Anterior posterior spacing with frenectomy and orthognathic surgery

Q:
I spoke with someone who mentioned several times the insufficient anterior posterior spacing in relation to frenectomy and orthognathic surgery. Is this new information? Or is this just something completely out of left field?
Thanks,
RA (QOM)

A:

Good afternoon,

I’m not sure what the anterior posterior spacing insufficiency specifically is referring to— so here are some of my thoughts.

In dentistry when we use the terms anterior-posterior (AP) we are talking about the direction from the front of the mouth to the back of the mouth.

In frenotomies, there is always an anterior and a posterior “component” to a lingual restriction. I showed some photos of the thin anterior (sail) that has a posterior component of fascia that overlies the genioglossus muscle. This fascia needs to be removed during the surgery — but always dictated by the other anatomical landmarks like nerves and arteries.

There are people with airway disorders that range from snoring to severe sleep apnea which can be caused by an (AP) narrowing of the oral airways as it descends down the pharynx– most frequently in the velopharynx — this can be expanded or enlarged in the AP direction with oral appliances, or with surgeries like MMA – Maxillary & Mandibular Advancement.

If I haven’t answered your question, please reach out to me again.

Thank you,

Dr. Karen