Navigating Pull Syndrome: A Case Report on Vestibuloplasty and Oral Hygiene

A 19-year-old patient presented with chief complaint of bleeding gums in the lower anterior region since 5-6 months. Clinical examination revealed significant plaque accumulation, periodontal pocket depths of 4.5-5 mm in relation to teeth 31, 32, 41, and 42, with a high frenal attachment classified as papillary. Additionally, shallow vestibular depth and narrow keratinized gingiva were noted. Treatment included subgingival debridement, laser-assisted curettage, vestibuloplasty, and frenectomy. In this case, the high frenal attachment and shallow vestibule contributed to plaque retention and periodontal breakdown. The combination of vestibuloplasty and frenectomy effectively addressed these challenges. Improving the patient's oral hygiene and promoting better oral hygiene practices, ultimately reduces the risk of future periodontal complications. Key Words: Frenectomy, Keratinized gingiva, Oral hygiene, Vestibuloplasty