When teeth are aligned with braces, the surrounding bone and gum tissue experience certain stresses that the body must resolve. The bone adapts as a result of certain specialized cells “dissolving” the existing bone followed by other cells that then create new bone. The gum tissue, however, is much more like skin in that it has elastic fibers that simply stretch or compress where they are attached to the moving tooth. After a crooked or rotated tooth is straightened, the stretched elastic fibers that attach around the neck of the tooth act almost like a rubber band to pull the tooth back toward its original position (relapse). Routine orthodontic retainers work well to maintain the new alignment if the amount of movement is minor or if orthodontics is done at an early age. However, if a tooth has been moved or rotated significantly, the most stable result is obtained by eliminating the stretch in the gum tissue by performing a procedure called a fiberotomy.
The purpose of the fiberotomy is to disconnect the stretched elastic fibers from the tooth. This is accomplished by making a very shallow incision under the gum line and around the circumference of the tooth. Of course, this is done comfortably with the aid of local anesthetic. The cut fibers are relieved of the tension and simply reattached to the tooth just like a cut in skin grows back together). The gums may have some minor soreness for a day or two after the fiberotomy but basically it is a simple procedure that will not interfere with your normal activities.
Very few family dentists perform the fiberotomy procedure and we generally refer you to a dental specialist called a periodontist. They are the experts in performing the fiberotomy correctly.
The good news about the fiberotomy is simply that it works. Research has shown it to be very effective at preventing ‘relapse of crooked teeth. Dr. Becker has been recommending this procedure for over ten years and she continues to believe that it is the single best step that can be taken to keep an orthodontically straightened tooth from returning to its original crooked alignment.