High Frenal Attachment

High Frenal Attachment

Write short note on high frenal attachment.
Answer. Frenum is a fold of mucous membrane usually with enclosed muscle fibers that attaches the lips and cheeks to the alveolar mucosa and/or gingiva and underlying periosteum.

In high frenal attachment the oral hygiene is hindered due to the shallow vestibule which is caused by high frenum attachment.

Frenectomy should be done for correction of high frenal attachment.

High Frenal Attachment Procedure

• Step 1: After anesthetizing the area, engage the frenum with a hemostat.
• Step 2: Incise along the upper surface of the hemostat, simultaneously make a similar incision along the under surface of the hemostat.
• Step 3: Remove the triangular resected portion of the frenum along with hemostat. This expose the fibrous connective tissue attachment to bone.
• Step 4: Make a horizontal incision to dissect and separate the fibers attached to bone.
• Step 5: If needed extend the incisions laterally and suture labial mucosa to apical periosteum.
• Step 6: Clean the surgical field and pack with guaze sponges till bleeding stops.
• Step 7: Cover the area by dry aluminum foil and apply periodontal pack.
• Step 8: Remove the pack after 2 weeks and repack if needed.