Plastic surgery of the frenulum of the upper lip (frenuloplasty) is a dental operation during which dissection of the mucous fold located in the oral cavity between the gum and upper lip is performed. This procedure is popularly called “trimming.” When the frenulum is located too low or passes between the front teeth, forming a gap, then such a frenulum is considered pathological. The modern dental clinic “World of Dentistry” offers several methods of plastic surgery of the upper lip frenulum.
Pathologies of the frenulum of the upper lip
Normally, the frenulum of the upper lip begins 5-8 mm above the necks of the front teeth. It can be seen if you lift your lip. The width of the bridle should be no more than 1 mm, it should be elastic and stretch well. The following pathologies of the upper lip frenulum can be distinguished:
- Low location. This violation causes a number of consequences:
- When moving the lips, a frenulum that is too low pulls on the interdental space. Because of this, it gradually expands.
- Dental necks become exposed. At the same time, food particles accumulate under the lip, which can cause an inflammatory process.
- Speech impairment.
- Formation of malocclusion.
- Wide bridle. May cause the following problems:
- Formation of a diastema (large gap between the front teeth).
- Incorrect position of the anterior incisors.
- Oral hygiene in the area of the upper units is difficult. Cotton swabs may be required for cleaning.
- In the absence of plastic surgery, permanent teeth grow with a large gap between them.
- Short bridle:
- If the length of the frenulum is too short, infants have problems with sucking. The baby cannot make sucking movements, begins to cry and abandons the breast.
- The incisors are not erupting correctly. They grow with an inclination forward.
- Disorders in speech development.
- Difficult hygiene, which provokes diseases and tooth loss.
- With delayed correction of the frenulum, chronic inflammatory diseases such as periodontitis and gingivitis occur. As a result, teeth become loose and fall out. In advanced situations, osteomyelitis may appear.
When should the procedure be performed?
The optimal age for surgery is 5-6 years. Children under 4 years of age are not subject to correction. The beginning of cutting off the mucous membrane should be done when the temporary front teeth have already completely fallen out, and the permanent incisors are at the stage of eruption.
What complications can be visualized during the procedure before the age of five: the formation of the jaw after the procedure, as a result of which repeated intervention may be necessary in the future; the child's upper lip performs only a third of the prescribed functions (the child does not speak, does not bite solid food, etc.).
Indications for plastic surgery
- The presence of a diastema - a wide gap between the teeth. If the frenuloplasty is not performed, the problem may turn from an aesthetic one into a dental one. When the frenulum is placed between the teeth, the units take an incorrect position and are injured, provoking the development of periodontitis.
- Periodontal diseases or the risk of their occurrence. Typically, such diseases are characteristic of a short frenulum, which pulls the gum upward, exposing the dental necks and roots. Plaque accumulates in these places, provoking the development of inflammatory processes.
- Inability to install a prosthesis. If the length of the frenulum is short, the structure will not be able to be held in the oral cavity when moving the lips.
- Inability to carry out orthodontic treatment. Incorrect positioning of the frenulum not only provokes malocclusion, but also prevents the installation of braces or plates.
- Speech disorders. Defects in the frenulum can cause the inability to pronounce certain sounds, usually vowels.
- Dysfunction of sucking function in infants. If a child cannot breastfeed, cries, or gains weight poorly, then frenuloplasty is performed.
At what age is it better to perform upper lip frenuloplasty?
The operation can be performed at any age, both children and adults. But it is better to perform plastic surgery when discomfort is detected in order to prevent complications. If the baby has no problems with sucking, but a frenulum defect is detected, then the operation is performed at the age of 5.5 years. The fact is that during this period, temporary teeth are replaced with permanent ones, and while the molar units have not completely erupted, you can easily prevent their divergence by eliminating the diastema. Some dentists recommend plastic surgery of the upper lip frenulum at 7-8 years of age. At this point, the front incisors have fully erupted, so the bite can be tracked and the operation performed more accurately.
Contraindications for surgery
- Dental diseases of the oral cavity.
- Disease of the jaw bone tissue (osteomyelitis).
- Complications of caries.
- Previous radiation therapy to the head and neck area.
- Serious disturbances in the functioning of the nervous system.
- Blood diseases.
- Infectious diseases in the acute phase.
- Mental illnesses.
- Metabolic disorders with a tendency to collagenosis.
- Presence of cancer.
Is it painful to trim the frenulum of the upper lip?
In our clinic, high-quality anesthetics are used during surgery. During the procedure, the child communicates with the doctor and does not even notice how the procedure is going on, since it takes a short amount of time.
Types of bridles according to size, density, area of attachment
- Thin, transparent, attached low at the edge of the gum, when the lips move, the gum tissue is injured, which contributes to regular periodontal inflammation.
- Thin, translucent, with low attachment to the alveolar edge, traumatic to the mucous tissue.
- A short, wide cord is woven into the apex of the interdental papilla, forming a wide diastema between the anterior teeth.
According to the structure of the tissue, the upper and lower frenulums are divided into mucous, fibrous, and mucous-fibrous.
Preparing for surgery
Frenuloplasty is a fairly simple operation, but it still has a number of contraindications. In this regard, it is necessary to conduct a thorough examination before the procedure. The list of mandatory diagnostic procedures includes:
- General blood and urine analysis.
- Fluorogram.
- Coagulogram.
