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Periodontology Specialist Trainee, Periodontology Unit, Centre for Host Microbiome Interactions, Faculty of Dentistry, Oral and Craniofacial Sciences, King's College London
There are various cases where Z-frenuloplasty, a specific Z-plasty technique, can be used, including prior to mucogingival surgery, to manage localized recession defects, pre-prosthetic surgery, post-orthodontic treatment, oral hygiene and ankyloglossia, to name a few. This case series demonstrates the versatility of the Z-plasty technique in oral surgery/periodontal procedures for a variety of indications, as well as describing the technique in detail. The frenectomy technique using Z-plasty for the removal of the abnormal labial frenum attachment is reliable, easy to perform, and provides excellent aesthetic results for a range of indications.
CPD/Clinical Relevance: An appreciation of the Z-plasty technique will allow for tissue healing by primary intention, reduces risk of tissue contractures, improves recovery time, and improves aesthetic results.
Article
A frenum is a mucous membrane fold that contains muscle and connective tissue fibres, attaching the lip and cheek to the alveolar mucosa, the gingivae, tongue and the underlying periosteum.1 Its primary function is to provide stability of the upper and lower lip and the tongue. An aberrant frenum causes gingival recession, either due to an interference in plaque control or due to a muscle pull. It also presents an aesthetic problem, and may compromise the orthodontic result in midline diastema cases, thus causing a recurrence after the treatment.2
The aberrant frena can be treated by frenectomy or by frenotomy procedures for aesthetic and functional reasons. Frenectomy is the complete removal of the frenum, including its attachment to the underlying bone, while frenotomy is the incision and the relocation of the frenal attachment.3
Z-plasty is a plastic surgery technique that is use to improve the functional and cosmetic appearance of scars. Z-frenuloplasty is the Z-plasty technique used on the frenulum, which helps to release scar contracture and relieve soft tissue tension. This case series demonstrates the versatility of the Z-frenuloplasty, or Z-plasty, in oral surgery/periodontal procedures for a variety of indications as well as describing the technique in detail.
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