Diastema size and type of upper lip midline frenulum attachment

Associations between maxillary labial frenum Morphology, Attachment, and Patient-Related clinical factors in Saudi Arabian Adults: Cross-sectional study

Objective

This study investigated the prevalence of maxillary labial frenum morphologies and attachment types and their associations with various patient-related clinical variables in a population of Saudi Arabian adults.

Methods

This study comprehensively examined 100 participants of both genders to categorize frenum types and attachment sites. The following clinical variables were recorded: probing depth, clinical attachment loss, attached gingiva width, overjet, overbite, diastema width, central incisor condition, occlusion, previous orthodontic treatment, and the incidence of gummy smile.

Results

The mean age was 32.6 years, and the average diastema width was 0.23 mm. The study found that the simple frenum type was the most common morphology (57 %), and gingival attachment was the most frequent attachment type (54 %). Simple frenum was significantly associated with class I occlusion (p = 0.018), and frenum with nichum was significantly associated with class II occlusion (p = 0.019). Females were more likely to exhibit simple frenum with nodule frenum than males (p = 0.042). Mucosal frenum attachment was significantly correlated with the absence of previous orthodontic treatment (p = 0.042).

Conclusion

The study identified a relationship between the features of the maxillary labial frenum and occlusion as well as previous orthodontic treatment. Our findings suggest that understanding each patient's unique frenum features can lead to more effective and personalized dental care, thus improving patient satisfaction.

Orofacial Deformities in 3 Related Rhesus Monkeys (Macaca mulatta) Resembling Human Binder's Syndrome

Binder's syndrome is a rare congenital deformity characterized by midface hypoplasia, particularly around the nasomaxillary area. Genetic etiology or developmental failure caused by prenatal exposure to teratological agents has been considered. In this article, we present 3 related rhesus monkeys born with orofacial deformities similar to those found in infants with the Binder phenotype. For the first time, a primate biomodel for this condition is presented. The clinical description and association with management and environmental factors are discussed. These findings reinforce the knowledge about the relationship between possible vitamin K metabolism interference and Binder's syndrome.

Associations among the occurrence or types of maxillary canine impaction, labial frenum attachment types, lateral incisor anomalies, and midline diastema in patients with and without impaction: A case-control study

INTRODUCTION

We tested whether the labial frenum attachment types may affect the occurrence or type of maxillary canine impaction.

METHODS

This case-control study was performed on 96 subjects (48 with maxillary canine impaction [20.50±4.99 years, 32 females], 48 controls [21.94±3.79, 31 females]). Types of canine impaction (buccal/palatal, bilateral/unilateral, left/right), types of upper lip middle frenums (mucosal, gingival, papillary), the anatomy of lateral incisors (impacted, peg shaped, small, normal), and the midline diastema were evaluated clinically and radiographically. Associations were examined using multiple binary logistic regression, 3-way repeated-measures ANCOVA, and Fisher tests (α=0.05, β=0.2).

RESULTS

The numbers of mucosal, gingival, and papillary frenums in the case group were '29, 14, and 5', respectively; in the control group, they were '25, 21, and 2' (Fisher, P=0.248). The numbers of mucosal, gingival, and papillary frenums were respectively '25, 11, and 1' in the palatally impacted canine subgroup; they were '4, 3, and 4' in the buccally impacted subgroup (Fisher, P=0.010). Abnormal laterals were present in 12 cases and 4 controls; normal laterals were observed in 36 cases and 44 controls (Fisher, P=0.053). Abnormal laterals were seen in 10 cases with palatally impacted canines and 2 cases with buccally impacted canines; normal laterals existed in 27 cases with palatally impacted canines and 9 cases with buccally impacted canines (Fisher, P=0.705). Lateral anatomy was not associated with frenum attachment (Fisher, P=0.827). Greater midline diastemas were seen in cases with maxillary canine impaction, papillary frenums, and abnormal laterals (ANCOVA, P≤0.016).

CONCLUSIONS

Buccal type of canine impaction is positively associated with papillary labial frenums. Canine impaction is 3.6 folds more prevalent in cases with lateral abnormality. Midline diastema is positively and independently associated with canine impaction, papillary frenums, and abnormal laterals.

