Stricture formation at the surgical site has obliterated the labial sulcus
and restricted the upper lip movement in the anterior region.
Upon an intra-oral examination, a large gingival swelling was observed in the labial sulcus
adjacent to the labial frenum in relation to the region of teeth 11-21, and palatinal mucosal tissue of left maxillary anterior had a verrucous surface appearance with an approximate size of 3 x 3 cm (Figure 1).
On physical examination, bilateral ptosis, epicanthus, bilateral limited outward gaze, depressed nasal bridge, anteverted nostrils, thin upper lip, downturned mouth corners, and micrognathia were observed, the labial sulcus
was obscure on the right side and the mouth corner was sliding to the left while crying (Picture 1).
Intraoral examination revealed multiple accessory maxillary and mandibular labial frenula with upper (class III) and lower lip tie along with the absence of the mucobuccal fold with the resultant reduced sulcus depth in the maxillary and mandibular labial sulcus
region (figure 2).
During the clinical examination, we noticed a palpable fluctuant swelling on the upper labial sulcus
, beneath the right nasolabial fold.
Preventive measures such as plaque related diseases of caries and periodontal disease, should be considered especially for those patients who have diminished oral opening and obliteration of the labial sulcus
that make oral hygiene maintenance difficult, even minor trauma from tooth brush may cause oral bullae that lead to scaring.
There was a big scarred defect in the anterior mandible area with no labial sulcus
Fusion of labial mucosa in the upper lip with gingiva over the alveolus of the incisor region obliterating the labial sulcus
with thickening in the labial frenum area was seen (7).
A hard concretion resembling the exposed bone of the lower jaw was there inside the gingivo labial sulcus
on examination of oral cavity.
While denture fissuratum was more commonly seen in the age group 60-75 years, and in the lower labial sulcus
than other areas in the mouth.
But later on expanded in size, became indurated involving entire lower lip, labial sulcus
, alveolar ridge and floor of the mouth.
Trauma had caused displacement of the tooth to a position at the level of the labial sulcus
, forcing the incisor to erupt towards laterally out of its position in the arch and impacted due to lack of space.