Management of a lacerated frenum and lip in a child with severe hemophilia and an inhibitor: report of case.
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Aminocaproates↗
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Histologic analysis of the hyperplastic maxillary anterior frenum.
Fifteen biopsy specimens from hyperplastic maxillary anterior freni were examined histologically by three investigators, and tissue components were subjectively rated on a predesigned scoring sheet. The presence of calcification and ossification associated with high levels of inflammatory infiltrates and reactive connective tissue confirm the fact that surgical excision of the hyperplastic frenum is warranted.
Adolescent↗
The maxillary frenum and surgical treatment.
This article reviews the role of the maxillary frenum in diastema formation and provides guidance on procedures to remove it in both dentate and edentate patients.
Diastema↗
[Histomorphologic evaluation of upper lip frenum in relation to the method of treating diastema].
The aim of this study was to determine collagen density in the hypertrophic upper lip frenum and scar forming after frenectomy and to compare the results with collagen density in a normal population (autopsy specimens). Differences in collagen density may cause problems in diastema closure and may eventually result in relapse of this condition. The study was done in 47 patients treated for diastema. Histomorphology was performed in 15 patients of this group. Autopsy material was obtained from 27 persons. Histomorphometric assessment of collagen density was done after staining of collagen fibers according to van Gieson. A computerized image analysis system was used for interactive detection of stained collagen fibers on the digitized microscopic image. The percentage of positive staining expressed as ratio of positive area to whole area of the field studied was determined and recorded as an Excel file. Collagen density was increased in the pathologic frenum and in the scar as compared with the normal frenum. The difference was statistically significant. Diastema treatment with frenectomy, fixed appliance and retainer produced more stable results as compared to treatment with a removable appliance without frenectomy. The results suggest that the similar collagen density observed in hypertrophic upper lip frenum and scar after frenetomy may hinder complete closure of diastema and facilitate relapse after treatment.
Adolescent↗
Atypical frenum formation at the donor site after mucogingival flap surgery.
The following case report illustrates the potential for the formation of a mucogingival problem in the form of a frenum at the donor site for a laterally positioned flap. Corrective surgery and suggestions to prevent complications at the donor site are discussed.
Gingival Recession↗
[Frenectomy associated with a triangular gingival graft].
In periodontal therapy, frenectomy is indicated when the frenum exerts tension on the gingival margin and interferes with proper oral hygiene. The procedure is also employed when the frenum prevents closure of a diastema during orthodontic therapy. Frenectomy should be done after the canines have erupted and before retention is started to prevent separation of the teeth. For an improved surgical and cosmetic result, the authors propose a triangular-shaped gingival graft after the frenum has been excised. The advantage of the procedure is to create an area of attached gingiva and enhance healing.
Diastema↗
Frenectomy plus free graft.
Where an unfavorable frenum is present, the technique of frenectomy plus free graft is perceived as an efficient, predictable procedure to improve the prognosis of a complete or partial denture.
Denture Retention↗
[The causes of longitudinal fracture of the upper complete denture base].
Laying the strain gauge on the design areas of palatal base and frenum labiorum of complete dentures and simulating the different shapes of notch of frenums by the photoelastic mould. The test of the base condition under static and dynamic load by electrical measurement method was carried out. The longitudinal breaking line on the front part of the palatal base was first observed. The causes of breaking may be due to: the weak effect of notch of frenum labiorum; stress concentration on the front part of the base; material fatigue caused by the repeated alternate force and the strength of base material reduced by unsuitable processing.
Dental Stress Analysis↗
Aesthetic solution for large maxillary anterior diastema and frenum attachment.
Resin-bonded porcelain veneer restorations can be used to correct unaesthetic diastemata caused by tooth position or discrepancies in the tooth size/arch development. The size of the diastema, size and proportion of the clinical crowns, tooth preparation, and dental occlusion require special attention; an excessive frenum attachment requires additional care and coordination of the treatment. This article describes the placement of six resin-bonded porcelain veneer restorations in a patient with a large diastema between the maxillary central incisors and associated frenum and soft tissue involvement. The learning objective of this article is to demonstrate the importance of pretreatment planning and problem solving in achieving predictable final restorations.
Adult↗
Relapse after orthodontic correction of maxillary median diastema: a follow-up evaluation of consecutive cases.
An evaluation of 96 treated orthodontic patients with maxillary median diastema ranging from 0.50 mm to 5.62 mm (mean 1.22, SD 0.85) was performed 4.0 to 9.0 years after completion of active treatment. Pre- and posttreatment data were gathered from available records. Follow-up data were gathered from records and interviews of 37 patients, and from phone interviews of 59 patients. The incidence of diastema relapse was 49% when scored as either presence of a measurable space at follow-up, a history of orthodontic or prosthetic retreatment to close a reopened space, or continued use of a retainer to control relapse tendency. Logistic regression analysis revealed that pretreatment diastema size and presence of a family member with a similar condition were the only significant risk factors for relapse (p<0.05), while pretreatment spacing in the maxillary anterior dentition approached significance (p = 0.10). No association was found between relapse and presence of an abnormal frenum or an osseous intermaxillary cleft, although patients with an abnormal frenum had a wider pretreatment diastema than those with a normal frenum (p<0.05). Fremitus of the maxillary incisors was the only parameter at follow-up associated with space reopening (p<0.01).
Adolescent↗
Hamular frenum modification: a removable denture prosthesis retention and stability enhancement.
A removable denture prosthesis, whether partial or complete, often requires preprosthetic surgery to achieve optimum stabilization and retention. While the hamular frenum may produce significant dynamic dislodging forces, a literature review did not reveal any reports dealing with this problem. A hamular frenum reduction surgical procedure using the free autogenous gingival graft procedure is described. Prosthetic function may be enhanced by eliminating the dynamic disrupting force of the hamular frenum along with improving posterior maxillary tuberosity contour and, as necessary, premaxillary form, allowing these contours to work in concert to develop a "cupping" stabilizing and retentive complex.
