Diseases of the frenum of the upper lip and tongue: causes, symptoms, diagnosis, treatment
Last reviewed: 23.04.2024
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Congenital abnormal position of the bridle of the upper lip
The shortening of the bridle of the upper lip is usually combined with the formation of a diastema between the permanent central incisors.
The excessively developed (broad) bridle of the upper lip reaches the gap between these teeth; sometimes it concerns the same excessively developed incisive papilla (papilla incisiva).
If the bridle is very short or attached to the edge of the alveolar process, it can delay the gingival papilla, resulting in a pathological gingival pocket. In it, the remains of food accumulate, causing chronic gingivitis and bad breath.
Treatment
The treatment consists either in lengthening the short frenum by moving symmetrical triangular flaps along AA Limberg, or in cutting off the frenum from the gum. In the latter case, the incision is made at the level of the attachment of the bridle to the gingival margin. On the cut bridle, 2-3 nodular sutures are applied with a thin catgut, and the gingival wound is covered with a strip of iodine gauze for 2-3 days. After 3-5 days, the wound is epithelialized.
[1]
Anomalies of attachment and length of the tongue frenulum
If the bridle is shortened and attached not only to the base of the lower surface of the tongue, but also to the front part of the tongue (up to the tip of the tongue), there is a restriction of the mobility of the tongue and difficulty in the pronunciation of some tooth-gingival sounds.
Treatment
Treatment can be carried out by moving counter triangular flaps of the mucous membrane, as when shortening the bridle of the upper lip. If, however, the shortening of the bridle is expressed significantly and the tongue is as it were soldered to the bottom of the oral cavity, the movement of the opposing triangular flaps of the mucous membrane may not give the desired result. In such cases, it is better to use the method of crosscutting with subsequent mobilization of the edges and suture of the resulting diamond-shaped wound on the border of the bottom of the oral cavity with the lower surface of the tongue.
[2]