Plastic frenulum of the upper lip: why do we need pruning, do I need to do and how?
What is undercutting of the frenulum of the upper lip and why do we need plastic?
Plastic frenulum of the upper lip corrective surgery undercut frenulum, which is carried out the patient has the appropriate indications for performing surgical intervention in the direction of the orthodontist, periodontist or speech therapist.
A little anatomy
The frenulum of the upper lip is a flexible strand of the mucous membrane of the oral cavity that connects the upper lip with the bones of the jaws and enables a person to freely move my lips, easily open and close your mouth.
Normally, the bridle is fastened at a distance of 5-8 mm from the necks of the front incisors. If it is attached below, or doesn’t behind the front incisors and the place of attachment is not visible, then talking about short frenulum of the upper lip.
In such patients it starts in the middle of the upper lip, and attached somewhere in the 4-6 mm above the gingiva in the region of the gap (diastema) between front teeth. Pathology of the bridle can be detected by external examination.
Why cut the frenulum of the upper lip? The thing is that its abnormal position can cause a number of complications.
Why to perform plastic surgery?
Clipping the frenulum is necessary to avoid the following consequences:
- Violations of the sucking reflex of the newborn. In infants the upper lip is actively involved in the act of sucking, and
violation of its mobility leads to problems with natural feeding. Sometimes the neonatologist can cut the bridle.
- Problems with diction. Because of her abnormal attachment, usually there are difficulties in the pronunciation of labial consonants and vowels. In this case, the speech therapist advises the cosmetic surgery, after surgery, the diction immediately improved.
- Short frenulum can cause the malocclusion and the violation of the process of mastication, so that there will be diseases of the gastrointestinal tract.
- The abnormal bridle and its close location to the edge of the front incisors interdental papillae gums pulled away in the space between them, which leads to the formation of bone between the alveoli of the teeth interval of the diastema, and the increase in the gap between the crowns.
- Shortened frenulum pulls the gums, resulting in periodontal pocket, has been postponed Tartar, and inflamed gums.
- Her abnormal fixing may cause instability of the teeth, the exposure of their roots, increased sensitivity.
- Because of the wide bridle constantly accumulate remnants of food and plaque is formed.
- Plastic correction is required for the prevention of periodontal diseases and inflammation of the oral cavity.
Indications for surgical intervention
The indication for correction is:
- The presence of a diastema between the front teeth. In this case, a wide bridle prevents the cutters to converge to the center, but because of the
regular exposure to slightly load the gap increases over time and teeth shift to the side of the center. In addition, due to permanent damage interdental papilla develops periodontitis.
- In the appointment of orthodontic treatment. All soft tissue strands of the oral cavity, including the frenulum of the upper lip, have a load on the dentition and affect the formation of occlusion. Therefore, if the orthodontic therapy is necessary, first, to make correction of the frenulum.
- At the risk of the appearance of periodontal diseases.
- Because of the shortened frenulum denture will constantly be reset, so before installing it is advisable to carry out its correction.
- If you have problems with diction.
When is the best time to conduct plastic
Despite the fact that this procedure is easy and usually does not cause any complications for newborns do it rarely only in the case where there are problems with natural feeding.
It is better to carry out the correction when the child turns 5 years and the front teeth were cut by 1/3. If you hold the plastic in this time, the diastema is not formed, and the front incisors will grow right.
Some doctors suggest to do the operation in 7-8 years when the 4 upper incisor came out. According to the testimony of the correction is recommended to teenagers and adults.
A contraindication to plastic surgery is:
- chronic disease of the mucous membrane of the oral cavity;
- multiple cavities with complications;
- radiotherapy of head and neck;
- chronic alcoholism;
- mental disorders;
- diseases of the blood;
- acute infection;
- malignant neoplasms;
- the BDD;
- chronic disease;
- the connective tissue, increased formation of keloids.
Preparing for the intervention
Before surgery you need to protonirovanie mouth as infectious foci can cause a number of complications.
Individual doctors require tests and roentgenofluorescent, but there is no special need, because the operation is less traumatic.
Before the procedure the child needs to feed, as on an empty stomach interference tolerated heavier and a starving man may impair blood clotting.
Varieties of the operation
There are several ways of plastic surgery, the choice of a particular method depends on the anatomy and fixing frenulum of the upper lip:
- If it is very narrow in the form of transparencies, and not be attached to the edge of the alveolar process carried out frenotomy, or the tearing of the frenulum. Cut it across, and applied along the seam.
- With the broad bridle resorted to frenectomy, or its excision. It is cut tight to the comb, at the same time excised interdental papillae and tissue, localized in the bone between the frontal incisors roots apart.
When frenuloplasty move the attachment point of the bridle.
The procedure is performed in two ways:
- When Y-shaped frenuloplasty fixed bridle excised by scalpel or scissors of the gingival. Then
mucosa remains defect in a diamond shape. Then the cut edge of the mucosa with a periosteal Elevator push formed inside of the vestibule, and there it is fixed to the periosteum with the nodal suture and the wound closed with stitches.
- When Z-shaped frenuloplasty (Limberg) after freezing is a vertical incision, which runs down the middle of the bridle. On both sides of it make two slant cuts at an angle of 60— 85 degrees so to form two triangular flap, which is then recorded while the slit should be moved in a horizontal plane. Then rasp peeled submucosal tissue along the periosteum, then a horizontal incision is sutured. To the periosteum of the flaps are fixed with catgut. These surgical interventions are performed on an outpatient basis.
Used for anesthesia Ultracain D-s Forte, the wound is sutured with absorbable suture materials. The whole procedure last a maximum of 15 minutes.
Increasingly popular the removal of the upper lip frenum with a laser. The place of operation is processed by a gel with an anesthetic, then the bridle is routed laser optical fiber, forming a beam of light, which «dissolves» the bridle. Simultaneously, the laser disinfects and seals the wound edges.
The advantages of laser plastics:
- the lack of vibration and different sounds that can scare the child;
- no need to stitches;
- no risk of infection;
- no pain and the scars;
- reduction in the duration of plastic surgery;
- the quick recovery.
The cost of the procedure varies from 3 to 5 thousand rubles.
My son had problems with diction. The speech therapist said it was due to a short frenulum of the upper lip and advised to make her correction.
After the operation the child began to clearly pronounce sounds. During the procedure the pain is not felt after the surgery suture left.
In most cases, complications after surgery is not observed. However, if you adjust too early in the stage of milk teeth, permanent teeth will grow crooked, the upper jaw can be formed small and narrow, which will cause progenie.
When the lower jaw is pushed forward and the upper poorly developed and by closing the jaws of the lower tooth row overlaps the top that will come to the problems with diction.
However, in each case, the doctor needs to decide individually the age at which to carry out surgery.
The rehabilitation period
Usually the recovery period passes without complications.
Sometimes, after the anesthesia wears off, you may receive mild pain.
To rehabilitation took place faster you need to follow some rules:
- Every day to carry out a thorough hygiene of the mouth. Two days is not solid and hot.
- 2-3 days to visit the doctor for postoperative inspection.
- In a week it is advisable to start doing myogymnastics, which will strengthen the mimic and chewing muscles. Some time will need to get used to the fact that the lips will move more freely. Almost immediately the improvement in diction. If the gap between the teeth has formed, you may require more prolonged treatment.
The rehabilitation period lasts a maximum of 5 days during which are all the discomfort and wounds heal.
Study on plastic will help to prevent the development of a number of dental problems. The procedure itself is painless and usually does not cause complications, so afraid its not worth it.