the mucous membrane are removed. Frenectomy is used for significant disorders that require extensive intervention.

General information about the procedure

Operation steps

Surgery to correct the labial frenulum begins with an assessment of the patient's condition. The surgeon conducts an examination, analyzes the indications for frenulum correction and clarifies the presence of concomitant diseases. The remaining stages look like this:

  1. Anesthesia. Local infiltration anesthesia is performed
  2. Making cuts on the frenulum. During frenotomy, a longitudinal incision is made to widen or lengthen the frenulum. In frenuloplasty, the incision is made in a Y or Z shape. For resection of the wide frenulum, a larger incision is made. This allows the surgeon to remove the film itself and adjacent tissue
  3. Delete. It is performed using a scalpel or laser. After removal, the specialist carefully treats the wound. This helps prevent infection and ensure proper healing
  4. Suturing the wound. Depending on the size and location of the wound, sutures are placed in such a way as to ensure its closure without tension
  5. Sutures. In order to minimize patient discomfort and simplify postoperative care, sutures are made using absorbable materials

After this, the specialist provides the patient with recommendations for oral care. This is necessary to prevent complications.

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Preparation

Before the intervention, the specialist refers the client for examination. It includes:

  • General blood test. Helps identify general health parameters (hemoglobin level and the presence of inflammatory processes)
  • Biochemical blood test (determines the condition of internal organs, including liver and kidney function)
  • Urine analysis (assesses kidney function and the presence of possible urinary tract diseases)
  • Coagulogram (assesses blood clotting)
  • ECG (checks the state of the cardiovascular system)

After this, concomitant diseases are treated - caries, gingivitis and other dental problems. The doctor then explains to the patient in detail how the surgery will proceed. He talks about possible complications and features of postoperative care. The doctor also gives recommendations on preparing for the intervention.

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Recommendations after surgery

After surgery to correct the frenulum of the upper lip, a number of recommendations must be followed. They look like this:

  • Avoid hard foods. In the first 2 days after surgery, it is not recommended to eat hard, hot or dry foods (crackers, cookies, nuts). These products may damage healing tissue and cause discomfort
  • Rinse your mouth with antiseptics recommended by your doctor. This will help prevent infection and speed up the healing process
  • Avoid aggressive brushing of teeth. In the first days after surgery, you must not touch the surgical area with a brush. Otherwise, you can damage the seams and cause additional inflammation

If the child complains of severe pain, and the operated area is swollen and red, you should immediately consult a doctor.

What does the doctor at the K+31 clinic think about plastic surgery of the upper lip frenulum in children?

Plasty is usually performed when the permanent incisors erupt. In this case, you can see the influence of the film on the formation of a diastema (gap between teeth). However, if the growth causes discomfort, there is no point in waiting until the child is 7-8 years old.

Some orthodontists suggest trimming the film after the teeth have erupted (at 12-13 years of age). This is due to the fact that it is not always the cause of diastema. Even after its removal and orthodontic treatment with braces, the fibrous scar can cause recurrence of tooth displacement.

However, in cases where the film is attached very low and grows into the papilla, it is advisable to perform the operation earlier. This will help avoid constant discomfort and injury.

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Answers to popular questions

Dental surgeons K+31 answered common questions about film trimming.

What are the risks associated with a labial frenulum defect?

A shortened frenulum leads to a number of problems. Firstly, it can provoke the formation of a diastema, which leads to the formation of gaps between the teeth.

Often the growth pushes back the gum, creating a gum pocket in which food debris accumulates. Against this background, the risk of inflammation and infections increases. This also affects the aesthetic appearance of the smile.

In infants, this defect makes it difficult to suck the breast, resulting in problems with feeding. Finally, the disorder leads to speech problems in adults - in particular, they have difficulty pronouncing certain sounds.

How is recovery after surgery going?

Recovery after classic surgery on the upper lip usually takes up to 5 days, and with laser correction - 1-2 days. You should visit a doctor 2-3 days after surgery to check healing.

After complete healing, it is recommended to perform myogymnastics. This will help strengthen the chewing and facial muscles.

How to avoid complications after surgery?

To do this, you must strictly follow your doctor's recommendations. In particular, you need to keep your mouth clean and avoid eating hard and hot foods.

If the oral cavity is not properly cared for, an inflammatory process develops. Against this background, scars form in 90% of cases.

It is also necessary to monitor the development of the jaw in children. If there are any signs of problems with speech or teeth, you should contact a specialist.

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