- 期刊
唇繫帶切斷術：牙周與矯正輔助治療
Labial Frenotomy: An Adjunct to Periodontal and Orthodontic Therapy
摘要
唇繫帶是口腔黏膜在上下顎中線處的皺摺，連接齒槽凸起與嘴唇。唇繫帶的異常附著會拉扯牙齦邊緣並限制唇的運動，可能因此引起牙齦退縮、牙間隙（diastema）、齒顎矯正治療後復發（relapse）、影響菌斑控制、假牙製作或術後傷口的穩定，甚至於影響美觀與發音。由於異常繫帶會對傷口造成拉扯，增加翻瓣張力，因此可能影響組織癒合或手術治療效果。異常的唇繫帶附著可考慮切除（frenectomy）或切斷（frenotomy）。唇繫帶異常早期多以徹底切除方式處理，且常延伸至舌側乳突（palatine papilla）。繫帶切除術的傷口較大、術後併發症較多，且可能造成齒間乳突的喪失。大多數的異常唇繫帶以保守的切斷方式即可達到繫帶移位的目的，且較不會造成美觀上負面的影響。本報告將分析異常唇繫帶的可能原因、繫帶切斷術的適應症、臨床操作、術後處理與治療時機，並以病例報告說明繫帶切斷術如何與牙冠增長術、翻瓣手術、骨脊保存術等其他術式合併應用於牙周與齒顎矯正的治療。
並列摘要
Abnormal labial frenum attachment will pull gingival margin and limit lip movement. If an abnormal frenulum is left untreated, it can result in marginal tissue recession, diastema, post-orthodontic relapse, may interfere with plaque control, prosthesis fabrication, and wound stability following surgery, and may affect facial esthetics and phonetics. Abnormal frenulum may also pull surgical wound and increase flap tension and may have adverse effects on tissue healing or treatment outcome. In the past, abnormal frenulum was completely removed by frenectomy, which was often extended to the palatine papilla. However, frenectomy creates larger wound, more complications, and loss of interdental papilla Most abnormal frenulum can be gently released and relocated in an apical direction by frenotomy, which produces more esthetically favorable results. The purpose of the paper is to introduce the indications and procedures of frenotomy and to present the use of frenotomy in combination with other surgical modalities in periodontal and orthodontic therapy.