Plastic surgery of frenulum and mucous cords

Complex treatment of periodontal and gum diseases.
Gumplasty
Plastic surgery of frenulum and mucous cords

In a normal healthy state, we do not think about the structure of the oral cavity, but it is quite complex.
Our soft tissues and muscular organs - lips, cheeks, tongue - are attached to the skull by thin mucous strands that hold the tissues in place. Such thin connecting cords are called “bridles”. In about 20% of the world's population, they are abnormal: too short or too thick, and may be attached in the wrong places. This creates tension in the tissues and causes a number of dental problems. To avoid them, “problematic” cords need to be corrected through a simple surgical operation. Depending on what problem the patient has and how the “anomaly” of the cord is expressed, you need to choose the type of surgical intervention and the time when it is optimal to perform it. We will tell you in this article how to carry out the correction in the best way.

What problems in the dental system are caused by “wrong” frenulums and cords?

It is very easy to distinguish the normal state of mucous cords from pathology: in pathology, their length is insufficient, and their location interferes with the movements of the lips and tongue. The pathology is congenital and cannot be cured non-surgically.

There are 3 types of pathology of the development of the mucous membranes of the oral cavity:

Excessively short or incorrectly attached frenulum of the upper and lower lips.
A short frenulum of the tongue, which limits its mobility.
Insufficient size of the vestibule of the oral cavity, i.e. the space located between the lips and gums

Each of these pathologies can cause disruption of the entire dental system, and very serious ones at that.

It can be:

Difficulty eating: A small child has difficulty sucking and later chewing food.
Problems with diction and pronunciation of individual sounds.
Inhibition of the growth of the lower jaw, as a result of which a discrepancy between the jaws develops and an incorrect bite is formed.
Diastema formation – i.e. the space between the central incisors on the upper jaw.
Gum diseases. Due to increased tension during articulation and constant trauma, inflammation of the gingival margin occurs and the gums recede with the formation of a periodontal pocket. This is followed by exposure of the roots of the teeth and their gradual loosening.

Rehabilitation period

To eliminate the risk of wound infection, dentists usually prescribe antibacterial drugs. In addition, it is necessary to treat the seams with prescribed solutions or ointments. Doctors also recommend:

temporarily give up too cold and hot food, carbonated drinks, spicy and sour foods;
do not visit the sauna or bathhouse for a week after surgery;
limit physical activity and do not overload your jaw muscles.

Full recovery takes on average 14 days.

Types of plastic surgery of frenulums and mucous cords

Depending on the type of pathology, there are 3 types of plastic surgery of frenulums and mucous cords:

Plastic surgery of the frenulum of the upper and lower lips. This is a simple operation that is performed very quickly. It is necessary for short or too voluminous frenulums of the upper and lower lips. It can be carried out by cutting or excision of the frenulum; in some cases, the place where the frenulum is attached is moved, with or even without sutures.
Plastic surgery of the lingual frenulum is necessary in the case of a short lingual frenulum, when the cord is attached closer to the tip of the tongue and impedes its mobility. It is carried out in the same way as lip frenuloplasty. If the cord is transparent and does not have muscle fibers and blood vessels, the operation will be bloodless and is carried out even without anesthesia.
Plasty of the oral vestibule or vestibuloplasty. The space between the lips and gums, limited by the cheeks, is the vestibule. If its depth is less than 5 mm, then when the lips move, a lot of tension is created on the gingival edge, which is literally undermined with every movement. Therefore, the main reason why such intervention is performed is periodontal disease. To increase the vestibule, the mucous membranes are dissected and the required depth is formed. The operation is performed on an outpatient basis and lasts no more than 20 minutes.

Lip frenuloplasty

Lip frenuloplasty

Most parents have a rather vague idea of the functions of the frenulum of the upper lip and its role in the normal functioning of the dental system. Therefore, when a specialist talks about the need for plastic surgery, many do not understand the importance of it.

