A minor oral surgical procedure to prevent the relapse of anterior interdental spacing after orthodontic correction.
Even after the completion of orthodontic treatment for correction of anterior interdental spacing and after continuous usage of removable retentive appliances, the relapse is quite common (canine to canine spacing and midline diastema).
Reason for Relapse
Is because of pressure exerted by the gingival fibres present as a thick band in the interdental area.
These particular fibres are mainly:
Currently Available Treamtments to Prevent Relapse
Using removable retention appliances :
Eg. Hawleys appliances with labial bows & finger springs.
By lingualy bonded splinted retainers.
By crowns and prosthesis.
By frenectomy/frenotomy for midline diastema
Interdental Gingival Fibrectomy
Interdental Gingival Fibrectomy is a minor oral surgical procedure to prevent the relapse of anterior interdental spacing after the orthodontic correction. The interdental gingival fibres like interpapillary fibres, intercircular fibres, transseptal fibres and transgingival fibres are being cut and removed to relieve the pressure between the realigned teeth preserving the normal anatomy and aesthetic appearance of the papillas.
Timing of the Procedures
This procedure has to be done after the closure of anterior interdental spaces and prior to the removal of fixed orthodontic appliances.
Fixed orthodontic forces has to be retained for a period of two months for the following reasons:
To allow complete bone formation around the bodily moved teeth.
To minimise scar formation
To confirm proximity of realigned teeth
No.12 BP blade and handle
Anaesthetise the canine to canine region of maxillary and mandibular arches by infiltration technique, where the surgery is going to be performed.
Using the suitable end of a spoon excavator, elevate the free marginal gingiva along the teeth on either side of the spacing, hook around the interdental labial papilla, slightly extending it downwards occlusally, then incise the anterior end of the col, with No.12 BP Blade preserving the normal anatomy and aesthetic appearance of labial papilla.
Similarly, in the palatal or lingual side, with the suitable end of a spoon exevator elevate the palatal mucosa along the tooth and hooke around the interdental lingual papilla and the col is pulled out palatally carefully and completely without tear. This pulled out col area is excised using a sharp scissors preserving the normal anaomy and easthtic appearanceof palatal papila.
Control bleeding and use hemostatic agents, if required
Recall after two days to tighten the Elastic chain and to confirm the proximity of the teeth
After two months, the fixed orthodontic forces are removed and scaling should be done and removable retention appliance has to be given for a period of one year.
This procedure serves to prevent the relapse of anterior interdental spacing and midline diastema after orthodontic correction. Definitely better than any other currently available temporary antirelapse solutions.