Management of High Frenulum Attachment in Upper Anterior Teeth: A Case Report

Introduction: Frenulum is a mucous membrane fold that attach lip and the cheek to the alveolar mucosa, gingiva, and underlying periosteum. A frenulum that extends to the gingival margin is pathogenic and indicated for removal. It causes diastema between teeth, gingival recession, difficult to maintain oral hygiene, the attached gingiva is weak, vestibule becomes short. Objective: The purpose of frenotomy is to reposition the frenulum attachment therefore improve esthetics smile from periodontal approach. Case Presentation: A 23 years old female patient came to RSKGMP Airlangga University with complaints of bleeding gums on the front of the maxillary teeth. On intra-oral examination, a high labial frenulum attachment was found in the mucosal folds. Case Management: Asepsis of the surgical area with povidone iodine, local anesthesia in the operating area, Clamp the labial frenulum region that will be incised using an artery clamp, followed by an incision at the top and bottom of the clamp using a 15C blade. Remove the muscle attachment, then suturing the gingiva with 4.0 silk suture, Irrigation with normal saline. Dry with gauze then cover the surgical area with a periodontal dressing (coe- pack). Patient were instructed restrict the movement of the lips and were prescribed antibiotics, analgesics and mouthwash. Conclusions: Frenotomy is a potential for treatment of improving periodontal aesthetics.