It could be attributed to the high frenal attachment along with the trauma.
The exact etiology is unknown, but a review of literature suggests that abnormally labially positioned tooth, very thin labial plates, high frenal pull, and sometimes long-standing trauma may cause the dehiscence and fenestration defects.
Farmer (1983) (25) found that many denture fractures are a direct result of malocclusion in combination with a maxillary denture with a deep labial notch, resulting from a high frenal attachment.
Frenectomy should be done in high frenal attachments and relief should be given on prominent mid palatal suture.
This case report highlights the importance of consideration of periodontal tissue harmony prior to commencement of any dental procedure and elaborates the diagnosis and management of an orthodontic patient, where the temporary anchorage device has undergone inadvertent, complete coverage by maxillary frenal muscle attachment.
The patient had failed to report for further appointments for the past three months and this had resulted in the complete coverage of the miniimplant by the maxillary labial frenal attachment.
A #15 blade was used to sever the frenal attachment by a transverse incision above and below the area held by the hemostat (fig.
However, after the loss of teeth, this frenal attachment interferes with denture stability.
In addition to creation of space between the maxillary central incisors, and thus creating an area for food impaction, the frenal tissues have been implicated with poor oral hygiene, due to difficulty in tooth brushing and the resultant inflammatory periodontal destruction.
Frenotomy: is a partial removal of the frenum and to relocate the frenal attachment so as to create an increased zone of attached gingiva between the gingival margin and the frenum.