What is the pruning of the bridle of the upper lip and why do I need plastic?

Plastic surgery of the bridle of the upper lip is a corrective operation to prune the frenum, which is performed by a patient who has the appropriate indications for surgical intervention in the direction of an orthodontist, periodontist or speech therapist.

A bit of anatomy

The bridle of the upper lip is an elastic lining of the oral mucosa thatconnects the upper lip with the bones of the jaw and enables the person to freely move his lips, easily open and close his mouth.

Normally the bridle is fastened at a distance of 5-8 mm from the necks of the front incisors. If it is attached below or in general comes behind the front incisors and the attachment point is not visible, then they speak of a short frenulum of the upper lip.

In such patients, it begins in the middle of the upper lip, and is fixed somewhere 4-6 mm above the gum, in the region of the gap( diastema) between the frontal incisors. The pathology of the bridle can be detected by external examination.

Why cut the bridle of the upper lip? The thing is that its anomalous location can cause a number of complications.

Why conduct plastic surgery?

Pruning the frenum is necessary to avoid the following consequences:

1. Sore reflex disturbances in the newborn .In infants, the upper lip is actively involved in the act of sucking, and impairment of its mobility leads to problems with natural feeding. Sometimes a neonatologist can cut the bridle himself.
2. Problems with diction .Because of its anomalous attachment, it is usually difficult to pronounce the labial consonants and vowels. In this case the speech therapist advises carrying out of a plastic, after operation diction at once improves.
3. A short frenum can cause bite pathology and malfunction of the chewing process of , resulting in gastrointestinal diseases.
4. In the case of an abnormal frenulum and its proximity to the edge of the frontal incisors, the interdental papillae of the gums are drawn into the space between them, which results in the formation of the interval between the alveoli of the teeth of the interval - of the diastema, and also the widening of the gap between the crowns.
5. A shortened bridle retracts the gum, resulting in the forming a gingival pocket, depositing tartar, and inflamed the gums .
6. Its abnormal attachment to the can cause instability of the teeth, denudation of their roots, increased sensitivity.
7. Because of the wide bridle, constantly accumulates remains of food, and the dental deposit is formed.
8. Plastic correction is required for the prevention of periodontal disease and inflammation of the oral cavity .

Indications for surgical intervention

Indication for correction is:

1. Presence of a diastema between the front incisors .In this case, the wide bridle prevents the incisors from converging to the center, and because of the , the effect of the regular low-load load widens with time and the teeth move away from the center. In addition, due to permanent damage to the interdental papilla, periodontitis develops.
2. When prescribing orthodontic treatment for .All soft-tissue cords of the oral cavity, including the bridle of the upper lip, exert a load on the dentition and affect the formation of the occlusion. Therefore, if the orthodontic therapy is indicated, it is necessary first, to correct the frenum.
3. At risk of occurrence of periodontal diseases .
4. Because of the shortened bridle, the removable denture will be permanently reset by the , so it is advisable to correct it before installing it.
5. In case of problems with the diction.

When it is better to carry out plastic surgery

Despite the fact that this procedure is considered easy and usually does not cause any complications to newborns, it is rarely done only if there are problems with natural feeding.

It is better to carry out correction when the child turns 5 years old and the front teeth are cut by 1/3.If you hold plastic at this time, the diastema does not form, and the front incisors will grow correctly.

Some doctors advise doing an operation in 7-8 years, when the 4 upper incisors have already climbed out. According to the indications, the correction is carried out by adolescents and adults.

Existing limitations

Contraindication to plastic is:

• chronic diseases of the oral mucosa;
• osteomyelitis;
• multiple carious cavities with complications;
• head and neck radiotherapy;
• chronic alcoholism;
• mental disorders;
• of blood disease;
• acute infections;
• malignant neoplasms;
• dysmorphophobia;
• chronic pathology;
• collagenases, enhanced formation of keloids.

Preparation for intervention

Before the operation, the oral cavity should be caved in, since infectious foci can cause a number of complications.

Individual doctors require to take tests and X-ray fluorography, but this is not necessary, because the operation is low-traumatic.

Before the plastic, the child needs to be fed, since the stomach is interrupted by heavier interference and a bloody person can worsen blood clotting.

Varieties of operation

There are several ways to conduct plastic, the choice of a particular method depends on the features of anatomy and fixation of the bridle of the upper lip:

1. If it is very narrow in the form of a transparent film and not attached to the edge of the alveolar process, frenotomy , or dissection of the frenum. Cut it across, and the seam is laid along.
2. With a wide bridle, is applied to the frenectomy, or to its excision. It is cut along a tight crest, simultaneously dissecting the interdental papillae and tissues localized in the bone gap between the roots of the expanded frontal incisors.

In frenuloplastika move the point of attachment of the bridle.

The procedure is carried out in two ways:

1. With the Y-shaped frenuloplasty, the fixed bridle is excised with a scalpel or gingival scissors. After that on mucous there is a defect in the form of a rhombus. Then the cut edge of the mucous decompressor is pushed back into the forming vestibule and there it is fixed to the periosteum with the help of a nodular suture and the wound is sutured.
2. With Z-shaped frenuloplasty( after Limberg), after a frost, a vertical incision is made, which passes in the middle of the frenulum. On both sides of it, two oblique incisions are made at an angle of 60-85 degrees so that two triangular flaps are formed, which are then fixed, and the central incision must move to the horizontal plane. Then the submucosal tissues are peeled off along the periosteum, then the horizontal incision is sutured. To the periosteum, the flaps are fixed with the help of catgut. These surgical procedures are performed on an outpatient basis.

Laser plastic

Increasingly popular is the removal of the bridle of the upper lip by the laser. The site of the operation is treated with an anesthetic gel, then a laser light guide is guided to the bridle, forming a light beam that "dissolves" the bridle. Simultaneously, the laser disinfects and seals the edges of the wound.

Advantages of laser plastics:

• lack of vibrations and various sounds that can frighten the child;
• bloodlessness;
• does not need to overlap;
• no risk, infect;
• no pain and post-operative scars;
• reduction in the duration of the plastic;
• quick rehabilitation.

The cost of the procedure varies from 3 to 5 thousand rubles.

Familiar firsthand

Possible complications of

In most cases complications after surgery are not observed. However, if the correction is made too early in the milk teeth stage, the permanent teeth will begin to grow crookedly, the upper jaw can form a small and narrow jaw that will cause the progeny.

When the lower jaw is advanced, and the upper jaw is poorly developed and when the jaws are closed, the lower dentition overlaps the upper dentition, which will lead to problems with diction.

However, in each case, the doctor must decide individually, at what age to perform surgery.

Rehabilitation period

Usually the recovery period passes without complications.

Sometimes, after the termination of anesthesia, mild pain may occur.

For rehabilitation to pass faster, you must follow certain rules:

1. Every day perform a thorough oral hygiene of .Two days is not hard and hot.
2. For 2-3 days visit the doctor for a postoperative examination.
3. In a week it is advisable to start doing myogymnastics , which will strengthen mimic and chewing muscles. For some time it will be necessary to get used to the fact that the lips will move more freely. Almost immediately, there will be an improvement in the diction. If the gap between the teeth has formed, then a longer treatment is needed.

The rehabilitation period lasts a maximum of 5 days, during which all unpleasant sensations and wounds heal.

A timely plastic surgery will help prevent a number of dental problems. The procedure itself is painless and usually does not cause complications, so you should not be afraid of it.