Paralleling Frenectomy Technique as A Support Successful of Fixed  Orthodontic Treatment for Central Diastema Closure

Fawzan Nur Ramadhan; Nastiti Mayangjati Surya Hapsari; Sri Pramestri Lastianny

Authors

Fawzan Nur Ramadhan Universitas Gadjah Mada
Nastiti Mayangjati Surya Hapsari Universitas Gadjah Mada
Sri Pramestri Lastianny Universitas Gadjah Mada

Keywords:

frenektomi

Abstract

Abstract

Introduction: Central diastema is a space between two central incisors that can be caused by attachment of frenum to the interdental papillae of maxillary central incisor. Abnormal attachment of superior labial frenum can affect aesthetic aspect, damage periodontal tissue, hinder proper maintenance of oral hygiene and inhibit treatment of diastema closure, thus frenectomy procedure is needed. Frenectomy is a complete removal of frenum’s fibrous tissue including the attachment on bone surface. Case and management: A 24-years-old male patient referred to Periodontics RSGM UGM Prof. Soedomo with chief complaint of frenum’s attachment that hinder tooth movement during orthodontic treatment. Clinical findings showed superior labialis frenum’s attachment reached interdental papillae in the palatal side. Frenectomy with paralleling technique is planned, with incision using scalpel on both lateral side of the frenum ridge. Discussion: Paralleling technique provides better perception in terms of postoperative pain and minimize complication risk compared to conventional technique. Primary closure is also more achievable because of thin parallel incision. Conclusion: Paralleling frenectomy technique is a procedure to eliminate predisposing factor of periodontal disease caused of frenum abnormal attachment and to support orthodontic treatment of diastema closure.

Keywords: paralleling frenectomy technique, central diastema, frenum.

Abstrak

Pendahuluan: Diastema sentralis adalah celah di antara dua gigi insisivus sentral yang dapat terjadi karena perlekatan frenulum yang mencapai maksila insisivus sentralis. Frenulum merupakan lipatan membran mukosa yang melekat pada bibir atau pipi di mukosa alveolar, gingiva dan periosteum di bawahnya. Perlekatan frenulum labialis superior yang tinggi dapat menyebabkan diastema sentralis yang mengganggu estetik, iritasi pada jaringan periodontal, menghambat dalam pemeliharaan kebersihan gigi dan mulut, menjadi penghalang dalam perawatan ortodontik pada gigi insisivus depan rahang atas sehingga membutuhkan tindakan frenektomi. Frenektomi adalah pengambilan seluruh jaringan fibrosa interdental pada bagian frenulum termasuk perlekatannya di bawah tulang. Laporan Kasus: Seorang pasien pria usia 24 tahun rujukan ortodontik datang ke RSGM UGM Prof. Soedomo dengan keluhan adanya perlekatan frenulum yang mengganggu pergerakan gigi selama perawatan ortodontik. Pemeriksaan klinis terlihat perlekatan tinggi frenulum labialis superior dengan eksistensi perlekatan mencapai papila palatina. Prosedur perawatan frenektomi dengan teknik paralel, insisi menggunakan blade dan scalpel pada kedua sisi lateral ridge frenulum. Pembahasan: Teknik paralel memberikan persepsi baik pada pasien dalam hal nyeri paska operasi dan komplikasi minimal bila dibandingkan teknik konvensional lainnya. Primary closure memungkinkan pada kasus ini, karena insisi paralel yang tipis. Kesimpulan: Frenektomi teknik paralel merupakan perawatan yang dapat dilakukan untuk menghilangkan faktor predisposisi penyakit periodontal akibat perlekatan frenulum tinggi serta bertujuan mengoreksi diastema sentralis dan mendukung proses perawatan ortodontik.

Kata Kunci: frenektomi teknik paralel, diastema sentralis, frenulum

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