Central Diastema Management Following Frenectomy Using the Incision Below the Clamp Technique: A Case Report

Abstract

Introduction: Central diastema is often a concern for patients due to aesthetic issues that affect their confidence, especially when smiling. One of the causes of central diastema is a high attachment of the frenulum, penetrating the papilla of the hard palate. The appropriate procedure to eliminate a high frenulum attachment is frenectomy, which with minimal bleeding can be performed using the incision below the clamp (IBC) technique.

Objective: To evaluate the effectiveness of the incision below the clamp (IBC) technique as an alternative option for frenectomy procedures in correcting a central diastema caused by an aberrant labial frenum attachment.

Case: A 30-year-old female patient complained that her front teeth had become spaced again after fixed orthodontic treatment three years ago. On objective examination, the superior labial frenulum was found to penetrate up to the papilla of the hard palate, causing a central diastema between teeth 11 and 21. A frenectomy was performed using the IBC method, which has the advantage of minimal bleeding. After the initial phase of treatment, the patient was educated on the need for frenectomy. During the next visit, the patient was asked to fill out the informed consent form, and the frenectomy procedure was performed using a scalpel.

Outcome: The IBC method was carried out by making an incision at the base of the frenulum, which had been clamped. Evaluation of the results was carried out up to 8 months after treatment. By the sixth month, spontaneous closure of the central diastema was observed. At the eighth-month follow-up, no recurrence of the aberrant labial frenum attachment or central diastema was detected.

Conclusion: The diastema was corrected, and the patient is satisfied with the treatment results. The IBC technique can be an alternative option for frenectomy procedures.