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Participants must answer at least 12 of 15 questions correctly (80%) to earn CE credit.

AGD - Self-Instruction Exercise No. 416 - Oral and Maxillofacial Surgery
A modified frenectomy technique: a new surgical approach

Self-Instruction Exercise No. 416
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Exercise No. 416
Subject Code: 310
Oral and Maxillofacial Surgery

The 15 questions for this exercise are based on the article A modified frenectomy technique: a new surgical approach on pages 34-38. This exercise was developed by Charles Martello, DDS, MAGD, in association with the General Dentistry Self-Instruction committee.

Reading the article and successfully completing this exercise will enable you to:

  • review the histology and anatomy of frena;
  • recognize the consequences of an abnormal frenal attachment; and
  • identify the advantages and disadvantages of a modified frenectomy technique.

Answers for this exercise must be received by December 31, 2018.

  1. An ectopic labial frenum may result in _________.

    A. vestibular augmentation
    B. broadened lip movement
    C. gingival hyperplasia
    D. a gap-toothed smile

  2. In the modified frenectomy surgical technique, sulcular incisions are made around the tooth, and the papilla is transposed to the buccal using a papilla preservation flap. After complete elimination of frenal attachments in the bone, the flap is repositioned and sutured back to the buccal surface.

    A. Both statements are true.
    B. The first statement is true; the second is false.
    C. The first statement is false; the second is true.
    D. Both statements are false.

  3. The term mucogingival surgery was first described in ____ by _______.

    A. 1996; Placek
    B. 1993; Miller
    C. 1976; Henry
    D. 1957; Friedman

  4. Which may cause the development of an ectopic labial frenum?

    A. ectolabial band elasticity
    B. pronounced descending maxillary labial tubercle
    C. intraoral position of the maxillary central incisors
    D. midline ossification of underlying labial tissue

  5. Frenal attachment to the labial interdental gingiva is classified as a ____________ attachment.

    A. papillary
    B. gingival
    C. mucosal
    D. papillary penetrating

  6. Which clinical observation would indicate the need for a frenectomy?

    A. space created from a congenitally missing lateral incisor
    B. movement of the tip of the papilla when the lip is pulled
    C. deficient oral hygiene–induced gingival recession
    D. large diastema due to avulsed maxillary central incisor

  7. The ________ frenectomy technique can be combined with the papilla preservation flap to efficiently preserve the papilla.

    A. classic
    B. Z-plasty
    C. carbon dioxide laser
    D. V-Y plasty

  8. Which flap incision was initially employed?

    A. pedicle
    B. envelope
    C. triangular
    D. semilunar

  9. Gingival sulcus depth was measured at ___ points.

    A. 2
    B. 4
    C. 6
    D. 8

  10. The purpose of the primary incision in stage 1, step 1 of the surgical technique is to_____________.

    A. provide access to the bony defect
    B. preserve the papilla
    C. expose the frenal attachment
    D. determine the gingival biotype

  11. In stage 1 of the surgery, step __ requires complete elimination of the frenal attachments to buccal bone.

    A. 1
    B. 2
    C. 3
    D. 4

  12. In stage 3, a diode laser was used to __________.

    A. curtail postoperative bleeding
    B. preserve papilla in the esthetic zone
    C. sever the frenal attachments
    D. eliminate the bony defect

  13. All of the following are advantages of the presented surgical technique except one. Which is the exception?

    A. papilla preservation
    B. incomplete frenum removal
    C. requires palatal incision
    D. minimal buccal surface scarring

  14. The 3-month follow-up showed that the papilla preservation flap plus frenectomy led to deep scarring and preservation of the interdental papilla. Use of a modified frenectomy and a papilla preservation flap results in minimal changes in the height and shape of the papilla in patients with diastemas wider than 2 mm.

    A. Both statements are true.
    B. The first statement is true; the second is false.
    C. The first statement is false; the second is true.
    D. Both statements are false

  15. How many patients were treated?

    A. 9
    B. 6
    C. 4
    D. 1


Please respond to the statements below, using the following scale:
1 Poor; 2 Below average; 3 Average; 4 Above average; 5 Excellent

Practicality of the content 1 2 3 4 5
Benefit to your clinical practice 1 2 3 4 5
Quality of illustrations 1 2 3 4 5
Clarity of objectives 1 2 3 4 5
Clarity of exercise questions 1 2 3 4 5
Relevance of exercise questions 1 2 3 4 5
Did this exercise achieve its objectives? Yes No
Did this article present new information? Yes No
How much time did it take you to complete this exercise? mins