A frenum is a naturally occurring fold in the thin, movable tissue in our mouths called mucosa. If the frenum is too large or too dense to allow the teeth to come together, the frenum is surgically released from the gum with a frenectomy. It has been the experience of the doctors to address a frenum that may compromise the outcome or stability of orthodontic treatment near the end of that process, while the orthodontic appliances are still in place. Between the upper front teeth a gingival graft is rarely needed in conjunction with the frenectomy, while the frenum would almost never be treated for lower teeth without a gum graft.
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