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Labial Frenectomy with the Sapphire
®
Portable Diode Laser:
(and Frenotomy procedures)
Tip: Initiated
Mode: Continuous Wave
Power: 1.0 W
Anesthesia: Local, as required
Technique: Contact
The procedures to relieve the frenum will differ for three basic areas: 1) Mandibular frenum – labial or buccal; 2)
Mandibular frenum – lingual (tongue-tied relief); 3) Maxillary frenum – labial and buccal.
Mandibular labial frenum attachments:
1. Place tension on the frenum by retracting the lip or cheek.
2. Beginning at the base of the attachment to the gingival tissue, make an
incision with the Sapphire Portable Diode Laser that is perpendicular to the
length of the frenum.
3. If necessary to achieve desired results, increase power level but always use
the lowest amount of power necessary to reach the treatment objectives and
avoid charring tissue.
4. Using continued tension, extend the incision until you are nearing
the periosteum.
Note: Do not cut into or damage the periosteum.
5. The incision may need to extend laterally when there is a wide attachment.
6. Wipe the debris from the hard and soft tissues using hydrogen peroxide or
warm saline solution.
Note: Sutures are usually not required.
Lingual frenum:
Lingual frenum relief must be approached with caution to ensure that you do not
inadvertently rupture or incise the rich vascular beds in the floor of the mouth and
the inferior border of the tongue.
• Grasp the frenum with a hemostat near the attachment to the tongue and use
a hemostat to protect the vascular complex as the incision is made and the
frenum released.
Maxillary labial frenum:
• Grasping the lip, place tension on the frenum and begin to make a
perpendicular incision at the most coronal aspect of the attachment to
the gingiva.
• With continued tension, release the frenum fibers as you are moving apically.
NOTE: Do not perforate or incise the periosteum.
Release all fibers down to the frenum attachment to the periosteum.
• A diamond shaped surgical area will indicate that you have released
the attachment.
• Use warm saline rinses to clean the area.
