Mouth braces . Braces are bands of connective tissue, muscle, or both, that attach the lip and cheeks to the alveolar mucosa or gum and the underlying periosteum. They are dynamic structures that change and are subject to variations in shape, size, and phases of growth and development.
Summary
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- 1 Features
- 2 types
- 3 Diagnosis
- 4 Pathologies
- 5 Frenulum surgery
- 6 Correct the frenulum
- 7 Times of analysis
- 8 Sources
characteristics
Buccal braces are bands of fibrous tissue that under certain circumstances can cause orthodontic, phonetic, periodontal, and prosthetic problems. When the upper labial frenulum descends into the palatal vault, it can cause an interincisive diastema; For its diagnosis, the Graver ischemia test or positive papilla sign is performed.
Extraoral panoramic radiography and periapical radiography are essential to rule out mesiodens and assess intermaxillary bone. There are three surgical treatment options: frenectomy, frenotomy, and a combination of both. The closure of the interincisive diastema is performed using fixed orthodontic appliances.
The lower labial frenulum is more frequently associated with anterior gingival retraction, and its treatment combines surgical technique and periodontal treatment. The lingual frenulum can cause ankyloglossia or a lower interincisal diastema. Ankyloglossia is associated with anterior open bite and posterior crossbite; If the limitation of the tongue is moderate, it can be treated with physical therapy and it does not resolve, the lingual frenectomy is performed.
Types
According to their location they are classified into:
- Upper labial frenulum; at birth it reaches the palatine papilla; With growth, the frenulum migrates apically, while a progressive closure of the diastema is observed.
- Lower lip frenulum
- Frenulum; in extreme cases they produce difficulties in feeding the baby, but in most cases it is the difficulty in pronouncing certain sounds such as the “r”, absence of projection of the tongue out of the mouth and appearance of a forked tongue as well as the increased caries due to the limited cleaning action of the tongue
- Laterals (at the height of upper and lower premolars)
Diagnosis
For its diagnosis, a complete clinical and radiographic examination is necessary, to rule out other causes such as:
- Supernumerary teeth: Mesiodens are a frequent cause of malposition of the central incisors with the appearance of diastemas.
- Digital suction, since it produces a vestibuloversion of the incisors that can be the cause of a diastema.
- Nasopalatine duct fissure cyst
- Maxillary perimeter increase
- Dental agenesis (lack of teeth) especially on the sides
Pathologies
These braces can easily be torn by strong shocks to the face or mouth , thereby allowing physical abuse.
- Lingual frenulum, ankyloglossia, also known as the tie tongue, is a congenital anomaly in which said frenulum is shorter than normal; so that the tip of the [tongue]] cannot protrude beyond the lower incisor teeth.
- The pathology in the upper labial frenulum is the most frequent and usually causes the separation (diastema) of the upper central incisor teeth. The cause may be due to the presence of a hypertrophic frenulum.
- Inferior labial frenulum: Like the superior labial frenulum, it can present a hypertrophy , although less frequent. In turn, it can lead to gingival recession of the lower central incisors.
Frenulum surgery
It is usual that sometimes before starting an orthodontic treatment it is necessary to carry out a small intervention to correct the position of a frenulum. We could divide the problems related to braces into two situations:
- Very strong lip braces with an insert (the place where the brace meets the gum) between the teeth creating a space between them (also called a diastema). In these cases, a small intervention must be performed that will remove the frenulum tissue from between the teeth to allow the space between the teeth to be closed with orthodontics (see animation at the bottom of this page)
- Short lingual frenulum: It creates a limitation of the lingual movements affecting speech and the proper development of the mouth . In this way, a short lingual frenulum could cause the tongue to not be able to contact the palate, which is important for creating an adequate widening of the upper jaw.
Correct the frenulum
When the lingual and labial frenulum are excessively short or thick, they should be corrected, since they can cause problems for your baby when taking the feeding. In the [[mouth] there are two braces, one holds the gum and the upper lip, the other connects the base of the mouth with the tongue.
Some babies have a very thick labial brace, so it can even lead to them preventing proper upper lip movement. The solution pediatricians give is to cut this membrane before the child begins to speak.
With the lingual frenulum there is not so much complication, since as the child grows, the frenulum stretches and the tongue goes beyond it as it lengthens. This membrane that joins the tongue with the base of the mouth, being so short and tight, makes it seem that the baby has the tip of the tongue divided in two.
However, there are some cases where having the baby difficulties to suckle and to begin to speak adequately, surgery is used , but you should always expect at least that the baby is already one year old .
Analysis times
There are 2 times in which it is important to analyze the development of the braces, one is in childhood, where the insertion of the braces can cause problems that lead to the need for orthodontic treatment.
And coinciding with advanced ages, where the presence of these braces can bring prosthetic or irritating problems on themselves. So it is necessary to evaluate them at an early age, where the early action of any pathology they present will reduce future problems.
