• The Journal of Korea Assosiation for Disability and Oral Health
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• v.9 no.2
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• pp.103-106
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• 2013

The lower labial frenum attached to the free gingival margin can promote local tension, resulting in tissue ischemia, promoting the development of gingival recession, as well as complicating oral hygiene, resulting in chronic inflammation. In this case, early diagnosis and surgical treatment is recommended. This is the case about surgical treatment of heavy mandibular labial frenum in pre-school child with a history of syndactyly surgery. A 5-year-old girl visited the clinic with the chief complaint of high labial frenum of the mandible. Hyperplastic lower labial frenum was attached to the free gingival margin on the primary mandibular lateral incisor area. After fifteen month follow-up, right after the eruption of the permanent lower right lateral incisor, 6 years old patient received lower labial frenectomy to prevent periodontal diseases in permanent teeth and to reestablish normal anatomic characteristics. After 2 years of follow-ups, there were no marked complications.

• Journal of the korean academy of Pediatric Dentistry
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• v.26 no.1
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• pp.69-76
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• 1999

The mandibular buccal frenum is defined as a fold of mucous membrane at the posterior labial vestibule and attaches the lips and the cheeks to the alveolar mucosa, gingiva, and underlying periosteum. The buccal frenum becomes a problem when its attachment is too close to the marginal gingiva. It may then pull on healthy gingiva, encourage plaque formation and interfere with tooth brushing. Especially, heavy buccal frenum mucogingivally results in insufficent attached gingiva, inadequate vestibular depth and high frenum attachment and also difficulty in eruption of mandibular premolar. Frenotomy, frenectomy and mucogingival surgery are used in treating heavy buccal frenum. Frenotomy with autogenous free gingival graft has been used popularly because of its stable result. But, it is difficult in younger children because of inadequate donor site, difficulty in making recipient site and behavior management. Frenotomy with apically positioned flap is considered as more efficient way for a very young child with heavy buccal frenum. Additionally, modified deep sedation with $N_2O-O_2$ can be used as an adjunct for the effective treatment outcome. Decrease in muscle pull, adequate width of attached gingiva and increased vestibular depth can be expected from this treatment approach.

• Journal of the korean academy of Pediatric Dentistry
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• v.21 no.2
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• pp.533-539
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• 1994

The mandibular buccal frenum is a fold of mucous membrane at the posterior labial vestibule, that attaches the lips and the cheeks to the alveolar mucosa, gingiva, and underlying periosteum. The buccal frenum becomes a problem if its attachment is too close to the marginal gingiva. It may then pull on healthy gingiva, encourge plaque formation and interfere with tooth brushing. Heavy buccal frenum mucogingivally results in insufficient attached gingiva, inadequate vestibular depth and high frenum attachment and also difficulty in eruption of mandibular second premolar. Frenectomy in various forms has been used for many years to remove the influence of the frenum. Unfortunately, the results are not always ideal and there is often postoperative relapse because of muscle pull. In this treatment, frenotomy was used in conjuction with autogenous free gingival graft with the object of removing the influence of the buccal frenum and creating an adequate and stable width of attached gingiva. We observed decrease in muscle pull, adequate width of attached gingiva and increased vestibular depth in addition to progressive eruption of second premolar. Periodic follow-up is needed for evaluation of relapse, grafting gingiva and also space regaining for second premolar.