Search Results (4)

Background/Objectives: The maxillary labial frenum (MLF) is a connective tissue structure attaching the upper lip to the maxillary alveolar process. Its morphology varies significantly among individuals and is often most prominent during early childhood. While hypertrophic or low-attaching frena have been associated with diastemas, feeding issues, and speech impairments, there is no causal evidence supporting early surgical intervention. This review aims to examine current evidence regarding the timing and necessity of frenectomy procedures and to evaluate the implications of early versus delayed intervention. Methods: A narrative review was conducted using twenty peer-reviewed articles published in the past 10 years, with one additional article from 2012 included for its ongoing relevance. Databases searched included PubMed, the NIH database, the Reference Manual of Pediatric Dentistry, and journals from the American Academy of Pediatrics. Inclusion criteria were English-language, peer-reviewed studies that addressed the morphology, classification, diagnosis, management, and outcomes of MLFs across age groups. Excluded were studies focusing solely on mandibular, buccal, or lingual frena; non-English publications; case reports; and articles lacking full-text availability. Results: The literature suggests that premature frenectomy, prior to the eruption of permanent maxillary canines, typically between 9 and 12 years of age, is associated with frenum regrowth, surgical complications, and orthodontic relapse. Additionally, a lack of standardized diagnostic criteria contributes to inconsistent clinical decision-making. Conservative management, including monitoring, is strongly recommended as the frenum often migrates apically as the maxilla develops. Factors such as airway obstruction and developmental delays should be ruled out before considering surgery. Conclusions: There is insufficient evidence to support early surgical intervention for MLF-related concerns. A conservative, individualized approach, delaying frenectomy until after permanent canine eruption, may minimize complications, improve long-term outcomes, and allow the frenum to migrate apically as the patient develops. Standardized diagnostic tools are urgently needed to guide clinical decision-making. Full article

Background: The labial frenulum may be associated with traction on the marginal gingiva of the incisors with resulting gingival recession, a condition known as “pull syndrome”. In this case, performing a frenulectomy at least 6 months before root covering surgery is necessary. Recently, tissue adhesives have been studied as a good alternative to conventional sutures. Methods: A 34-year-old female affected by pull syndrome of the central lower incisors underwent frenulectomy, and an n-hexyl-cyanoacrylate tissue adhesive was used to ensure wound closure. Results: The patient was instructed in hygiene maneuvers and rinsed with 0.12% chlorhexidine-based mouthwash for 15 days. The glue was partially removed at 7 days, and for the remaining, natural disposal time was expected. The wound healing process was complete after 15 days with minimal postoperative discomfort. Conclusion: This n-hexyl-cyanoacrylate surgical glue could be proposed as a viable alternative to conventional sutures during surgical procedures involving wide flaps with the impossibility of first-intention healing. Moreover, it could be indicated to reduce operative time and patients’ discomfort, even if these hypotheses should be confirmed by future clinical studies. Full article

An abnormal and hypertrophied upper labial frenulum (ULF) can cause diastemas, gingival recession, eruption abnormalities, and the onset of carious and periodontal problems in the upper central incisors, as well as aesthetic and functional disorders of the upper lip. The goal of this investigation is to review the evidence on the surgical techniques that are currently available for treating ULF in order to identify the best approach. PubMed, Scopus, Cochrane Library, and Embase were searched for papers that matched our topic from 13 November 2012 up to 22 November 2022 using the following Boolean keywords: “frenulum” and “surgery*”. A total of eight articles were selected for the purpose of the review. ULF can be surgically treated using either traditional scalpel surgery or laser surgery. The latter is the better option due to its intra- and post-operative benefits for both the patients and the clinicians, in terms of faster healing, fewer side effects and discomfort, and greater patient compliance. However, a higher learning curve is required for this technique, especially to calibrate the appropriate power of the laser. To date, it is not possible to identify which type of laser achieves the best clinical results for the treatment of ULF. Full article

Background: The labial frenula are triangular plicas departing from the alveolar mucosa and attaching themselves at different heights of the gingiva. Sometimes a high attachment can determine a gingival recession. The most suitable surgical resolution is the use of laser devices. The aim of this study was to compare the labial frenulectomy through the use of Diode and CO₂ laser techniques in pediatric patients with a high labial frenulum attachment, clarifying at the same time the preventive role of the surgical treatment to avoid further recession. Methods: A pilot randomized, double-blinded clinical trial was conducted to compare both the surgical advantages and the preventive treatment of laser technology using two different wavelengths within a population of pediatric patients with a high labial frenulum attachment. Different parameters intra and post-surgery were taken into account (Bleeding, Wound Healing, Gingival Recession, Periodontal pocket and Numerical Scale Value for pain) to compare Diode versus CO₂ laser therapy. Results: Although both the laser devices provide a good performance in the post-operative period, the Diode laser shows better results (p < 0.001) in three of the five parameters evaluated. Conclusions: From the results it was found that the Diode Laser device is more suitable compared to the CO₂ device. Full article