Aged↗
A postretention study of patients presenting with a maxillary median diastema.
The purpose of this study was to assess postretention stability of maxillary midline diastema closure, to search for predictors of relapse, and to test for associations between relapse and other postretention changes. The sample consisted of 35 patients with pretreatment diastemas ranging from 0.9 mm to 3.0 mm (mean 1.4, SD = 0.5) following eruption of the maxillary canines. Data were gathered from treatment charts, study models, periapical radiographs, and cephalograms taken pretreatment, posttreatment, and 1 to 26 years postretention (mean 11.4, SD = 6.4). Measurable diastema relapse was observed in only 12 cases. The majority of the relapse was 0.6 mm or less, and maximum relapse was 3.0 mm. Abnormal frenums and/or intermaxillary osseous clefts did not appear to be risk factors for relapse, and no pretreatment predictors of relapse could be established. The only posttreatment change associated with diastema relapse was proclination of the maxillary incisors (p < 0.01).
Adolescent↗
[Mucogingival aspects of orthodontic patients].
During the last twenty years the opinions about the necessity of an adequate gingival band for dental health are developing. Modern tendencies, nowadays, provide gingival increase only in few cases: 1. difficulties in plaque removing; 2. frenum connection in marginal gingiva; 3. gingival absence around prosthetic crown; 4. gingival recessions. The Authors, according to literature, data consider the indications to gingival increment and affirm the importance of a correct pre-orthodontic and periodontal evaluation in order to avoid periodontal attachment-loss using an easy surgery.
Epithelial Attachment↗
The diastema, the frenum, the frenectomy: a clinical study.
1. The pretreatment relationship between a clinically "abnormal"-appearing maxillary midline frenum and a midline diastema showed a strong, but not absolute, correlation. A certain percentage of patients demonstrated (1) a diastema but not an "abnormal" frenum or (2) no diastema but an "abnormal" frenum. 2. Diastema cases in which there were "abnormal" pretreatment frenums demonstrated a decidedly stronger potential for relapse after orthodontic closure. The exceptions to the rule were explained by the clinician's inability to differentiate between "normal" and "abnormal" frenums and by the periodontium's apparent (if not consistent) ability to recognize the frenal and interdental tissues following orthodontic tooth movement. 3. A three-stage surgical procedure was shown to be very effective in alleviating the relapse phenomenon following orthodontic treatment of diastemas. The surgical procedures were successful in avoiding many of the hazards to the periodontium associated with previous techniques.
Child↗
Variations in expression of oral-facial-digital syndrome (type I): report of two cases.
Two case reports are presented, both clearly demonstrating the diagnosis of oral-facial-digital syndrome, type I, but widely different in the expression of the condition. The first patient showed only mild expression of the syndrome. On examination at the age of 4 years there were no obvious extra oral signs, intraoral findings included the presence of supernumeraries in the primary dentition, spacing in two areas and the presence of an extra frenum. The second can be considered as a more severe case. This patient had many of the typical manifestations, including frontal bossing, a degree of zygomatic hypoplasia and clinodactyly. Orally, the most striking finding was a bilateral cleft palate which had not been diagnosed prior to examination at the age of 6 years. Other findings included multiple frena and a bifid tongue.
Child↗
[Our experience in the correction of a short frenulum labialis by Z-plasty].
The authors report their experience of the reconstruction by z-plasty in cases of shortness of the lip frenum. Amongst several techniques they used for this correction they got best results utilizing a z-plasty, with wide flaps, planned so that after the transposition of the flaps the medial branch of the z-plasty falls horizontally into the deeper vestibular fornix. In all cases treated by that z-plasty the A. obtained a widening of the adherent part of the gingiva, deepening of the vestibulum, no recurrence of the shortness was observed.
Humans↗
Acellular dermal allograft for vestibuloplasty--an alternative to autogenous soft tissue grafts in preprosthetic surgical procedures: a clinical report.
Various vestibular extension procedures have been described in the literature over the past 6 decades, including the use of free gingival grafts. An acellular dermal allograft has been used as a substitute for autogenous soft tissue grafts in root coverage procedures. This clinical report describes the use of such an allograft as a substitute for palatal donor tissue in the vestibular extension of an edentulous maxillary arch with multiple frenum attachments before fabrication of a complete denture. In this patient, healing was uneventful, and 6-month clinical observations demonstrated an apical positioning of the mucogingival junction with an increase in vestibular depth, and the absence of multiple frenae. The acellular dermal allograft appears to be a useful substitute for autogenous palatal grafts in preprosthetic surgery. This approach has many advantages over the free gingival graft, including no donor site morbidity, unlimited availability, and better color match.
Aged↗
Mandibular deviations in TMD and non-TMD groups related to eye dominance and head posture.
This study was designed to determine whether eye-dominance affects head posture (rotation) and in turn, whether head posture is associated with mandibular frenum midline deviation, in both TMJ and control subjects. Eye dominance was determined using three tests: Porta, Hole, Point tests. Natural head posture was evaluated using the Arthrodial protractor. Mandibular frenum deviation was recorded as left, right or no deviation. Fifty female subjects were included in the study, 25 TMJ patients attending the Gelb Craniomandibular Pain Center and 25 non-TMJ control subjects. The findings indicate that eye dominance and direction of head rotation are strongly associated in both TMJ and control subjects. Further, in TMJ subjects mandibular deviation occurred in greater frequency than in controls and tends to occur in the contra lateral direction of head rotation.
Adult↗