Safety and efficacy of maxillary labial frenectomy in children: A retrospective comparative cohort study

Common indications for removal of maxillary frena in children (lip-tie) include difficulty performing oral hygiene, oral incompetence resulting in difficulty producing bilabial speech sounds (/b/, /p/, /m/), difficulty removing food from a spoon, habitual open mouth breathing, improving the cosmetic appearance of the smile line, lip fullness and diastema closure. In the mid 1900’s surgical procedures to correct lip ties fell out of favor and practitioners were counselled that if a diastema (horizontal space between teeth-typically the upper two front teeth) was present, it was best to wait until after orthodontic closure to release the tight maxillary frenum. This paper presents a cohort study where 192 consecutively treated pediatric patients underwent maxillary labial frenectomy in a private pediatric dentistry clinic from January 2015 to May 2018. The maxillary labial frenectomy was performed using a diode or CO2 laser. The conclusion was that with treatment of a diastema with proper technique and case selection there was a 94.5% closure in the diastema and in their sample did not leave scar tissue that impedes orthodontic closure. The authors concluded that maxillary frenectomy should be considered in patients with hypertrophic maxillary frenum causing symptoms of difficulty with oral hygiene, cosmetic concerns, bilabial speech sounds, or anterior caries without the worry of scar tissue formation.