Comparison of two surgical techniques for the treatment of abnormal upper labial frenal attachment

INTERVENTION: Intervention1: Maris T Technique for maxillary labial frenotomy: Maxillary labial frenotomy performed using the Maris T Technique with bilateral pedicle flap under local anesthesia. The technique involves T shaped incisions to release the frenal fibers while preserving and repositioning the apical flap to reduce tissue tension and improve wound healing patient comfort and esthetic outcome. Control Intervention1: Conventional frenotomy technique: Maxillary labial frenotomy was performed under local anesthesia using the conventional scalpel technique. A hemostat was used to engage the labial frenum, and the frenal tissue was excised with two converging incisions to completely release the fibrous attachments extending to the periosteum. Muscle fibers were dissected as required to eliminate tension, and the wound margins were approximated with interrupted sutures to achieve primary closure. The procedure aimed to relieve the aberrant frenal attachment, facilitate wound healing, improve patient comfort, and restore normal function. CONDITION: Health Condition 1: K068‐ Other specified disorders of gingiva and edentulous alveolar ridge PRIMARY OUTCOME: Early wound healing assessed using the Landry Turnbull and Howley Healing IndexTimepoint: Postoperative Day 1 Day 3 and Day 7 SECONDARY OUTCOME: Patient satisfaction assessed using a 5 point Likert Scale at Day 7 ; Gingival oedema assessed using the Loe and Silness Gingival Inde Xat Day 3 Day 5 and Day 7 ; Functional discomfort during speech and mastication assessed using the Visual Analog Scale at Day 3 and Day 7 ; Postoperative bleeding assessed using a four point bleeding score immediately after surgery and at 24 hours ; Rescue analgesic consumption recorded during the first 7 postoperative days ; Scar formation assessed clinically at 1 month ; Functional improvement assessed at 1 month ; Adverse events including infection wound dehiscence delayed healing and excessive scarring recorded throughout the study periodTimepoint: Postoperative Day 1 Day 3 and Day 7 INCLUSION CRITERIA: Patients aged 18 to 40 years Presence of papillary or papillary penetrating frenal attachment Systemically healthy individuals Patients willing to participate and provide informed consent