Frenectomy for supporting diastema closure correction in orthodontic patients

Introduction: The maxillary frenulum can cause aesthetic problems or jeopardize orthodontic results in cases of central diastema, causing relapse after treatment. One of the etiologic factors of central diastema persistence is an aberrant frenulum. The most common way to diagnose frenulum attachment is with the blanch test. One of the treatments for aberrant frenulum is frenectomy. Frenectomy can reduce the risk of relapse from central diastema closure. The purpose of this case report is to describe the stages of frenectomy in a case of maxillary central diastema. Case report: A 24-year-old woman came to the Periodontics Specialist Clinic due to a referral from the Department of Orthodontic, Dental Hospital Universitas Airlangga with complaints of loose maxillary front teeth and planned to be treated using fixed orthodontic devices at Department Orthodontic. The blanching test examination showed that the labial frenulum was in the high frenulum category. Case management: Frenectomy was performed using a scalpel. After extraoral and intraoral asepsis, infiltration anesthesia was performed on the labial and palatal sides of tooth 11,21. Clamp the maxillary labial frenulum using a hemostat and then incise the frenulum using blade no 15c in a V shape, then incise the frenulum attachment on the interdental to the palatal region with an elliptical incision. Interrupted suturing using Nylon thread size 4.0. The surgical area was closed using a periodontal pack. Suturing was removed on day 14. Follow-up at 19 months showed no diastema in the anterior maxilla, the patient wore a retainer in the maxilla and a fixed retainer in the mandible. There were no further complaints after the treatment. Conclusion: Frenectomy before orthodontic treatment helps accelerate the treatment progress to correct the central diastema.