Alabama Tongue-Tie Center, Pelham, AL, USA.
The Breathe Institute, Los Angeles, CA, USA.
Int Orthod. 2022 Jun;20(2):100630. doi: 10.1016/j.ortho.2022.100630. Epub 2022 Mar 10.
Maxillary frenectomy in children is a common procedure, but concerns about scar tissue affecting diastema closure prevent many clinicians from treating prior to orthodontics.
To determine if maxillary frenectomy is safe and if diastema size is affected by early treatment.
Paediatric patients with hypertrophic maxillary frena were treated under local anaesthesia with diode laser and CO laser. Diastema width was compared by calibrating and digitally measuring initial and postoperative intraoral photographs.
In total, 109 patients were included: 95 patients with primary dentition (39% male; mean age 1.9 years±1.5 years) and 14 with mixed dentition (43% male; mean age 8.1±1.3 years) with a mean follow-up of 18.0±13.2 months. No adverse outcomes were noted other than minor pain and swelling. In the primary dentition, a decrease in diastema width was observed in 94.7% with a mean closure of -1.4±1.0mm (range +0.7 to -5.1mm). In the mixed dentition, a decrease in diastema width was observed in 92.9% with a mean closure of -1.8±0.8mm (range 0 to -3.5mm). 74.5% of patients in the primary dentition and 75% of patients in the mixed dentition with preoperative diastema>2mm improved to<2mm width postoperatively.
Frenectomy is associated with cosmetic and oral hygiene benefits and when performed properly, does not impede diastema closure and may aid closure. Technique and case selection are critical to successful outcomes. IRB ethics approval was obtained from Solutions IRB protocol #2018/12/8, and this investigation was self-funded.
儿童上颌系带切除术是一种常见的手术，但由于担心疤痕组织影响牙缝关闭，许多临床医生在进行正畸治疗之前都避免进行这种手术。
确定上颌系带切除术是否安全，以及早期治疗是否会影响牙缝大小。
在局部麻醉下，使用二极管激光和 CO2 激光对患有肥大性上颌系带的儿科患者进行治疗。通过校准和数字测量初始和术后口内照片来比较牙缝宽度。
共有 109 名患者纳入研究：95 名患者处于替牙期（39%为男性；平均年龄 1.9 岁±1.5 岁），14 名患者处于混合牙列期（43%为男性；平均年龄 8.1 岁±1.3 岁），平均随访时间为 18.0 岁±13.2 岁。除了轻微的疼痛和肿胀外，没有观察到其他不良结果。在替牙期，94.7%的患者观察到牙缝宽度减小，平均关闭量为-1.4±1.0mm（范围为+0.7 至-5.1mm）。在混合牙列期，92.9%的患者观察到牙缝宽度减小，平均关闭量为-1.8±0.8mm（范围为 0 至-3.5mm）。在替牙期，术前牙缝宽度>2mm 的 74.5%的患者和混合牙列期术前牙缝宽度>2mm 的 75%的患者术后改善至<2mm。
系带切除术具有美容和口腔卫生的益处，并且在正确实施的情况下，不会妨碍牙缝关闭，反而可能有助于关闭牙缝。技术和病例选择对于获得成功的结果至关重要。本研究获得了 Solutions IRB 伦理委员会的批准（方案编号 2018/12/8），并由作者自行出资。
