Fiberotomy

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#1 Post by **calypsojunky** » Fri Oct 06, 2006 10:03 am

My orthodontist told me that after my treatment, he will perform a fiberotomy, which basically cuts through the gingival fibers around a tooth to prevent them from rotating back to their crooked positions.
It sounds scary, and I haven't seen other other posts about it.
I was wondering if anyone has had that done, and what you thought of the procedure.
Thanks!

#2 Post by **calypsojunky** » Fri Oct 06, 2006 5:38 pm

No one has a response?

I found this picture on the internet, and it's making me nervous!
http://pittsburghdentalimplants.com/med ... fiber1.jpg

#3 Post by **simplywired** » Sat Oct 07, 2006 1:04 pm

I don't think anyone else here has heard of it either. Maybe something new? Perhaps you should suggest that you would prefer a permanent retainer or plain old retainers. It would make be nervous also and who needs it!

#4 Post by **Lisa65** » Sat Oct 07, 2006 1:25 pm

I never heard of it, but that pic looks awful!

#5 Post by **samantha_lou** » Sat Oct 07, 2006 1:25 pm

I have heard of the procedure, but never seen it performed or had it performed in the practice I work at. This is a procedure that cuts the "memory" fibers of the teeth, i.e. they will have no desire to return to their pre-treatment positions. I will say though, this isn't something that I hear a lot of ortho's offering as the solution to their biggest problem. I have heard that it works very well, although I don't have much idea about how invasive it is, or how it is actually performed.

#6 Post by **Lisa65** » Sat Oct 07, 2006 1:38 pm

I looked it up and found a few references.

Like Samantha_Lou says, some of the gingival fibres which attach the teeth to the gums are cut. The theory is that when the teeth are rotated and moved during the time being braced, some of those fibres are stretched. So that when the braces are taken off, those fibres "want" to go back to their original positions, especially on teeth which required a lot of rotating during treatment. Cutting some of them and allowing them to reattach in an unstretched position will hopefully improve retention of the teeth in their new positions. Although that pic looked gruesome, they use local anaesthetic injections and healing only takes about 3 days. Then the braces are left on for another 3 weeks or so to allow the teeth to resettle and the fibres to reattach.

Having said that, I did find a reference to one article where volunteers had one tooth "fiberotomied" and the corresponding tooth on the other side not done - and there was no significant difference in the amount of movement after debracing.

#7 Post by **fyrelight** » Sat Oct 07, 2006 1:38 pm

I've heard that it's usually used only on rotated teeth, so they don't go back to their former rotated positions. It apparently is safe, and the fibers grow back accordingly, but part of me would be very hesitant, afraid my teeth would fall out!

#8 Post by **David** » Sat Oct 07, 2006 5:24 pm

My daughter had it done and it was no big deal. It's mainly done in situations where the teeth have been rotated.

It's done under local anaesthetic and, in simple terms, the doc uses a scalpel with the blade flat on the face of the tooth and slides it up under the gum. It looks a bit gruesome due to the blood but apparently it is quite painless.

As for it's effectiveness, I'm not convinced as after three or four years some of her teeth have moved back toward where they were.

Don't get me going on the competence (or attitude) of her ortho, particularly with regard to retainers.

#9 Post by **calypsojunky** » Sat Oct 07, 2006 7:58 pm

Phew, thanks for your replies, I'm glad at least it's not completely obscure.
As far as my case goes, I think the orthodontist intended for me to have retainers of some kind in addition to the fiberotomy. He made it sound like no big deal at all, so I didn't give it much thought until I saw the bloody picture. I guess I'd be willing to go through with it if it significantly decreases my chance of having a relapse, but if the difference is not that significant, I might have some second thoughts.
I guess I'll ask him the next time I go in.

#10 Post by **Joanna20** » Sun Oct 08, 2006 7:36 am

Gosh, good luck with that.

Joanna

#11 Post by **twe10** » Wed Oct 18, 2006 9:05 am

I had braces when I was in Junior High - I am going back to have them put back on (GULP!) at the end of this month...I am now 31

I had braces for two years and had the fiberotomoy when it was done - I ended up biting into an apple a month after the surgery and it screwed up my teeth and it was extremely painful.

If there have been tests that show that there is a difference having the surgery and not having it - I would like to see it.

I would say NOT to do it - my sister got her braces off three months after me and my parents said that they would not be doing the fiberotomy and repeating the problem.

Tom in Toledo, Ohio

#12 Post by **rsprouse** » Wed Oct 18, 2006 7:32 pm

I had braces when I was in Junior High - I am going back to have them put back on (GULP!) at the end of this month...I am now 31

I had braces for two years and had the fiberotomoy when it was done - I ended up biting into an apple a month after the surgery and it screwed up my teeth and it was extremely painful.

If there have been tests that show that there is a difference having the surgery and not having it - I would like to see it.

I would say NOT to do it - my sister got her braces off three months after me and my parents said that they would not be doing the fiberotomy and repeating the problem.

Tom in Toledo, Ohio

Tom,

A quick search of PubMed indicates quite a few articles showing a short term benefit from a fiberotomy. There are also journal articles out there questioning its efficacy as well. You are entitled to your own opinion on what will work, but remember that your sample size is very small. What works for one person won't necessarily work for everyone. There are people out there that have likely benefited from the procedure. It is too bad that you don't seem to be one of them.

Regards,
Rory

#13 Post by **florencegal** » Thu Oct 19, 2006 1:50 pm

Cripes - I'm too scared to even look at the photos!

That sounds truly gruesome.... (but then I am a big baby when it comes to blood so don't listen to me too much on this!)

Anyway calypso make sure you really talk this through with your ortho next time you go in and only go ahead if you're comfortable with it. Maybe he can suggest what your alternatives are or put you in touch with another patient that's had this done in the past?

I'm sure you'll come to the best decision for you on this - best wishes

x

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