Vestibuloplasty, plastic surgery of the upper lip frenulum in children

Indications for surgery

The optimal distance between the lip and the neck of the front teeth is 0.8 mm. With a physiologically correct structure, a person does not have problems with speech, articulation, or difficulties with eating. Pathology can be noticed during external examination. The feasibility of plastic surgery is determined by the doctor.

It is prescribed in the presence of relevant complications:

1. Difficulties in installing the prosthesis. A short frenulum prevents the prosthesis from fastening. Impaired lip mobility will lead to constant slipping of the prosthesis.
2. Periodontal diseases. When the gums are strongly raised, food begins to accumulate under the lip, which gradually rots.
3. Diastema. An unattractive gap between teeth is not only a violation of aesthetics. The incisors, which constantly deviate forward, move apart. If the cause of this is incorrect placement of the frenulum, surgical intervention is prescribed.
4. Obstacles in setting the bite. Incorrect structure of the frenulum prevents the installation of plates and braces. A load is created on the upper row of teeth, so a correction procedure is necessary.
5. Incorrect latching of the nipple by the baby during breastfeeding. A child who has not mastered the sucking technique does not eat enough, does not gain weight, and becomes restless and noisy. In addition, a nursing woman experiences pain when feeding. If plastic surgery is done in time, lactation can be maintained.
6. Impaired diction. It happens that a short frenulum becomes a serious reason for pronouncing sounds. This is the rarest reason, which is an indication for surgery.

The procedure is prescribed for children from 5.5 years old, but some dentists advise postponing it until the first incisors appear in order to get the desired effect.

When is the best time to have plastic surgery?

Despite the fact that this procedure is considered easy and usually does not cause any complications for newborns, it is rarely done only when there are problems with natural feeding.

It is better to carry out the correction when the child turns 5 years old and the front teeth have erupted by 1/3. If plastic surgery is performed at this time, a diastema will not form, and the front incisors will grow correctly.

Some doctors recommend surgery at 7-8 years old, when the 4 upper incisors have already come out. According to indications, correction is carried out for adolescents and adults.

Benefits of the procedure

Anomaly of the frenulum can occur in both adults and children. This is the result of rare visits to specialists or inattention on the part of dentists. There is no need to panic if indications for surgery appear in adulthood. In a short time, without consequences, a competent surgeon will eliminate the problem.

Benefits of the procedure:

• no pain;
• no excessive bleeding;
• takes a few minutes;
• no need for hospitalization or restrictions;
• inability to contract an infection from instruments during surgery;
• The rehabilitation period lasts no more than 5 days.

What is labial frenuloplasty?

The labial frenulum is a fold of mucous membrane that connects the lip and gum. Plastic surgery of the frenulum of the upper and lower lips is done to eliminate pathologies that can have unpleasant consequences in the form of impaired diction and the formation of malocclusion. This operation itself is very simple and has minimal contraindications. It is done if the frenulum is too short or too wide, which affects the position of the teeth and the condition of the gums. For example, due to a wide frenulum, a diastema may appear - a gap between the central incisors. In this case, either surgery using the classical method or laser plastic surgery of the upper lip frenulum will help.

Sometimes plastic surgery is performed on the frenulum of the tongue - the membrane connecting the lower part of the tongue and the mucous membrane of the lower jaw. In children, surgery promotes the correct formation of the bite and prevents speech defects; in adults, it is a necessary measure for effective prosthetics with a removable structure or implantation. Read more about tongue frenuloplasty here.

Methods of carrying out

The type of surgery prescribed by the doctor depends on what type of pathology is diagnosed. No special preparation is required. The medical center will sanitize the oral cavity to prevent infection. Parents are advised to feed their child before the procedure, as hunger may impair blood clotting. Classic plastic surgery of the upper lip frenulum is performed in several ways:

1. Frenotomy. Dissection of the frenulum is indicated if the frenulum is too narrow, has no points of attachment to the alveolar process and resembles a transparent film. A transverse incision is made and sutures are placed longitudinally.
2. Frenectomy. During the procedure, the interdental papilla, as well as the tissues located in the interdental space of the central incisors, are excised several millimeters. Prescribed for wide frenulum.
3. Frenuloplasty. The method involves moving the attachment site of the upper lip frenulum. In a modern medical center, two types of frenuloplasty are performed:
   Y-shaped (excision with a scalpel and securing the flesh deep under the gum);
4. Limberg Z-shaped (sutures using catgut and stitching to restore the correct position of the frenulum).
5. Laser plastic surgery of the upper lip frenulum is an advanced method chosen by specialists from leading medical centers. Local anesthesia in the form of a gel is first applied to the operated cavity. A laser beam is directed at the frenulum, which dissolves the tissue. He also sterilizes and seals the excision edges.

A little anatomy

The frenulum of the upper lip is an elastic cord of the oral mucosa that connects the upper lip to the bones of the jaw and allows a person to move his lips freely and open and close his mouth without difficulty.
Normally, the frenulum is attached at a distance of 5-8 mm from the necks of the frontal incisors. If it is attached below or even extends beyond the frontal incisors and the attachment point is not visible, then they speak of a short frenulum of the upper lip.

In such patients, it begins in the middle of the upper lip, and is attached somewhere 4-6 mm above the gums, in the area of ​​the gap (diastema) between the frontal incisors. Pathology of the frenulum can be detected during external examination.

