Z-frenuloplasty: A Better Way to ‘Untangle’ Lip and Tongue Ties

Introduction: An abnormal frenulum can cause aesthetic and functional problems such as a midline diastema, localized gingival recession, loss of sulcus depth and ankyloglossia. This may lead to problems with speech articulation and swallowing. The aim of this article was to highlight the use of a novel surgical technique used for the treatment of hypertrophic frenula known as Z-Frenuloplasty. Method: This technical note outlines the indications and procedure involved in performing a Z-Frenuloplasty. Incisions are made to raise flaps which are later repositioned in a ‘Z-plasty’ flap closure. In the case of maxillary diastema, the pre – maxilla scar tissue is excised and the site is left to granulate and heal. Sutures are removed a week later. Results: Z-Frenuloplasty helps to release scar contracture and relieve soft tissue tension. The appearance of a scar is also improved with this technique as it helps to both relax and re – align the tissues. This procedure can also be used to position a short frenulum more apically for better aesthetic and functional results. Conclusion: The appropriate management of hypertrophic frenula can be challenging but with the use of the Z-Frenuloplasty technique, it has been shown that favorable results can be achieved with improved aesthetic and functional outcomes.