Comparative evaluation of modified frenectomy with papilla preservation flap versus conventional technique in upper labial frenectomy: a randomized controlled trial

Introduction:Cosmetic concerns among patients have led to an increased demand for dental treatments aimed at achieving a perfect smile. One of the main cosmetic issues in adults is the gap between the upper incisors, known as diastema, and the upper lip frenulum is often a contributing factor to this condition. Therefore, it is imaportant to focus on this aspect.Objective:To explore a new technique for cutting the upper lip frenulum in patients with a gap between the central incisors while avoiding the negative effects of the traditional technique.Materials and methods:This randomized controlled clinical trial included 20 patients diagnosed with abnormal upper lip frenal attachment and diastema between the central incisors. The study compared the modified frenectomy technique with a papilla preservation flap against the traditional "Archer" technique. Each technique was performed on 10 patients, and outcomes such as scar formation, gingival inflammation, and post-surgical pain were evaluated.Results:The "modified frenectomy with papilla preservation flap" technique prevented scar formation in the papilla area between the upper incisors in nine cases, while scar formation occurred in seven cases using the traditional technique. There were no statistically significant differences in gingival inflammation post-surgery. Pain levels were lower with the modified technique: on the first day, the average pain score was 1.5 for the modified technique and 2.8 for the traditional technique. By the third day, the average pain was 4.3 for the modified technique and 6.9 for the traditional technique, with pain decreasing by the seventh day to an average of 0.7 for the modified technique and 1.6 for the traditional technique.Conclusion:The modified frenectomy with a papilla protection flap effectively reduces scarring, enhances healing, and minimizes postoperative pain, offering a more comfortable and aesthetically better result than conventional methods.