Evaluation of variations in morphology and attachment of frenum in diverse population - A cross-sectional study

Abstract

Background: Frenal attachments are thin folds of mucous membrane with enclosed muscle fibers that attach the lips to the alveolar mucosa and underlying periosteum. It also has septomaxillary ligament that transmits septal growth force to premaxilla. Most often, during the oral examination of the patient the dentist gives very little importance to the frenum, for assessing its morpholology and attachment. However, it has been seen that an abnormal frenum can be an indicator of a syndrome or can cause severe mucogingival problems and prevalence of unaesthetic diastema. Objective: So, the aim of the present study was to evaluate the variations in morphology and attachment of Frenum in diverse population. Materials and methods: The present cross-sectional study enrolled 400 patients comprising both males and females within the age group of 20-40 years. The frenal attachment was recorded according to the classification by Mirko et al. (1974) and . The data was arranged in a tabulated form and analyzed using SPSS software. Chi square test was used for the analysis of the data. Results: Around 61.3%, 30.3%,26.7% of the population in age group 20-30 showed gingival, papillary, papilla penetrating type of frenal attachment respectively. Presence of diastema was seen in 63.6% of female population and 36.4% in male population. Conclusion: It can be concluded that the type of frenal attachment varies with the ethnicity of the population and that diastema is more prevalent amongst females with papilla penetrating type of frenal attachment.

Variations in Maxillary Frenal Morphology in a Sample of Newari Children of Bhaktapur

“…These studies have related their findings based on age, gender, race, and ethnicity. 10,14,15,[18][19][20] Inconsistent to our study, mucosal frenal attachment was to be prevalent in studies done by Kotian et al, 18 Pandian et al 21 We also observed similar findings based on Mirko's classification of maxillary labial frenum according to location.…”

“…1,24,25 In this instance, the papillary and papillary penetrating frenum attachment are the only two considered as pathological. 15 In this study, very less number of the papillary type (6.2%) and papillary penetrating type (4.1%)…”

“…5,14,18,21,27 In line with our results, Rathod et al reported simple frenum as most common type followed by frenum with nodule and frenum with appendix. 15 However study done by Nagavent et al 27 and Birader et al 28 the persistent tectolabial frenum was the common type after simple frenum. These differences may be due to geographical variations of study population, diverse ethnicity taken into consideration and the sample size.…”

“…Abnormal location of the maxillary frenum causes masticatory problems. Frenum attached to gingival margins interferes with tooth brushing and thus worsens oral hygiene maintenance 15 leading to periodontal problems. 9 In small children, the aberrant maxillary frenum also causes breast feeding problem.…”

Prevalence of Maxillary Labial Frenal Attachments Types and Midline Diastema in Egyptian Children with Fully Erupted Maxillary Permanent Canines: A Cross Sectional Study

“…This finding agrees with Lertpimonchai et al, 2017;Divater et al, 2019 and can be justified by interference with oral hygiene measures, and the accumulation and retention of plaque. Besides, the opened periodontal pocket, made it easier for food particles to enter (Rathod et al, 2020) In terms of the association between oral hygiene and gingivitis, patients with poor oral hygiene had severe and moderate gingivitis, while those with satisfactory oral hygiene showed mild, moderate, and no gingivitis. These results were in agreement with Pawlaczyk-Kamieńska, Torlińska-Walkowiak and Borysewicz-Lewicka, 2018 and can be linked to the amount of bacterial plaque accumulated on the tooth surface which initiates the inflammatory process in the gingiva that increases the likelihood of gingivitis (Pawlaczyk-Kamieńska, Torlińska-Walkowiak and Borysewicz-Lewicka, 2018).…”