Published date: Apr 25 2022

Journal Title: KnE Medicine

Issue title: The International Online Seminar Series on Periodontology in conjunction with Scientific Seminar

Pages: 302-312

DOI: 10.18502/kme.v2i1.10863

Sri Pramesti Lastiannysri.pramestri@ugm.ac.idDepartment of Periodontics, Faculty of Dentistry, Gadjah Mada University Denta Street No.1, Sleman, Yogyakarta, Indonesia

Muhammad YusufPeriodontics Specialist, Dentist Education Program

Background: High frenum attachment has a detrimental effect on periodontal tissue and esthetics. High adhesion to the frenulum can lead to gingivitis and central diastema, which are indications for frenectomy. A better oral aesthetic appearance improves the overall appearance and personality and self-confidence when smiling. Short clinical crown is often a patient complaint, one of the causes being altered passive eruption.

Objective: To describe the correction of high frenulum with frenectomy and correction of altered passive eruption with crown-lengthening surgery with ostectomy.

Case Report: A 23-year-old patient presented to the periodontics clinic of Dental and Oral Hospitals Gadjah Mada University (RSGM UGM), with complaints of short front teeth and difficulty in cleaning the teeth in the maxillary anterior region. The management of high frenulum was done by frenectomy, followed by crown lengthening using a scalpel.

Results: The four-week control showed corrected altered passive eruption and coral pink gingiva.

Conclusion: Frenectomy is an action to overcome high frenulum which aims to prevent periodontal disease. Crown lengthening is a treatment for correction of functional and aesthetic disturbances associated with altered passive eruption.

Keywords: frenectomy, altered passive eruption, crown lengthening

[1] Aroni MAT, Pigossi SC, Pichotano EC, de Oliveira GJPL, Marcantonio RAC. Esthetic crown lengthening in the treatment of gummy smile. International Journal of Esthetic Dentistry. 2019;14(4):370–382.

[2] Thahir H, Djais AI, Wendy S, Achmad MH, Akbar FH. Management of maxillary labial frenum with comparison of conventional and incision below the clamp techniques: a case report. Journal of Dentomaxillofacial Science. 2018;3(1):61–66.

[3] Buana AAGBA, Murdiastuti K. Esthetic crown lengthening with ostectomy and frenotomy for treatment of gummy smile: A case report from Prof. Soedomo Dental Hospital, Yogyakarta-Indonesia. Indonesia Journal of Biomedical Science. 2018;12(2):32-35

[4] Suryono S. Incision below the clamp sebagai modifikasi teknik insisi pada frenektomi untuk minimalisasi perdarahan. Majalah Kedokteran Gigi Indonesia. 2011;18(2):187– 190.

[5] Yadav RK, Verma UP, Sajjanhar I, Tiwari R. Frenectomy with conventional scalpel and Nd: YAG laser technique: A comparative evaluation. Journal Indian Society of Periodontology. 2019;23(1):48–52.

[6] Devishree, Gujjari SK, Shubhashini PV. Frenectomy: A review with the reports of surgical techniques. Journal of Clinical and Diagnostic Research. 2012;6(9):1587– 1592.

[7] Protásio ACR, Galvão EL, Falci SGM. Laser techniques or scalpel incision for labial frenectomy: A meta-analysis. Journal Maxillofacial Oral Surgeons. 2019;18(4):490– 499.

[8] Narayanan M, Laju S, Erali SM, Erali SM, Fathima AZ, Gopinath P V. Gummy smile correction with diode laser: Two case reports. Journal of International Oral Health: JIOH. 2015;7(2):89–91.

[9] Oliveira PS, Chiarelli F, Rodrigues JA et al. Aesthetic surgical crown lengthening procedure. Case Reports Dentistry. 2015.

[10] Assaf M. Esthetic crown lengthening for upper anterior teeth: Indications and surgica techniques. International Journal Dental and Medical Research. 2014;1(3):86–91.

[11] Pedraza JAQ, Salinas BRG, Fierro NC, Najera RIS, Trevino JJF, Delgado IR. Crown lengthening procedure using aesthetic measurement gauges: A case report. International Journal of Applied Dental Science. 2017;3(2):95– 97.

[12] Kalsi HJ, Bomfim DI, Hussain Z, Rodriguez JM, Darbar U. Crown lengthening surgery: An overview. Primary Dental Journal. 2020;8(4):48–53.

[13] Marzadori M, Stefanini M, Sangiorgi M, Mounssif I, Monaco C, Zucchelli G. Crown lengthening and restorative procedures in the esthetic zone. Periodontology 2000. 2018:1-9.

[14] Lee EA. Aesthetic crown lengthening: classification, biologic rationale, and treatment planning considerations. Practical Procedures and Aesthetic Dentistry. 2004;16(10):769–780.

[15] Kusumo N. Estetik crown lengthening dengan metode minimal invasif: Evaluasi 1 tahun. Jurnal Ilmiah dan Teknologi Kedokteran Gigi. 2019;15(1):21–24.

[16] Bhuvaneswaran M. Principles of smile design. Journal of Conservative Dentistry. 2010;13(4):225–32.

[17] Alpiste-Illueca F. Altered passive eruption (APE): A little-known clinical situation. Medicina Oral Patologia Oral y Cirugia Bucal. 2011;16(1):e100-104.