Unraveling the Maxillary Frenectomy Debate
Maxillary frenectomy, a common procedure in children, has long been debated among clinicians. The primary concern? Scar tissue post-surgery affecting diastema closure. However, a recent study sheds light on this topic, suggesting that early treatment might not be as detrimental as once believed.
The Source Article Details
Safety and efficacy of maxillary labial frenectomy in children: A retrospective comparative cohort study by Richard T Baxter et al. in 2022.
Cited By: 4 (Updated: December 4, 2023)
The Source Article's Abstract
Background
Maxillary frenectomy in children is a common procedure, but concerns about scar tissue affecting diastema closure prevent many clinicians from treating prior to orthodontics.
Objectives
To determine if maxillary frenectomy is safe and if diastema size is affected by early treatment.
Materials and Methods
Paediatric patients with hypertrophic maxillary frena were treated under local anaesthesia with diode laser and CO laser. Diastema width was compared by calibrating and digitally measuring initial and postoperative intraoral photographs.
Results
In total, 109 patients were included: 95 patients with primary dentition (39% male; mean age 1.9 years ±1.5 years) and 14 with mixed dentition (43% male; mean age 8.1±1.3 years) with a mean follow-up of 18.0±13.2 months. No adverse outcomes were noted other than minor pain and swelling. In the primary dentition, a decrease in diastema width was observed in 94.7% with a mean closure of −1.4±1.0mm (range +0.7 to −5.1mm). In the mixed dentition, a decrease in diastema width was observed in 92.9% with a mean closure of −1.8±0.8mm (range 0 to −3.5mm). 74.5% of patients in the primary dentition and 75% of patients in the mixed dentition with preoperative diastema >2mm improved to <2mm width postoperatively.
Conclusions
Frenectomy is associated with cosmetic and oral hygiene benefits and when performed properly, does not impede diastema closure and may aid closure. Technique and case selection are critical to successful outcomes. IRB ethics approval was obtained from Solutions IRB protocol #2018/12/8, and this investigation was self-funded.
The Source Article References
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- The superior labial frenulum in newborns: what is normal? by Santa Maria, 2017 in Glob Pediatr Health
- Breastfeeding improvement following tongue-tie and lip-tie release: a prospective cohort study by Ghaheri, 2017 in Laryngoscope
- Breastfeeding difficulties and oral cavity anomalies: The influence of posterior ankyloglossia and upper-lip ties by Pransky, 2015 in Int J Pediatr Otorhinolaryngol
- Diagnosing and understanding the maxillary lip-tie (superior labial, the maxillary labial frenum) as it relates to breastfeeding by Kotlow, 2013 in J Hum Lact
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- Uncovering dental implants using a new thermo-optically powered (TOP) technology with tissue air-cooling by Romanos, 2015 in Lasers Surg Med
- Diode laser soft-tissue surgery: advancements aimed at consistent cutting, improved clinical outcomes by Georgios, 2013 in Compend Contin Educ Dent
- Oral diagnosis of abnormal frenum attachments in neonates and infants: evaluation and treatment of the maxillary and lingual frenum using the Erbium: YAG laser by Kotlow, 2004 in J Pediatric Dent Care
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Citing the Source Article (APA)
Baxter, R.T., Zaghi, S., Lashley, A.P. (2022). Safety and efficacy of maxillary labial frenectomy in children: A retrospective comparative cohort study. International Orthodontics, 20(2), 100630-100630. 10.1016/j.ortho.2022.100630
Key Findings from the Study
- Early treatment of a lip-tie does not form scar tissue that prevents diastema closure.
- Treating lip-tie in the primary dentition yields present and future cosmetic benefits.
- Providers should consider treating a lip-tie for oral hygiene or cosmetic concerns.
Implications for the Medical Profession
These findings have significant implications for orthodontists and pediatric dentists. The study suggests that early frenectomy offers cosmetic and oral hygiene benefits without impeding diastema closure. This could change how clinicians approach maxillary frenectomy in children, allowing for earlier interventions without fearing long-term repercussions.
FAQs
Does early frenectomy impede diastema closure?
No, when performed correctly, it does not impede diastema closure and may even aid in its closure.
Are there any adverse outcomes associated with the procedure?
The study noted no significant adverse outcomes other than minor pain and swelling.
As medical professionals, staying updated with the latest research and adapting our practices is crucial. This study offers a fresh perspective on a long-debated topic. What are your thoughts on these findings? Share your insights and experiences in the comments below.