FRENECTOMY
CONTENTS
✓ Anatomy of frenum
→ Definition
→ Etiology
→ Histology
→ Development
→ classification
✓ Frenectomy and Frenotomy
→ Definition
→ Indications
→ Diagnosis
→ Classification
• Classical frenectomy
• Millers technique
• V-Y Plasty
• Z- Plasty
• Modified frenectomy technique
• Vestibuloplasty with secondary epithelization
• Submucosal frenotomy
• Frenectomy using electrocautery
• Frenectomy using lasers
• Comparison of all the techniques
(each procedure covered under the headings of introduction,
indications, armamentarium, technique, advantages,
disadvantages)
✓ Possible complications
✓ Lingual Frenectomy
→ Anatomy and development
→ Definition
→ Physiological functions and limitations
→ Classification
→ Associated syndromes
→ Procedure
✓ Healing of a frenectomy wound- a comparison
✓ References
, ANATOMY OF A FRENUM
DEFINITION
A frenum is a fold of mucous membrane, usually with enclosed muscle fibers, that attaches
the lips and cheeks to the alveolar mucosa and/or gingiva and underlying periosteum.
✓ Triangular found in maxillary and mandibular alveolar mucosa, located between the
central incisors and canine premolar area.
HISTOLOGY
✓ Elastic and muscle fibres (Orbicularis oris - horizontal bands and oblique fibres) (Knox and
Young).
✓ Dense collagenous tissue and elastic fibres but no muscle fibres in the frenulum [Henry,
Levin and Tsaknis].
DEVELOPMENT
Maxillary labial frenum develops as a post-eruptive
remnant of the ectolabial bands which connect the
tubercle of the upper lip to the palatine papilla
When the 2 central incisors erupt widely separated,
no bone is deposited inferior to the frenum.
V-shaped bony cleft between the two central
incisors
Abnormal frenum attachment
✓ The mandibular frenum is considered as aberrant when it is associated with a decreased
vestibular depth and an inadequate width of the attached gingiva
CLASSIFICATION
1. Frena may be long and thin, or short and broad.
2. Classification of frenal attachments by Sewerin (1971)
✓ Normal frenum
✓ Simple frenum with a nodule
✓ Simple frenum with appendix
✓ Simple frenum with nichum
CONTENTS
✓ Anatomy of frenum
→ Definition
→ Etiology
→ Histology
→ Development
→ classification
✓ Frenectomy and Frenotomy
→ Definition
→ Indications
→ Diagnosis
→ Classification
• Classical frenectomy
• Millers technique
• V-Y Plasty
• Z- Plasty
• Modified frenectomy technique
• Vestibuloplasty with secondary epithelization
• Submucosal frenotomy
• Frenectomy using electrocautery
• Frenectomy using lasers
• Comparison of all the techniques
(each procedure covered under the headings of introduction,
indications, armamentarium, technique, advantages,
disadvantages)
✓ Possible complications
✓ Lingual Frenectomy
→ Anatomy and development
→ Definition
→ Physiological functions and limitations
→ Classification
→ Associated syndromes
→ Procedure
✓ Healing of a frenectomy wound- a comparison
✓ References
, ANATOMY OF A FRENUM
DEFINITION
A frenum is a fold of mucous membrane, usually with enclosed muscle fibers, that attaches
the lips and cheeks to the alveolar mucosa and/or gingiva and underlying periosteum.
✓ Triangular found in maxillary and mandibular alveolar mucosa, located between the
central incisors and canine premolar area.
HISTOLOGY
✓ Elastic and muscle fibres (Orbicularis oris - horizontal bands and oblique fibres) (Knox and
Young).
✓ Dense collagenous tissue and elastic fibres but no muscle fibres in the frenulum [Henry,
Levin and Tsaknis].
DEVELOPMENT
Maxillary labial frenum develops as a post-eruptive
remnant of the ectolabial bands which connect the
tubercle of the upper lip to the palatine papilla
When the 2 central incisors erupt widely separated,
no bone is deposited inferior to the frenum.
V-shaped bony cleft between the two central
incisors
Abnormal frenum attachment
✓ The mandibular frenum is considered as aberrant when it is associated with a decreased
vestibular depth and an inadequate width of the attached gingiva
CLASSIFICATION
1. Frena may be long and thin, or short and broad.
2. Classification of frenal attachments by Sewerin (1971)
✓ Normal frenum
✓ Simple frenum with a nodule
✓ Simple frenum with appendix
✓ Simple frenum with nichum