In reality, the problem must be resolved in a timely manner to avoid unpleasant medical and aesthetic consequences. It is the presence of the frenulum that allows you to speak correctly, move your lips, open and close your mouth. With its defects (too short frenulum, its improper fastening), the mobility of the lips is significantly reduced, their functioning is disrupted, and various aesthetic defects develop. And at an older age, an orthopedic dentist will refer you for frenulum correction in order to prepare for prosthetics.

Indications:

The presence of a gap (diastema) between the central incisors. The frenulum of the upper lip, growing into the interdental papilla and forming a thick cord, does not allow the incisors to converge towards the center. Moreover, due to constant low load, the diastema will increase, and the teeth themselves will move forward and away from the center. In such a situation, the interdental papilla is constantly exposed to injury - this can lead to periodontitis and, as a consequence, tooth loss. In preparation for orthodontic treatment . As mentioned above, all kinds of soft tissue cords in the oral cavity, including the frenulum of the upper lip and tongue, create small loads on the dentition and significantly affect the bite. Therefore, if your child needs to have his bite corrected, you need to pay attention to the frenulum of the upper lip. For periodontal diseases and the threat of their occurrence. In this case, the frenulum of the upper lip seems to “pull” the gum from the teeth. There is a loss (sagging) of the gums - a very unpleasant thing that will require long-term and expensive treatment. In preparation for removable prosthetics. When the lips move (for example, while talking or eating), a short frenulum of the tongue can cause the denture to fall off. Naturally, we are talking about those who use removable dentures. Very, very rarely, a severely shortened frenulum of the upper lip can cause disturbances in sound production and speech therapy problems. This is also an indication for plastic surgery of the upper lip frenulum.

How it proceeds:

One of the main conditions for carrying out the operation, if we are talking about children, is that the child must sit quietly in a chair for at least 10-15 minutes. The operation is performed under local anesthesia and takes about a quarter of an hour. It is absolutely painless and does not cause any discomfort (the child sits with his mouth slightly open and can even talk). The bridle is trimmed. Sutures are placed on the surgical wound, which do not need to be removed later - absorbable suture materials are used.

The entire regime at this time comes down to three simple rules: 1. Thorough oral hygiene 2. Refusal of rough and hot foods for 1-2 days. Eliminate chips, nuts, apples and carrots for 2-3 days. 3. Postoperative examination. Usually carried out the next day or every other day.

Plastic surgery of the frenulum of the lower lip

Most often it is carried out according to the indications of a speech therapist or orthodontist or orthopedist. This operation is usually required for young children. Sometimes pathologies in the development of the frenulum are detected by a pediatrician while still in the maternity hospital. In newborns, they are expressed by difficulty sucking, breast refusal, and slow weight gain. If plastic surgery is not done at this stage, the child will develop malocclusion and impaired chewing function. In adults, it is prescribed by an orthopedic dentist to prepare for prosthetics. Otherwise, with a short frenulum of the lower lip, the removable denture will tip over.

Cases of the development of a thick and short frenulum or several strands at once in the lower jaw are considered pathologies. They can lead to:

malocclusion,
gaps between teeth,
speech defects,
gum pocket,
periodontal disease,
mobility of teeth.

To avoid complications, it is necessary to perform plastic surgery. For children, it is recommended to have surgery on the lower lip mucosa before the eruption of permanent teeth. In adults, plastic surgery is possible at any age as prescribed by a specialist.

How it goes:

under local anesthesia;
dissection or excision of the frenulum of the lower lip;
antiseptic treatment;
suturing;
ointment bandage.

The patient receives recommendations for care; it takes 15-20 minutes to correct the frenulum. For a follow-up examination in 7 days.

Plastic surgery of buccal cords

The elimination of such cords and folds is most often used when preparing the oral cavity for prosthetics, especially with toothless jaws and defects of the alveolar process, when they worsen or completely eliminate the wearing of dentures.

How it goes:

local anesthesia;
excision of the mucous cord;
antiseptic treatment;
suturing;
ointment bandage.

