Methods of vestibuloplasty and frenuloplasty in the complex treatment of inflammatory periodontal diseases



Frenuloplasty of the frenulum of the tongue and lips

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About the procedure

The frenulum of the foreskin
is a fold of skin located longitudinally between the foreskin and the head of the penis, and serves to move the skin of the foreskin, which sometimes opens and closes the glans. Its normal length ensures unimpeded movement of the foreskin, so it does not cause any discomfort to a man during an erection, but in the case of a shortened frenulum, it is impossible to completely expose the head of the penis, which can cause pain during erection and lead to injury (rupture) of the frenulum.

A rupture of the frenulum of the foreskin is accompanied by severe pain and bleeding, and in the absence of qualified surgical intervention and spontaneous healing, scars form at the site of the rupture, further reducing the elasticity of the frenulum, which often leads to repeated rupture and disturbances in the male sexual function.

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Symptoms and signs

The frenulum of the tongue is thin sections of the mucous membrane that serve as an additional attachment of the tongue and lips to the oral cavity. If the frenulum ligaments are shortened (due to a congenital anomaly), which in modern dentistry is called “shortening the frenulum,” then frenuloplasty will correct the situation. A shortened frenulum is often found in adults and children; less often, the absence of the entire frenulum is diagnosed when the tongue is completely attached to the floor of the mouth.

Do I need treatment?

A shortened frenulum of the tongue or lips is a pathology for which frenuloplasty is used. Is this operation necessary? The presence of this pathology has its consequences, including problems with speech (for example, a lisp) or inadequate development of teeth.

There is an opinion that frenuloplasty in children is undesirable until the age of 6, after which it is recommended, since the child begins to have active and close communication at school, and any problems with speech can cause psychological problems. Sometimes the operation is performed in infancy, otherwise the child will not be able to suckle milk.

Correcting pathology in children and adults is the doctor’s recommendations and the patient’s decision.

Indications for frenuloplasty:

• presence of a gap between the front teeth;
• for periodontal diseases;
• before orthodontic treatment or prosthetics;
• displacement of the gums in the apical direction;
• prevention of bone lysis;
• on the recommendation of a speech therapist.

Consequences

This pathology can lead:

• to deterioration of blood circulation in the periodontium;
• to more frequent mechanical injuries;
• to the formation of tartar and gum recession (exposure of the necks of teeth);
• to curvature of the bite and the appearance of an abnormal gap between the teeth.

There may also be problems with speech and normal use of the vocal apparatus in both children and adults.

Symptoms of a shortened frenulum

• The appearance of cracks on the frenulum during sexual intercourse. During sex, the skin of the foreskin exposes the head of the penis, and the shortened frenulum prevents it from returning to its original place, which leads to cracks.
• Painful sensations when exposing the head and erection.
• Discomfort during sex.
• The erect penis bends downwards.

The frenuloplasty procedure
, a low-traumatic and quick surgical operation to remove skin fold pathology, will help restore normal movement of the frenulum. It is carried out not only to excise scars at the site of a rupture that has already occurred, but also to prevent injury to the frenulum.

Frenuloplasty of the frenulum of the upper lip

Normally, the frenulum of the upper lip has a length of 0.5–0.8 mm from the necks of the anterior teeth. If the bridle attachment is too low or extends beyond the front incisors, then it is considered shortened. An abnormal location of the frenulum can lead to a number of disruptions in the functioning of the oral apparatus (improper articulation, impaired lip movements, etc.).

Frenuloplasty is used to correct the frenulum of the upper lip, but it is prescribed if there is a gap between the front teeth, in preparation for orthodontic treatment or prosthetics, etc.

Correction is made in two ways:

• Y-shaped plastic surgery: a scalpel and special gum scissors are used to excise the frenulum, after which a diamond-shaped suture is created;
• Z-shaped plastic: three incisions are made - vertical and two oblique. The moment of fixation is very important to avoid weakening the tension of the mucosa.

Details of frenuloplasty and recovery period

Usually the operation lasts no more than half an hour.
Frenuloplasty is performed on an outpatient basis, under local anesthesia, without any pain for the patient. The surgeon cuts the fold of the frenulum transversely and sutures the incisions lengthwise. Also during the operation, growths of scar tissue that form at the site of an existing injury are removed. Rehabilitation time is minimal

, a few hours after the operation the patient is allowed to go home, and after a week and a half they are allowed to return to work and lead their usual lifestyle, with the exception of heavy physical activity and sexual contact. You can have sex 14-16 days after the stitches have completely healed. Due to the good blood supply to the genital organ, the sutures heal quickly and disappear almost without a trace, the scars are invisible. This type of frenuloplasty completely eliminates the possibility of frenulum ruptures, since the original cause of injury – skin tension – is eliminated. After the operation, the extended frenulum will allow the foreskin to move freely, ensuring unhindered exposure of the head of the penis, and relieving the patient of all discomfort. A possible complication of the operation is the risk of infection, so the sutures must be treated according to the doctor’s recommendations.

