Evaluation of esthetics, pain scores, and prognosis of modified paralleling technique for high frenal attachment: A case series

A frenum is a thin fold of mucous membrane that attaches the lips to the alveolar mucosa and the periosteum. The frenum provides stability and supports the lips and the tongue. Normally, the terminal end of the frenum is seen till the alveolar mucosa or the gingiva. However, in some individuals, the frenum extends to or beyond the interdental papilla. Such an aberrant or high frenular attachment compromises plaque control, orthodontic treatment, denture retention, and esthetics. Therefore, surgical correction of the high frenal attachment is recommended either by completely removing the frenum (frenectomy) or repositioning it (frenotomy). Frenectomy or frenotomy can be performed either with a surgical blade, electrocautery, or lasers. Frenectomy using a surgical blade is considered to be more invasive compared to other methods, as it involves mild-to-moderate bleeding, the formation of large surgical wounds, and the chances of scarring during healing. Hence, many modifications to the conventional frenectomy technique have been explored to provide a simpler, faster, and minimally invasive surgical approach. The present case series highlights a novel frenectomy technique involving a modification of the paralleling technique for frenal correction.