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Geoffrey R. Bauman, DMD, MS | Frenectomy/Frenuloplasty in Newark

Geoffrey R. Bauman, DMD, MS / Board Certified,  American Board of Periodontology
Fellow, Midwest Implant Institute





Frenectomy is a surgical technique used to cut a frenum, which is a muscle attachment.  In the mouth there are 3 major frena:  1)  Maxillary Labial (upper lip frenum),  2) Mandibular Labial (the lower lip frenum), and 3)  Lingual Frenum (the tongue frenum).  Of these major frena, by far the most common frenum that requires only frenectomy (or frenuloplasty) is the Maxillary Labial Frenum.   It is sometimes said to require just a "snip" of the frenum and often, that is all that is required for the Lingual Frenum (tongue frenum).   However, the goal of the Maxillary Labial Frenectomy/Frenuloplasty (upper lip frenum) is usually to allow the upper front teeth to come together and close the space between them  (although there are occasions when this frenum pulls on the gum in between the teeth or interferes with denture seating but those are not nearly as common an indication).  This space (termed a diastema) is generally related to the frenum under the lip, particularly its extesion between the teeth as a grissly, rubbery tissue.  If one tries to close the space between such teeth orthodontdically without removing that tissue, it tends  to rebound against the teeth and cause the space to open again after the braces are removed.  A simple snip under the lip will not address the rubbery tissue between the teeth nor the very hard bone character that tends to interfere with space closure.    These extra steps generally help assure the closure or maintenance of closure of the space between the front teeth.   

The Mandibular Labial Frenectomy has been found to be a rare indication in and of itself.   In the dental literature, almost all frenectomies of this type were found later to require gum grafting.  When the frenum is found to be pulling on the edge of the gum such that a frenectomy is indicated for the lower lip, it is almost never adequate to just do the frenectomy.   If the Mandibular Labial Frenum appears to require removal/relocation, it is generally advisable to do a gum graft along with the frenectomy to prevent having to do a second surgery later.  Otherwise, there will likely be gum recession as a result later. 

The Lingual Frenectomy is the least common indication and is only required if this frenum interferes with speech (such that the person cannot make S, Z, T, TH sounds adequately) or causes the patient to injure the frenum repeatedly when trying to stick the tongue out of the mouth, or when it pulls heavily on the gum on the tongue side of the teeth.