1.
frenectomy
Ryan Pandu Digjaya
PPDGS IBM FKG UGM
Kuliah bedah preprostetik

2.
TECHNIQUE
1. the simple excision technique,
2. the Z-plasty technique,
3. localized vestibuloplasty with secondary
epithelialization,
4. the laser-assisted frenectomy.

3.
1. the simple excision technique

4.
• For the simple excision
technique, a narrow elliptical
incision around the frenal area
down to the periosteum is
completed

5.
• Placement of the first suture
should be at the maximal depth of
the vestibule and should include
both edges of mucosa and
underlying periosteum at the
height of the vestibule beneath
the anterior nasal spine.
• This technique reduces
hematoma formation and allows
for adaptation of the tissue to the
maximal height of the vestibule.
• closed with interrupted sutures

6.
VIDEO

7.
2. the Z-plasty technique,
Small elliptical excision of mucosa and
underlying loose connective tissue.

8.
Flaps are undermined and rotated to
desired position

9.
Closure with interrupted sutures.

10.
VIDEO

11.
3. localized vestibuloplasty with secondary
epithelialization
WideV-type of incision made at most inferior
portion of frenal attachments in area

12.
Supraperiosteal dissection completed, releasing
mucosa and fibrous frenal attachments.

13.
Diagram of mucosal margins sutured to periosteum.
Mucosal margins sutured to periosteum at depth of
vestibule.

14.
VIDEO

15.
4. the laser-assisted frenectomy.
Supraperiosteal ablation of mucosal and dense
fibrous frenal attachments.
Healing occurs by secondary epithelialization.

16.
VIDEO

17.
Lingual Frenectomy
tip of tongue to lingual aspect of mandible. In
edentulous patients, movement of the tongue will
dislodge the dentures

18.
Bilateral lingual blocks and local infiltration in the anterior area provide
adequate anesthesia for a lingual frenectomy.
Placement of a
hemostat across the frenal attachment at the base of the tongue for
approximately 3 minutes provides vasoconstriction and a nearly

19.
The tongue is retracted superiorly, and the margins of the wound are
carefully undermined and closed parallel to the mid-line of the tongue.
Careful attention must be given to blood vessels at the inferior aspect of
the tongue and floor of the mouth and to the submandibular duct
openings.

20.
Soft tissue closure with interupted
suture

21.
TRIMAKASIH