Frenectomy and Treatment of Gum Recession
Tight frenum attachments and frenectomy
Many people have heard of “tongue-tied”, which is specifically known as a frenectomy. It is a condition where the front of the tongue is tied down to the gum behind the lower front teeth. This tight tissue is referred to as the lingual frenum. It results in a variable degree of restriction in tongue movement, which in turn can interfere with speech and feeding in babies and younger children. In a young child learning to talk, such an anatomical restriction can complicate oral movements and result in poor speech development.
In order that speech development can take place unimpeded by restricted tongue movement, a suitably trained dental surgeon, oral surgeon or pediatric surgeon can remove this tight tissue in a procedure called a frenectomy. It can be performed using a conventional scalpel or nowadays, more commonly we use a laser of suitable power and wavelength. Lasers offer advantages over a scalpel that include a lack of bleeding during the procedure and thereafter, no need for stitches, and very little discomfort after the procedure. A return to normal movement and an absence of discomfort takes only a few days.
A second type of frenum attachment problem may exist
This second type of frenum attachment problem is associated with localised gum recession where the frenum attachment connects the inner surface of the cheek or lip to the interdental gum papilla between the teeth. The slight pull of such an attachment in conjunction with inflammation of the gum margin, as seen in gingivitis, can result in a very localised form of gum recession.
By surgically dissecting out the frenum and releasing the tension on the inflamed tissues at the gum margin, further recession can be prevented. In adults where gum recession has resulted from a combination of inflammation and tension applied to the frenum, it is possible later to surgically correct the recession by a second minor surgical procedure.
Treatment of gum recession
The repair of recession is achieved using a connective tissue graft that may be obtained in three ways. First, it may be harvested from a patient’s own tissues known as an autograft (same individual), from suitably prepared collagen from the pig known as xenograft (different species) and finally human donated and suitably prepared tissue called an allograft (same species but different individual).
The deep surface of the same patient’s palate may be used as an autograft tissue donor site. Pig collagen membrane (xenograft) may be used such as “mucograft” (manufactured by Geistlich). Finally, an allograft may be used as a graft from donated human tissue after suitable preparation (supplied by BioHorizons).
All three techniques work. The benefit of using either a xenograft or allograft is the avoidance of a second surgical site for harvesting in the same individual. The benefit of a synthetic graft is the avoidance of a harvest site and the avoidance of using donated human tissue. Depending on patients’ preferences, Dr. Priestland finds the best results for small grafts are achieved using autografts. Larger grafts are best achieved by both xenografts and allografts.
Soft tissue grafting, bone grafting, and bone regeneration are particular interests of Dr. Priestland. He has been involved in the area of surgery since 1990 and has continued attending courses, symposia, and conferences to ensure he is able to provide the most up to date therapy for his patients.
If you would like to know more about frenectomy, or to book an appointment, please contact us today.