- Mar, 23 Ene 2007, 16:20
[Histomorphologic evaluation of upper lip frenum in relation to the method of treating diastema][Article in Polish]
Z Katedry i Zakladu Ortodoncji Pomorskiej Akademii Medycznej w Szczecinie, al. Powstafc6w Wlkp. 72, 70-111 Szczecin.
The aim of this study was to determine collagen density in the hypertrophic upper lip frenum and scar forming after frenectomy and to compare the results with collagen density in a normal population (autopsy specimens). Differences in collagen density may cause problems in diastema closure and may eventually result in relapse of this condition. The study was done in 47 patients treated for diastema. Histomorphology was performed in 15 patients of this group. Autopsy material was obtained from 27 persons. Histomorphometric assessment of collagen density was done after staining of collagen fibers according to van Gieson. A computerized image analysis system was used for interactive detection of stained collagen fibers on the digitized microscopic image. The percentage of positive staining expressed as ratio of positive area to whole area of the field studied was determined and recorded as an Excel file. Collagen density was increased in the pathologic frenum and in the scar as compared with the normal frenum. The difference was statistically significant. Diastema treatment with frenectomy, fixed appliance and retainer produced more stable results
as compared to treatment with a removable appliance without frenectomy. The results suggest that the similar collagen density observed in hypertrophic upper lip frenum and scar after frenetomy may hinder complete closure of diastema and facilitate relapse after treatment.
PMID: 15552858 [PubMed - indexed for MEDLINE]
“el tratamiento del diastema mediante frenectomia, aparatología ortodoncica fija (para esta es imprescindible que hayan erupcionado los caninos definitivos) y mantenedor de espacio produce resultados mas estables”
: Am J Orthod. 1977 May;71(5):489-508. Links
The diastema, the frenum, the frenectomy: a clinical study.Edwards JG.
1. The pretreatment relationship between a clinically "abnormal"-appearing maxillary midline frenum and a midline diastema showed a strong, but not absolute, correlation. A certain percentage of patients demonstrated (1) a diastema but not an "abnormal" frenum or (2) no diastema but an "abnormal" frenum. 2. Diastema cases in which there were "abnormal" pretreatment frenums demonstrated a decidedly stronger potential for relapse after orthodontic closure. The exceptions to the rule were explained by the clinician's inability to differentiate between "normal" and "abnormal" frenums and by the periodontium's apparent (if not consistent) ability to recognize the frenal and interdental tissues following orthodontic tooth movement. 3. A three-stage surgical procedure was shown to be very effective in alleviating the relapse phenomenon following orthodontic treatment of diastemas.
The surgical procedures were successful in avoiding many of the hazards to the periodontium associated with previous techniques.
PMID: 266363 [PubMed - indexed for MEDLINE]
“una cirugia en tres pasos, seguida por tratamiento ortodoncico del diastema se ha mostrado muy eficaz en evitar las recidivas (reapariciones) del diastema”
: Rev Stomatol Chir Maxillofac. 1977;78(5):351-6. Links
[Z-plasty technic, applied to hypertrophy of the upper labial frenum][Article in French]
Puig JR, Lefebvre E, Landat F.
The authors used the technique of Z-palsty in the surgical treatment of hypertrophy of the superior labial fraenum. They consider that this operation is indicated when there is hypertrophy of the fraenum with a low insertion, associated with an inter-incisor diastema, and that the lateral incisors have appeared without causing the diastema to disappear
. This technique eliminates the possibility of a hypertrophic scar, a possible source of failure.
PMID: 270800 [PubMed - indexed for MEDLINE]
“consideran qeu ests intervención esta indicada cuando existe un frenillo con inserción baja y diastema interincisal que no se cierra tras la erupción de los dientes definitivos”
: Clin Ter. 1989 Jul 31;130(2):95-100. Links
[The superior median frenulum. Surgical-orthodontic treatment of a recurrence][Article in Italian]
Antoni R, De Angelis D, Gravina GM, Accivile E.
The authors illustrate the etiopathogenic factors of the pathology resulting from superior inter-incisal diastema combined with labial frenulum. They point out that it is not possible to solve the examined pathology without an adequate program set out in close cooperation between orthodontist and periodontal surgeon. They also describe a case of relapse after frenectomy carried out before the suitable age for obtaining a final result which is lasting and constant.
PMID: 2529088 [PubMed - indexed for MEDLINE]
los autores señalan que no es possible resolver esta patologia sin un programa adecuado en estrecha cooperación entre el cirujano y el ortodoncista. tambien describen un caso de recidiva (reincidencia) por una frenectomia realizada antes de la edad adecuada para la obtención de resultados curaderos y constantes”
: Pediatr Dent. 1995 May-Jun;17(3):171-9. Links
The midline diastema: a review of its etiology and treatment.Huang WJ, Creath CJ.
University of Alabama at Birmingham, USA.
A midline diastema usually is part of normal dental development during the mixed dentition. However, several factors can cause a diastema that may require intervention. An enlarged labial frenum has been blamed for most persistent diastemas, but its etiologic role now is understood to represent only a small proportion of cases. Other etiologies associated with diastemas include oral habits, muscular imbalances, physical impediments, abnormal maxillary arch structure, and various dental anomalies. Effective diastema treatment requires correct diagnosis of its etiology and intervention relevant to the specific etiology. Correct diagnosis includes medical and dental histories, radiographic and clinical examinations, and possibly tooth-size evaluations. Appropriate treatment modalities have been described. Timing often is important to achieve satisfactory results. Removal of the etiologic agent usually can be initiated upon diagnosis and after sufficient development of the central incisors. Tooth movement usually is deferred until eruption of the permanent canines,
but can begin early in certain cases with very large diastemas.
PMID: 7617490 [PubMed - indexed for MEDLINE]
en este habla que no todos los diastemas (solo un peqeuño porcentaje) estan producidos por la hipertrofia del frenillo labial. que el tratamiento del diastema exige diagnosticar previamente las causas. dice que los tiempos son muy importantes para obtener resultados satisfactorios. y textualmente “los movimientos dentales se suelen retrasar hasta la erupción de los caninos definitivos”
1: Pediatr Med Chir. 1992 Nov-Dec;14(6):637-40. Links
[Indications for therapy of labial frenum][Article in Italian]
Mazzocchi A, Clini F.
Clinica Odontoiatrica Universita di Brescia, Italia.
Reporting some cases and literature researches, the Authors point out the indications of labial frenum therapy. The results show no correlations between teeth diastema and frenum: surgical therapy of frenum is recommended after complete eruption of permanent teeth
. The correct surgical procedure must be radical and conducted in a short time: frenectomy prolonged to the incisive papilla, is recommended.
PMID: 1298940 [PubMed - indexed for MEDLINE]
“la terapia quirurgica del frenillo se recomienda despues de la erupción de la dentición permanente”
como no se como andais de ingles , he traducido de estos resumenes las partes qeu interesan a la causa.
en resumen, en una buscqueda bibliografica de mas de 300 articulos solo he encontrado 2 favorables a las extirpadción temprana del frenillo. uno griego y uno frances, que ademas hace alusión a "una vieja tecnica en desuso"
espero qeu esto satisfaga vuestras ansias de conocimientos.
RECUERDA: las recomendaciones del foro NO PUEDEN sustituir a la consulta con un medico (NI LO PRETENDEN)