You should also perform professional oral hygiene, in particular, remove carious lesions and cure dental diseases.
Before visiting a specialist, you need to eat a hearty meal, since after plastic surgery you will have to refrain from eating for several hours. After a snack, you should brush your teeth and rinse your mouth.
Kinds
The main reasons for the development of the anomaly are;
- viral diseases suffered by the expectant mother in the first or second trimester;
- long-term toxicosis, exacerbation of any disease;
- intoxication that developed in the first trimester;
- frequent stressful situations;
- unfavorable surrounding ecology;
- bruises and injuries to the abdominal area during pregnancy.
The following degrees of anomaly are distinguished (according to the complexity of the expressed symptoms and tissue condition):
- a mild degree is expressed in a reduction in the normal size of the frenulum;
- with average severity, a decrease in size occurs due to the peculiarities of attachment to the lip and gum;
- severe degree is characterized by speech disorders, difficulties in eating, large gaps appear between the anterior units of the row.
Plastic surgery methods
Depending on the type of pathology and structural features of the frenulum, various surgical techniques can be used.
- Laser plastic surgery. This method is the most modern. The laser allows you to reduce the time of surgery and subsequent recovery, and also prevents bleeding, as it “seals” the edges of the wound. In addition, the laser has an antiseptic effect, does not cause severe pain and does not leave a scar. The procedure goes as follows:
- The frenulum is treated with an anesthetic gel.
- The laser beam is directed to the problem area.
- Tissues are vaporized under the influence of the beam, blood vessels are sealed and sterilized.
- Frenuloplasty. This technique for correcting the position of the frenulum is carried out using surgical instruments. The operation is performed under local infiltration anesthesia. Depending on the shape of the frenulum incision, there are 2 frenuloplasty techniques:
- Y-shaped.
- Z-shaped.
Both techniques allow you to move the frenulum to the desired location. Before the procedure, injection anesthesia is performed, and sutures are applied with a special self-absorbing thread. Frenuloplasty is usually prescribed when the frenulum is too short. The incision is made transversely, as a result of which the organ becomes longer. After this, a suture is placed along the cut edge.
- Removal of the frenulum or frenectomy. The frenulum is removed if it is too wide. An incision is made along the edge of the mucosa. In this case, the papilla located between the teeth and a small part of the tissue near the roots of the incisors are excised.
- Plastic surgery of the frenulum of the upper lip with decortication. It is used if the frenulum has grown into the free edge of the gum. During plastic surgery, not only the frenulum itself is affected, but also the strands of connective fibers at the site of fusion are removed. The operation is of great importance, since if the ingrown tissue is not excised, the gums will be destroyed.
Content:
Lip frenuloplasty is a corrective operation to trim the fold that attaches the lip to the jaw. Lip frenuloplasty was first performed in the middle of the last century. But now this procedure can be performed using a laser. It is laser lip frenuloplasty that will be discussed later in this article.
If there is an incorrect structure of the frenulum, a person begins to experience problems from this even in childhood, and over time they gradually intensify. The development of malocclusion, predisposition to periodontal disease, problems with articulation - this is not all that a person with an irregular lip frenulum may encounter.
Laser lip frenuloplasty can not only make your smile more beautiful, but also correct various problems with speech or with the installation of orthopedic structures, which are often observed in patients with improperly developed labial frenulum.
Laser excision of the labial frenulum is performed without complex special preparation, and the entire operation takes place quite quickly, and the patient does not experience any significant inconvenience. Laser surgery for lip frenuloplasty is a modern and excellent method of correcting it.
Postoperative recovery
Normally, after the anesthetic wears off, pain occurs in the surgical area. With laser plastic surgery, the discomfort is much less pronounced. In order for the healing of the wound surface to be successful, it is necessary to follow the recommendations:
- Do not eat food for 2-3 hours after surgery.
- Over the next two days, you should eat only soft food, the temperature of which will be optimal. This is necessary so as not to injure the mucous surface of the oral cavity.
- Perform regular hygiene using a soft toothbrush. After brushing your teeth, you should rinse your mouth.
- If the operation was performed on a child, then parents should monitor the hygiene of his teeth.
- At the appointed time, visit a specialist for a preventive examination.
- A week after the intervention, it is necessary to begin performing exercises to strengthen the masticatory and facial muscles. The rules for performing gymnastics will be announced by the doctor.
The first few days after the procedure you will feel some discomfort due to the changes that have occurred as a result of the surgery. However, the discomfort usually goes away after 4-5 days. During this period, the mucous membrane heals, and diction is restored. In order for the interdental gap caused by the incorrect position of the frenulum to disappear, it will take much more time.
Rules for rehabilitation after frenuloplasty
Many parents are interested in whether it is dangerous to have frenuloplasty. There can be only one answer here - it’s more dangerous not to do it at all. The procedure is very simple to perform, and there are almost never any complications after it. But, of course, as after any other operation, you need to follow some recommendations:
- limit consumption of hot and cold foods,
- Carry out oral hygiene with extreme caution,
- follow the doctor’s orders and do language exercises to restore speech after the procedure,
- visit a speech therapist to learn how to speak correctly.
These simple recommendations will help maintain health and very quickly return your child to a full life. But parents will definitely be required to monitor compliance with the rules.
1 Kozlova S.I. Hereditary syndromes and medical genetic counseling. Atlas-reference book, 1996.
