Z Plasty – An Aesthetic Surgery for Aberrant Labial Frenum: A Case Report


Background: Aberrant labial frenum can cause central diastema, gingival recession and affect aesthetic appearance. Several techniques are available for removing the attachment of an abnormal frenulum. Z-plasty is a surgical technique used for thick and wide hypertrophy frenum associated with central diastema and short vestibule.

Objective: To discuss the Z-plasty technique for aberrant labial frenum.

Case Report: A 23-year-old woman was referred to the Periodontia Department of Hasanuddin University Dental Hospital for a frenectomy. Intraoral examination showed a diastema on maxilla centralis incisive and a labial frenulum’s attachment extending to the palatine papilla. The frenectomy procedure was performed using the Z-plasty technique.

Results: Follow-up after one week and one month showed a good healing process with minimal scars and gingival color according to the surrounding tissue.

Conclusion: Z-plasty frenectomy can provide good aesthetic and functional results for removing the attachment of hypertrophy frenum.

Keywords: frenectomy, labial frenum, hypertrophy frenum, Z-plasty

[1] Newman MG, Carranza FA. Clinical periodontology. 13th ed. Philadelphia: Elsevier. 2019. Periodontal and peri-implant surgical anatomy; 595-596.

[2] Reddy S. Essentials of clinical periodontology and periodontics. 3rd ed. New Delhi: Jaypee Brothers Medical. 2011. Mucogingival surgery; 372–373.

[3] Bagchi SS, Sarkar P, Bandyopadhyay P. Case report management of aberrant frenum: Series of cases. Annals of Applied Biology Sciences. 2016;3(2): 34-39.

[4] Chaulkar P, Mali R, Mali A, Patil V, Lele P, Patil P. An aesthetic avenue to an aberrant labial frenum: A clinical case report. International Journal of Scientific Research. 2016;5(8): 53–55.

[5] Gupta V, Pant V, Singh P. Labial frenotomy through Z-plasty-A case report. Periodontology. 2018;10(6): 49-50.

[6] Janarthanan S, Arun RT, Srinivasan S, Kumar SS, Meenakshi PT. Frenectomy with unilateral displaced pedicle flap: A case report. International Journal of Scientific Research. 2019;8(4): 55–57.

[7] Kaur G, Malik S, Grover D, Sharma A. Surgical management of aberrant labial frenum using modified Z-frenuloplasty: A case report. International Journal of Surgery Case Reports. 2015;1(10): 5-8. https://doi.org/10.17354/cr/2015/3.

[8] Medikawaty R, Mardiana AA. Management of frenectomy and gingival depigmentation in preprosthetic patients: Case report. Makassar Dental Journal. 2019;8(2):83– 86.

[9] Kapoor S, Vandana, Kaur S, Prashar P, Kaur G. High aberrant labial frenum and its different treatment modalities: A case series. Indian Journal of Comprehensive Dental Care. 2018;8(2): 1164–1167.

[10] Mehrotra K. Majhi SS, Triveni MG, Mehta DS. Z- plasty: An esthetic approach for maxillary labial frenum. Archives of Dentistry and Oral Health. 2018;1(2):13–17.

[11] Anahita P, Thomas B, Amitha R. Management of an aberrant mandibular buccal frenum - A case report. Journal of Dental Sciences. 2018;3(1): 5–7.

[12] Olivi M, Genovese MD, Olivi G. Laser labial frenectomy: A simplified and predictable technique: Retrospective clinical study. European Journal of Paediatric Dentistry. 2018;19(1): 56-60. https://doi.org/10.23804/ejpd.2018.19.01.10.

[13] Barot VJ, Brahmbhatt JM. Z-plasty: An esthetic eraser for labial frenum. Universal Research Journal of Dentistry. 2016;6: 48-52.als of Applied Biology Sciences. 2016;3(2): 34-39.