Private practice, Rome, Italy.
Contract Professor, Catholic University of Sacred Heart, Rome, Italy.
Eur J Paediatr Dent. 2018 Mar;19(1):56-60. doi: 10.23804/ejpd.2018.19.01.10.
Anomalous maxillary median labial frenum may be associated with undesired effects such as persistence of diastema between anterior teeth or traction of marginal gingiva. The aim of this study was to propose a surgical frenum repositioning technique that is minimally invasive, safe, easy, reproducible, and predictable. Another objective of the study was to identify clinical scenarios that could have indication for labial frenectomy associated with early orthodontic therapy, so as to justify early frenum repositioning in children. A retrospective assessment of clinical outcomes of this technique is described.
A total of 20 frenectomies were performed on children aged 8 to 10 years. Frenectomies were performed with Er:YAG laser set at 150mJ 2.25-3.0W and 15-20 pulse per second, with water spray. Recall visits were done at 7, 21 and 90 days and 1, 2, 3 and 4 years.
At post-operative visits, all patients reported no post-operative pain or minimal discomfort. None experienced post-operative bleeding at a distance of few hours. All patients reported that the procedure was well tolerated and "acceptable". No recurrences occurred 4 years after frenectomy.
The Er:YAG laser used in this study allowed considerable reduction of the operating time, reducing the amount of local anaesthetic used as well as avoiding surgical sutures. The surgical design and technique also minimised post-operative discomfort and complications resulting in stable healing overtime, making the procedure fully accepted by children.
上颌正中唇系带异常可能与不良影响相关,如前牙之间的间隙持续存在或边缘牙龈的牵引。本研究旨在提出一种微创、安全、简便、可重复且可预测的唇系带重新定位手术技术。本研究的另一个目的是确定可能需要行唇系带切除术并联合早期正畸治疗的临床情况,从而证明儿童早期行唇系带复位的合理性。本文描述了对该技术的临床结果进行回顾性评估。
对 20 名 8 至 10 岁的儿童行唇系带切除术。采用 Er:YAG 激光(能量 150mJ,功率 2.25-3.0W,脉冲频率 15-20Hz,水流速度 5ml/s)进行手术。术后第 7、21 和 90 天,以及术后 1、2、3 和 4 年进行随访。
在术后随访时,所有患者均报告无术后疼痛或轻微不适。数小时内无患者发生术后出血。所有患者均表示该手术过程耐受性良好且“可接受”。4 年后,所有患者均未出现复发。
本研究中使用的 Er:YAG 激光显著缩短了手术时间,减少了局部麻醉药物的使用量,避免了手术缝线。手术设计和技术还最大限度地减少了术后不适和并发症,从而实现了稳定的愈合,使该手术完全被儿童接受。