The patient is given recommendations and sent home; the appointment time is about 30 minutes. Do not use the prosthesis for 4-5 days, exclude rough foods, spicy, salty foods.

Stitches will be removed in 7-9 days.

Reviews

I doubted for a long time whether to install an implant or not. People live without it. But the doctor clearly showed in an animation program what would happen if treatment was not started. Convinced! The operation was painless and, most importantly, fast. Now I have already installed a crown. The result is pleasing, I shouldn’t have gone without a tooth for so long! And what’s also important is that it’s not expensive, because... prices for implants in other dentists in Kirov are much higher.

Olga Viktorovna Okatieva

Last year I had 3 implants placed in my lower jaw. The installation went well, there was practically no pain, and there was no swelling. At first there was discomfort, but after surgery this is normal. Now I enjoy looking in the mirror!

Pavel / Kirov

After pregnancy, my tooth completely decayed. The doctor, after the examination, said that inflammation had developed and the tooth must be removed and an implant made. Before the operation, she took all the necessary tests - for sugar, hemoglobin and various infections, which speaks of the professional approach in the work of the doctors. I was very lucky to get to this clinic. The attending physician was a good doctor, he encouraged me, and the best part is that I did not feel any pain during the operation. After all the procedures, the tooth looks like a natural one!

Larisa / Kirovo-Chepetsk

Pavel / Kirov

Larisa / Kirovo-Chepetsk

When is it necessary to perform plastic surgery of the frenulum and mucous cords?

Dentists have determined the age at which it is best to do one or another type of mucosal plastic surgery.

Plastic surgery of the frenulum of the upper and lower lips is recommended to be performed at the age of 5-8 years, when the central incisors have erupted. If a child has problems eating and making sounds, then the operation can be done earlier, waiting for the baby front teeth to appear.
Tongue frenuloplasty is often recommended to be performed immediately after birth, since at this age it is completely painless and prevents all subsequent problems. It is customary to check the frenulum of the tongue immediately after birth. But, if the pathology has not been identified, then correction can be carried out either as it manifests itself, or at any other age as necessary.
Plasty of the oral vestibule is recommended for children aged 8-9 years, after the appearance of all lower permanent teeth.

But very often patients come to us with already formed dental problems, the cause of which is pathology of the frenulum and mucous cords. In these cases, correction should be carried out at any age, if it has not been done earlier.

How is plastic surgery of the frenulum and mucous cords performed?

Introduction of anesthesia. In most cases, the operation is performed under local anesthesia. Sometimes even an application is enough if the transparent cords are being trimmed - such an operation will be painless and bloodless. It is not recommended to perform such operations under anesthesia, except for children who are too excitable.
Disinfection of the surgical field. This type of operation requires very thorough disinfection of the surgical field - the absence of complications and the speed of healing depend on this.
Surgical stage. Trimming, excision and/or relocation of the frenulum attachment site. Suturing is carried out as necessary.
Final treatment of the wound with a disinfectant solution. A bandage or a special plate can be placed over the wound after vestibuloplasty to form the required depth of the vestibule.

All types of mucosal plastic surgery are performed on an outpatient basis and are well tolerated by patients.

Features of band plasty

Surgical correction of the cords is performed by a dental surgeon. The intervention is carried out strictly according to indications. The doctor chooses the appropriate technique taking into account the clinical picture, the structural features of the mucous folds and the patient’s age. Before plastic surgery, sanitation of the oral cavity is mandatory. Tartar, carious cavities and other defects increase the risk of complications in the postoperative period.

The main stages of cord plastic surgery:

anesthesia - usually the operation is performed using local infiltration anesthesia, since the procedure is considered non-traumatic;
disinfection - the working field and surrounding areas are treated with antiseptic agents;
surgical intervention - cutting or moving the cord and suturing it according to the chosen scheme;
final treatment - the wound is disinfected, covered with a tampon or a special plate is applied to expand the vestibule.