Frenectomy with laterally displaced flap: An aesthetic approach

Abstract

Frenum is a mucous membrane fold that attaches the lip and the cheek to the alveolar mucosa, gingiva, and the underlying periosteum. The frena may endanger the gingival health when they are attached closely to the gingival margin. An aberrant frenum is presupposed to create functional and aesthetic problems. Archer’s ‘classical frenectomy’ is an extensive procedure including the excision of fibers, interdental papilla, and exposure of the alveolar bone up to the palatine papilla. The aftermath delayed healing, loss of interdental papilla, and unusual scar led toward the traditional approaches such as Edward’s frenectomy, frenum relocation by Z-plasty, and free gingival graft, with their practical and esthetic restriction. A superior approach to make a primary closure in midline and to bypass anaesthetic scar by creating a zone of attached gingiva, frenectomy is associated with lateral pedicle graft. Miller, in his study on 27 subjects, proposed that newly created zone of attached gingiva may have bracing effect inhibiting reopening of diastema. A case report of this approach with its well defined benefits is presented.