The present study was to evaluate a combination of a frenctomy technique and a lateral positioned pedicle graft, so as to ensure primary closure with the gingiva across the midline. 27 patients All ortho cases with abnormal frenulum broad, and there was no apparent attached gingiva in the midline and the interpapilla could be moved by stretching the frenuklum.
Procedure: a horizontal incision to separate the frenulum from the ,interdental papilla; excision of the frenulum and exposure of the labial alveolar bone in the midline; a laterally positioned pedicle graft to obtain primary closure across midline and gingivoplasty of any excessive interdental tissue labially or palatally. Horizontal incision should not be in the free gingiva. Resorbable suture 4-0 gut. Pack left on for 2 weeks.
The result is not only a stable ortho result but a pleasing esthetic result. No relapse occurred in 24 cases and only slight relapse in 3 cases. Relapse is when floss passes though with no contact.
The procedure made no effort to destroy transseptal fibers. The ideal time for the surgery is after ortho movement is complete and about 6 weeks before the appliance is to be removed. Care should be taken to extend the incisions into the lip as far as is necessary to assure that a remnant of the frenulum is not left on the lip.
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