The Prevalence of Oral Mucosa Lesions in Pediatric Patients

The prevalence of oral mucosa lesions (OMLs) among children varies from 4.1% up to 69.5%. There is a lack of sufficient epidemiological data and adequate knowledge about OMLs in relation to minors' gender and age. The aim of the study was to evaluate the prevalence of OMLs in children, patients of the oral pathology clinic in south-western parts of Poland, and to investigate the potential correlation between the occurrence of particular types of OMLs and the gender and age. A retrospective study was performed using a total of 2474 clinical charts from 2015 to 2019. Data collected included age, gender, and OMLs' type. The prevalence of OMLs in minors was 5.21%. Aphthae was the most frequent diagnosis. Boys were more commonly affected, and traumatic erosion and ulcers were significantly more often detected in males. The mean age of children was 8 y/o, preschoolers were significantly more often diagnosed with geographic tongue, while Morsicatio buccarum was significantly more common in school children and adolescents. Clinicians should be familiar with OMLs prevalence and with its specific frequency in connection to age and gender of children. Furthermore, they should be aware of the diversity of OMLs found in the oral cavity of children and that their frequency in the pediatric population is different from that in adults.

Association between superior labial frenum and maxillary midline diastema - a systematic review

BACKGROUND

Pediatric otolaryngologists have seen an increased focus on upper lip frenum as a possible culprit for feeding difficulties and the development of maxillary midline diastema (MMD). This increase may be encouraged by parents' exposure to medical advice over the internet about breastfeeding and potential long-term aesthetic concerns for their children. Subsequently, there has been increased pressure on pediatric otolaryngologists to perform superior labial frenectomies. There has been a reported 10-fold increase in frenectomies since the year 2000. However, there is no consensus within the literature regarding the benefit of superior labial frenectomy in preventing midline diastema.

OBJECTIVE

To provide physicians and parents with the most updated information by systematically reviewing the available literature for the association between superior labial frenum and midline diastema.

METHODS

A literature search was performed in MEDLINE (PubMed), EMBASE, Web of Science, the Cochrane Library and Dental and Oral Sciences Source (DOSS). Using the Covidence platform, a systematic review was conducted. The initial 314 articles identified underwent systematic review and 11 studies were included in the final review.

RESULTS/DISCUSSION

Available data, primarily from the dental literature, showed that two subtypes of frenum: papillary and papillary penetrating frenum, are associated with maxillary midline diastema. Superior labial frenectomy should be delayed until permanent lateral incisors have erupted, as this can spontaneously close the physiological MMD. Current literature recommends against frenectomy before addressing the diastema with orthodontics, which helps to prevent diastema relapse. It is also imperative to rule out other odontogenic and oral cavity causes of diastema, such as thumb sucking, dental agenesis, and other causes. Online information may not always be fully representative and should be interpreted in the full context of the patient's medical history before referral for surgical intervention.

Evaluation of the distance between the central teeth after frenectomy: a randomized clinical study

Purpose:

The present study aimed to evaluate the periodontal status and the distance between the teeth one year after frenectomy in patients with abnormal frenums in the maxillary and mandibular midline.

Materials and methods:

This study included 50 patients (24 men and 26 women) between the ages of 13 and 53 who have frenum-induced diastemas between the incisors. The abnormal frenums were removed via conventional frenectomy. The distances between the teeth before and one year after the surgery were measured with a caliper. To determine the periodontal status, the pocket depth, plaque index, and bleeding on probing were measured from four surfaces. In addition, the amount of attached gingiva and degree of gingival recession were recorded and were statistically analysed.

Results:

A significant decrease in the distance between teeth before and after frenectomy was observed (p<0.05). There was a statistically significant difference in the amount of gingival attachment, pocket depth, degree of gingival recession, plaque index, and bleeding on probing (p<0.05).

Conclusion:

The removal of abnormal frenums with frenectomy can contribute to the reduction in the distance between the teeth. In addition, frenectomy increases the amount of gingiva and decreases the depth of the pocket, gingival recession, amount of plaque, and bleeding.