Operation process

Frenuloplasty does not require thorough preparation, as it is a low-traumatic surgical treatment method. Regardless of age, it is recommended to undergo general tests to determine the presence of inflammatory processes in the child’s body. The main requirement is pre-feeding the baby. Depending on the chosen method of plastic surgery of the frenulum of the tongue, such manipulations are performed.

The cutting method involves making an incision in the frenulum followed by suturing the lateral edges of the mucous membrane with a transverse suture, capturing deep-lying tissues. Removal occurs in this way. A special tool is used to clamp a certain part of the frenulum. Next, an upper and lower cut is made in the fabric, creating a triangle shape. The procedure ends with mobilization and suturing of the wound edges.

The movement is carried out by separating a strip of tissue between the interdental gingival papilla and the transitional fold, with further suturing of the resulting wound. Next, the detached triangular flap is sewn along the edge of the wound surface.

One of the most popular methods of frenuloplasty is the use of laser. During this dental procedure, excess tissue is burned off with a laser, the edges are sealed and sterilized. This method of plastic surgery of the frenulum of the tongue is completely bloodless and does not require sutures.

Results of frenuloplasty

In case of qualified surgical care and compliance with recommended postoperative procedures, the risk of complications after frenuloplasty is minimal.
And, after the stitches heal, the problem can be considered completely eliminated. Phone numbers and addresses of all clinics performing plastic surgery of the foreskin frenulum are presented on our portal.

Below are clinics and experienced doctors who perform frenuloplasty in Moscow and Russian cities. You can find out the cost of frenuloplasty services, contraindications, ratings and reviews, and also make an appointment online.

Frenuloplasty for a gummy smile

A gummy smile is a smile in which a significant portion of the upper gum is exposed. The cause is a congenital anomaly, anatomical features or malocclusion. One solution for correcting a gummy smile is frenuloplasty.

This operation is prescribed if the frenulum of the upper lip is excessively tight or very short, which inhibits the movements of the lip. The operation involves cutting the frenulum.

What to do after treatment?

When the operation is performed, the doctor gives individual recommendations for the recovery period. The plan includes visits to the dentist to monitor healing and check the results.

Complications

Negative consequences after frenuloplasty rarely occur, but the following complications are possible:

• inflammation of the foreskin;
• cutting and pain during urination;
• pain during erection;
• temporary loss of sensation in the head of the penis.

If the patient follows all the instructions of the urologist surgeon, then in 95% of cases complications can be avoided.

Get frenuloplasty of the frenulum from an experienced surgeon at the KDS Clinic in North-Eastern Administrative District at the address: Moscow, st. Belozerskaya, 17g.



Contraindications

Plastic surgery of the frenulum of the penis is not performed if there are contraindications:

• the presence of sexually transmitted infectious diseases;
• an inflammatory process occurring on the surface of the head of the penis or foreskin;
• type 1 diabetes mellitus in the acute stage, when the patient’s blood glucose level exceeds 15 units;
• a blood clotting disorder caused by an insufficient number of platelets (the operation is carried out after stabilization of the biochemical blood test values).

Before frenuloplasty, urologists conduct a full examination and refer for tests. If the results are good, surgery is performed. If there are contraindications, treatment is prescribed.

Penile frenuloplasty surgery

Surgery to reduce the gap between the head of the penis and the foreskin involves cosmetic removal of part of the frenulum in order to create more space for the penis to enlarge during erection. Frenuloplasty of the foreskin is performed using a scalpel, clamps and suture material used at the completion of the surgical operation. After completion of medical manipulations by the specialists of our clinic, the patient is able to fully engage in sexual intercourse without experiencing any discomfort.

Rehabilitation after surgery

Patients with a short frenulum do not need to adhere to any diet, even in case of surgery, since the latter is performed under local anesthesia. As for lifestyle, until the postoperative wound is completely healed, a man must refrain from sexual intercourse, since this can lead to separation of the surgical sutures and in such a situation a repeat operation will be simply inevitable.

Hygiene of the external genitalia in the postoperative period is also very important. It should be done after every visit to the toilet. The postoperative wound is treated not only with water, but also with a solution of non-concentrated antiseptic, followed by application of an aseptic dressing.

The main goal of rehabilitation in the postoperative period is to prevent the development of purulent infection, as well as to ensure that the surgical wound heals as quickly as possible with the formation of the smallest scar. As for the prevention of purulent infection, modern antibacterial agents are prescribed for this purpose. Since in most cases, the operation is performed in adolescence, the use of fluoroquinolone drugs is contraindicated for patients. In this case, drugs from the group of macrolides, which include clarithromycin and azithromycin, are better suited.

For rapid healing of a surgical wound and a small scar, it is recommended to treat the surgical site daily with alcohol or iodine with the obligatory application of an aseptic dressing. If the wound is clean, then under no circumstances should you use any fat-based ointments, since they are intended to treat purulent wounds, and for clean wounds they can only prolong the healing process.

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