Frenectomy

frenectomy

1. frenectomy Ryan Pandu Digjaya PPDGS IBM FKG UGM Kuliah bedah preprostetik

2. TECHNIQUE the simple excision technique, the Z-plasty technique, localized vestibuloplasty with secondary epithelialization , the laser-assisted frenectomy .

3. 1. the simple excision technique

4. For the simple excision technique, a narrow elliptical incision around the frenal area down to the periosteum is completed

5. Placement of the first suture should be at the maximal depth of the vestibule and should include both edges of mucosa and underlying periosteum at the height of the vestibule beneath the anterior nasal spine. This technique reduces hematoma formation and allows for adaptation of the tissue to the maximal height of the vestibule. closed with interrupted sutures

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7. 2. the Z-plasty technique, Small elliptical excision of mucosa and underlying loose connective tissue.

8. Flaps are undermined and rotated to desired position

9. Closure with interrupted sutures.

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11. 3. localized vestibuloplasty with secondary epithelialization Wide V-type of incision made at most inferior portion of frenal attachments in area

12. Supraperiosteal dissection completed, releasing mucosa and fibrous frenal attachments.

13. Diagram of mucosal margins sutured to periosteum . Mucosal margins sutured to periosteum at depth of vestibule.

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15. 4. the laser-assisted frenectomy . Supraperiosteal ablation of mucosal and dense fibrous frenal attachments. Healing occurs by secondary epithelialization .

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17. Lingual Frenectomy tip of tongue to lingual aspect of mandible. In edentulous patients, movement of the tongue will dislodge the dentures

18. Bilateral lingual blocks and local infiltration in the anterior area provide adequate anesthesia for a lingual frenectomy. Placement of a hemostat across the frenal attachment at the base of the tongue for approximately 3 minutes provides vasoconstriction and a nearly

19. The tongue is retracted superiorly, and the margins of the wound are carefully undermined and closed parallel to the mid-line of the tongue. Careful attention must be given to blood vessels at the inferior aspect of the tongue and floor of the mouth and to the submandibular duct openings.

20. Soft tissue closure with interupted suture

21. TRIMAKASIH