Why do they trim the frenulum of the upper lip? The thing is that its abnormal location can cause a number of complications.

Postoperative care

Typically, recovery after surgery is very fast. Especially if you follow your doctor's recommendations. In rare cases, the patient may experience slight pain. A week later, you need to visit a doctor to make sure the operation was successful. In order for rehabilitation to proceed without complications, you need to follow simple rules:

• maintain oral hygiene;
• If you experience discomfort during the recovery stage, visit a doctor;
• Do not eat hot or solid food for two days.

After a week, the doctor may advise you to master the technique of myogymnastics. Her work is aimed at strengthening the chewing and facial muscles. Patients note improvement in diction immediately after surgery.

Indications

Upper lip frenuloplasty is a surgical operation. The frenulum of the lip is a special fold of skin in the oral cavity that provides additional attachment of a person’s lips to the jaw. A referral for such an operation must be given by a doctor, speech therapist or orthodontist.

Lip frenuloplasty is most often performed for speech therapy and dental problems in children.

It is done using different methods: frenotomy (dissection), frenectomy (removal), frenuloplasty, laser plastic surgery.

The type of operation depends on the indications. Performed under local anesthesia.

Since plastic surgery to correct the frenulum is a serious surgical intervention on the body, it must certainly be justified.

Under no circumstances should an operation be performed just because the frenulum seems very short. There are a number of indications, and only if they are present, the operation should be performed.

Diastema

A diastema is a prominent gap between the front teeth. Most often, the tongue of the frenulum is located in it.

The operation in this case is necessary because with chewing movements the diastema will only expand, which leads to an unaesthetic appearance of the patient’s oral cavity.

In addition, solid food constantly injures the exposed tongue of the frenulum, which simply will not have time to heal. This is also dangerous for a number of gum problems, the most common of which is periodontal disease.

A dentist can refer you for frenuloplasty surgery after identifying diseases, abnormalities, or the patient’s complaints of psychological discomfort.
At the same time, he does not make any appointments in the preoperative period; this is the task of another specialist.

A dentist can only give recommendations on preparing for surgery and monitoring the state of the bite after it.

Cosmetologist, dermatologist, trichologist

Kalinina Olga Alexandrovna

4 years of experience

Bite change

The tongue of the frenulum puts a certain pressure on the teeth, which leads to the formation of an incorrect bite. If this was noticed in time, then the patient must be given braces or plates, and the interfering frenulum must be removed.

Other

Other indications:

1. The presence of any diseases associated with the gums. The fact is that the frenulum can be a kind of provocateur of the onset of gum disease. It seems to expose the upper teeth, and in this very place an infection of the gums forms, which, in the future, spreads to all the others.
2. Installation of a denture . Before installing the prosthesis, you need to adjust the shape of the frenulum, since it will prevent the prosthesis from holding tightly.
3. problems . In case of impaired speech functions, incorrect pronunciation of any sounds and other speech therapy problems, plastic surgery to correct the frenulum is recommended.

Are there any contraindications

Despite the prevalence of the procedure, not everyone undergoes the operation. There are a number of contraindications to this procedure:

• mental and neurological diseases;
• pathologies of the structure of the oral cavity;
• blood diseases;
• exacerbation of the infectious process;
• complicated caries;
• oncology;
• radiation exposure to the neck and head, carried out shortly before surgery;
• osteomyelitis.

The cost depends on the complexity of the procedure. The price for specialist services is fixed and includes a preliminary consultation and anesthesia.

Parents should understand that plastic surgery of the upper lip frenulum is a simple operation that will help save the child from many problems. The technology is simple, and the consequences of non-intervention may be more serious than short-term fear of the procedure.

Is it necessary to trim the short frenulum of the upper lip of a child?

A bridle is considered defective if it is too short, wide, tight, incorrectly positioned, or consists of two folds instead of one. Low attachment of the frenulum to the lower or upper lip provokes the following complications:

• 
  Photo: short frenulum of the upper lip in a child

  disturbance of the sucking reflex in infants;

• caries of baby teeth;
• speech defects and pathologies of speech organ development;
• discomfort while chewing food;
• the formation of gum pockets in which plaque accumulates;
• exposure of tooth roots;
• increased sensitivity of enamel;
• increased risk of developing periodontal diseases: periodontal disease, periodontitis, gingivitis;
• tooth mobility;
• change in the position of the dentition.

A frenulum that is too short and tight is fraught with the following problems:

• formation of interdental diastema (gap);
• inability to part your lips wide and smile fully;
• speech impairment, distortion of sound pronunciation;
• malocclusion: due to the constant tension of the interdental papilla, the front teeth protrude strongly forward.

Ways to solve the problem

Frenumplasty at the VID clinic is performed using a diode laser. The advantages of this method are: painlessness of the procedure, speed and low trauma.

In infants, it is possible to perform a frenotomy, when the short hyoid frenulum is dissected without the use of anesthesia and subsequent suturing.

Gingivoplasty is used to treat gum recession. A lateral flap is taken from the area of ​​the hard palate and applied to the area of ​​the exposed root.

Gum level correction is usually carried out along with artistic restoration of teeth or prosthetics and involves the use of laser technologies.