Safety and efficacy of maxillary labial frenectomy in children: A retrospective comparative cohort study

Pediatric High Labial Frenum Management: Utilizing a Diode Laser for the Transformation of the Smile of an Eight-Year-Old Child

Median diastema is a physiological occurrence that is frequently seen in the maxillary jaw. Therefore, a median diastema has been associated with a wide range of etiological variables, including thumb sucking, supernumerary teeth, tongue thrusting, some dentoalveolar discrepancy, and hypodontia. Patient esthetic and function demands are both negated by the labial frenum's abnormal location in relation to the maxillary anterior teeth, which results in diastema and gingival recession. Lasers are now being used in several fields of dentistry as an alternative to conventional scalpel operations. Frenectomy can be done through the use of electrosurgery, laser surgery, or the classic scalpel technique. This pathological frenum can be very well excised with a diode laser. Due to its applicability, sufficient coagulation, lack of suture requirements, and reduced discomfort and inflammation, the diode laser can be utilized in pediatric dentistry. High-connected midline diastema has remained a subject of debate when it comes to management and the right time to intervene and treat it. Both orthodontists and pediatric dentists agree that frenectomy should not be done after the closure of the orthodontist gap or before the appearance of the permanent canine teeth. However, several conditions, including the child's psychological status, parents' concerns, the closure's unpredictable effects on the future, and the expense of combined therapies, may lead to an early intervention for therapy during the primary or mixed dentition. In this specific scenario, a child who was eight years old underwent a diode laser frenectomy. After seven days, a follow-up examination showed normal position and attachment of the frenum and no signs of infection at the site of surgery.

Effects of topically administered 0.6% hyaluronic acid on the healing of labial frenectomy in conventional and 940-nm indium gallium arsenide phosphide (InGaAsP) diode laser techniques in pediatric patients: a randomized, placebo-controlled clinical study

This study aimed to investigate the effects of 0.6% hyaluronic acid (HA) gel on the healing process and postoperative pain levels after diode laser-assisted labial frenectomy in pediatric patients. Ninety-six pediatric patients (females, 50 and males, 46) aged 8-14 years were randomly divided into four groups as follows: (1) conventional frenectomy with 0.6% topically administered HA (CFH, n = 24); (2) conventional frenectomy with placebo gel (CFP, n = 24); (3) frenectomy performed by diode laser with 0.6% topically administered HA (DLH, n = 24); and (4) frenectomy performed by diode laser with placebo gel (DLP, n = 24). HA application was continued for 1 week thrice daily after the frenectomy. Visual analog scale forms were collected from patients 1 week after the operation. In addition, the plaque index, gingival index, periodontal probing depth, and keratinized tissue width and thickness were recorded. This process was repeated 1 and 3 months after the first visit. The DLH group revealed significant differences in the probing depth, bleeding on probing, keratinized gingiva width, and attached gingiva width according to dual comparisons of the initial, first, and third-month values (p = 0.010, p = 0.007, p<0.001, and p = 0.001, respectively). Significant differences were observed between the CFP and CFH groups according to the initial and initial third-month values with regard to the bleeding on probing (p=0.019 and p = 0.019, respectively). The attached gingival thickness revealed significant differences between the CFP and CFH groups for the initial and initial-third-month comparisons (p = 0.005 and p = 0.007, respectively). The mean values of the initial and initial-third-month differences were significantly higher in the CFH group than those in the CFP group. HA- and laser-assisted labial frenectomies revealed better outcomes in terms of the probing depth, attached gingiva width, keratinized gingiva width, healing process, and postoperative comfort.

Twelve-Year Follow-Up of Laser Frenectomy during Early Mixed Dentition

Median maxillary labial frenum (MMLF) is one of the oral freni, found on the inner side of the centre of the upper lip. Maxillary midline diastema (MMD) is commonly associated with highly attached frenum, and frenectomy during early mixed dentition is controversial. A 6-year-old boy came with a chief complaint of unpleasant spacing between the two upper front teeth. A median maxillary high attached labial frenum with midline spacing of 5 mm was diagnosed. A consensus was made with the child's father to remove the frenum by laser. Diode laser frenectomy was done, and subsequent follow-up for 12 years revealed no relapse and complete closure of the diastema. Frenectomy during early mixed dentition could be a suitable option for the closure of midline diastema.

Maxillary Frenulum and "Lip Tie": What Parents Understand

Objective

To determine the proportion of parents that have some knowledge of abnormal maxillary frenulum, or "lip tie," and their sources of this information.

Study Design

Cross-sectional study.

Setting

Otolaryngology clinic.

Methods

Consecutive parents of children ≤12 years of age presenting at a pediatric otolaryngology clinic were surveyed to discover their understanding of "lip tie" in children. The survey included questions on the effects of "lip tie," where they learned about "lip tie," whether they thought their child had "lip tie," whether they had a child undergo "lip tie" division, and how concerned they would be if they thought their child had "lip tie." Information on participant demographics and social media was collected.

Results

Overall, 59.8% (193) of the 323 parents surveyed had heard of "lip tie"; of those, 17.1% (33) had a child that had undergone "lip tie" surgery. Most parents (91.2%, 176) thought "lip tie" caused breastfeeding problems. Roughly one-quarter of parents (51 of 197 responses) rated their concern about "lip tie" as >8 of 10 on a Likert scale (mean, 5.7). The reported sources of "lip tie" information included lactation consultants (36.8%, 71), nurses (22.8%, 44), and pediatricians (31.6%, 61) as well as nonmedical sources, such as social media, family, and friends (68.4%, 132). Overall, 87% (282) of the 323 participants reported daily use of social media.

Conclusion

Although many parents are concerned about "lip tie," much of their information on this condition comes from nonmedical sources. Social media would be a valuable platform to provide accurate information on "lip tie."