All about Frenectomy

 Frenectomy is a dental procedure in which frenum is removed. Frenum is a small portion or a fold which holds the organ in the body and prevents it moving too far. There are several methods in order to perform this process. The lingual frenectomy, in which the frenum of the tongue is removed, is done in a medical condition which is known as ankyloglossia (limited tongue mobility). The removal of frenum of lips is called as labial frenectomy.

Usually one end of the frenum is connected to a muscular part of the body, like the tongue or lip, and the other to a relatively static part such as the floor of the mouth in the case of the tongue, or to the gums in the case of the upper lip.

Too much restriction of movement of the tongue, for example, is not necessarily a good thing since it can interfere with normal function and this is why a frenectomy may be required.

There are several frenula that are associated with types of frenectomy:

• Genital frenectomy can be performed to remove frenulums from genitalia
• Lingual frenectomy (of the tongue) as treatment for ankyloglossia
• Labial frenectomy (of the lip) is very common with patients undergoing denture treatment in order to get the proper fit of dentures or patients who have tissues attached to centre of upper lip and causing recession of gums or gap between the upper front teeth called central incisors.
• A frenectomy can also be performed to remove a section of tissue (the frenulum) that attached to the gingival tissue between two teeth.

There are many people in which a large frenum creates problem, especially during talking. The symptoms of limited tongue movement or ankyloglossia, in which the tongue movement remains limited, can be seen at various stages. In infants, this fold sometimes create problem during feeding. A child at the age of 12 to 18 months can be found to have difficulty in speaking. The frenum if large can get stuck in between the teeth in older children and even in adults. These people may find difficulty in taking out their tongue from their mouth fully. Sometimes during tongue protrusion, the frenum also pushes the gum tissues as well. At many occasions, it is seen that frenum is attached in between the upper teeth which are present at front. Labial frenectomy is performed in such cases in order to make free the upper lip so that it could move freely. This condition is mainly found in children after their upper teeth get erupted. Sometimes this problem could be observed in infants. A space is created in between the teeth if the frenum is deep. An orthodontist, if closes the space, then still the frenum pushes the teeth away from each other. The baby teeth could not erupt properly in the mouth if the frenum attachment is deep. Frenum should have proper position without any interference in adults, since the large frenum may create problem in closing the mouth if dentures are required to be worn. Therefore; sometimes, a dentist ask the patients to have frenectomy before applying dentures to their teeth. 

In gingival frenectomy, the frenum of the gingival tissue present in between the two teeth is removed. Frenectomy is a simple procedure and it could be done in the dental office easily. There are very rare complications of this procedure. Before frenectomy in a child, there are several things that a dentist considers. Sometimes, the things eventually correct themselves and there would not be any need of a procedure. However; if the problem persists, then the surgery becomes mandatory. If a child has become unable to speak properly due to frenum problem, then he or she might need to see a speech therapist as well who would offer certain exercises in order to enable the child to speak properly.

Frenum is removed with the help of scalpel or laser. Laser is especially used since it could minimize the bleeding and hence the suturing need is reduced. In addition, laser causes much less pain, however; it costs more. On the contrary, scalpel causes more bleeding and pain along with that it requires more sutures. During frenectomy, younger children may require general anesthesia, however; the older children and adults may undergo this operation in local anesthesia. 

The simple excision technique 

For the simple excision technique, a narrow elliptical incision around the frenal area down to the periosteum is completed 

The Z-Plasty Technique