A frenum is a fold of tissue or muscle connecting the lips, cheek or tongue to the jawbone. The most common places to find frenums are at the midline between the front top teeth, the bottom front teeth or connecting the tongue to the lower jawbone. A frenectomy is the removal of one of these folds of tissue.
Sometimes a frenum can be attached too close to the teeth on the gums causing either recession or spaces between teeth. The frenectomy procedure involves the removal of the tissue attachment between the teeth. In cases where there is a gap between the two front teeth, prior to orthodontic closure, studies have shown that without a frenectomy procedure, there is a 70% incidence of the of the space reopening after the braces are removed. Most commonly, the frenectomy procedure is completed near the completion of the orthodontic treatment.
In the case shown above, before orthodontics was started, the 2 upper front teeth had a gap between them, with the frenum extending between the teeth. When orthodontics pulled the 2 teeth together, the frenum bunched up. The frenectomy was then performed to eliminate the pull of the frenum and prevent the space from opening up again.