Aberrant Frenum - Frenectomy

Question 1

Frenulum definition

Answer 1

A small and or fold of integument or mucous membrane that controls, curbs, or limits the movement of organ or part

Question 2

Aberrant Frenum

Answer 2

Atypical/abnormal insertion of labial, buccal, or lingual frenula capable of retracting gingival margins, creating diastemas, and limiting lip and tongue movements

Question 3

Frenectomy

Answer 3

The cutting of a frenum, especially the release of ankyloglossia

Question 4

Frenulectomy

Answer 4

The excision (total removal) of a frenulum

Question 5

What is the Etiology of an Aberrant Frenum

Answer 5

After eruption of central incisors, the labial frenum will gradually transpose in an apical direction
The inability of the frenum to migrate during alveolar growth and tooth development has been implicated in the persistence of aberrant frenum

Question 6

What are the classifications of labial frenum

Answer 6

Mucosal
Gingival
Papillary
Papillary penetrating

Question 7

Mucosal Labial frenum

Answer 7

Insertion of the frenum ends in the mucosa, or at the most at the MGJ

Question 8

Gingival Labial Frenum

Answer 8

Insertion of the frenum ends in the gingiva between the MGJ and the base of the interdental papilla

Question 9

Papillary Labial Frenum

Answer 9

Insertion of the frenum ends at the interdental papilla, but does not penetrate the palatal aspect of the tissue

Question 10

Papillary Penetrating Labial Frenum

Answer 10

Insertion of the frenum ends at the interdental papilla, and penetrates to the palatal aspect of the tissues

Question 11

What Genetic Syndromes are associated with Aberrant maxillary frenums?

Answer 11

Ellis-vanCreveld Syndrome

Orofacial-digital syndrome

Question 12

What Genetic Syndromes are associated with absence of maxillary frenums?

Answer 12

Ehlers-Danlos syndrome

Holoprosencephly

Question 13

Epidemeology of Papillary Penetrating Labial frenum

Answer 13

More prevalent in younger children
Least common in adults
Associated with Midline Diastemas

Question 14

What is the most overall common type of aberrant frenum?

Answer 14

Gingival

Question 15

What is the histology of frenums

Answer 15

Both orthokeratinized and parakeratinized epithelium
Collagen fibers
Chronic inflammatory infiltrate

Question 16

What are the most common origins of trauma to children’s frenums?

Answer 16

Car accidents
Falls
Child abuse

Question 17

What are the most common origins of trauma to adult’s frenums?

Answer 17

Denture-induced lesions

Question 18

What are the indications for a frenectomy?

Answer 18

Recession
Interference with oral hygiene
Diastema
Denture fabrication

Question 19

What are the different types of frenectomy surgical options?

Answer 19

V-shaped incision
Z-plasty incision
Lasers
Electrosurgery

Question 20

Frenectomy scarring can lead to what?

Answer 20

Resistance to orthodontic tooth movement
Ortho treatment should be considered before the frenectomy
However, wide and thick frenums may require removal prior to space closure

Question 21

Ankyloglossia

Answer 21

“tongue tied”
Congenital oral anomaly characterized by an abnormally short lingual frenum
Can be partial or complete

Question 22

Ankyloglossia incidence

Answer 22

0.02-10.7%
M:F = 3:1
No racial prediction

Question 23

How to diagnose ankyloglossia

Answer 23

Abnormally short tongue

Tongue may have a notched or heart shape upon protrusion - the tip of the tongue is stuck on the lingual of the teeth

Question 24

T/F - The mere presence of ankyloglossia is insufficient to recommend surgical correction

Answer 24

True

Question 25

Anatomic indications for ankyloglossia correction

Answer 25

Notching of the protruding tongue tip
Inability of the tongue tip to contact the maxillary alveolar ridge
Restriction of lateral tongue movement
Restriction of tongue protrusion beyond the mandibular alveolus

Question 26

What are functional concerns regarding ankyloglossia?

Answer 26

Breastfeeding

Speech

Question 27

What treatment via frenectomy improve?

Answer 27

Breastfeeding
Tongue mobility
Speech and articulation