The labial frenum, midline diastema, and palatine papilla: a clinical analysis.
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The fluorescein angiographs of the attached gingiva of 10 out of 12 subjects showed distinct areas of ischaemia which were clinically not discernible when standardized tensions of 100 g or 200 g tensions were exerted on the mandibular frenum. The fluorescein angiographs were reproducible in 3 out of 4 cases and the ischaemic areas reached the adjacent gingival margins in 5 cases. Possible hypoxic damage of the periodontium by tension of frenum is discussed.
From the analysis of histories, dental casts, and cephalograms of 471 children of the Burlington Growth Centre sample, interrelationships between the degree of spacing, crowding, diastema and frenum and suture type were derived and the following conclusions were drawn: 1. Suture type remains more constant through development than frenum type. 2. Frenum type is reasonably constant but may change from low to medium or high attachments, but only to a higher level of attachment. 3. Frenum and suture type are related; frenum types 5 and 6 (low attachment) are associated with spacing and with suture types 3 and 4. 4. The primary factors contributing to maxillary diastema appear to be degree of spacing or crowding in most cases, the specific types of sutures and frenum making a minor contribution.
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PURPOSE: The purpose of this study was to determine the prevalence of different types and insertions of labial frenums as well as midline diastema in Peruvian children between 0 and 6 years of age. METHODS: A sample of 1,355 children was selected for the study. A clinical examination was done to classify the labial frenum, measure gingival insertion levels, and quantify midline diastema. Descriptive statistics and the Spearman test were used. RESULTS: The most prevalent frenums were the simple frenum (59%) and the persistent tectolabial frenum (25%). The level of gingival insertion moved apically with age. The midline diastema was wider in younger children and decreased with age. A significant inverse relationship (r=-0.27; P=.001) was found between the level of gingival insertion and the midline diastema. CONCLUSION: The most prevalent frenum was the simple frenum. A significant inverse correlation between the gingival insertion level and the midline diastema was found.
The aim of this study was to determine the prevalence of midline diastema, tongue tie and frenum attachments amongst school children in Nairobi. A total of 1802 children aged between 4 and 16 years were selected randomly using multistage sampling technique. To avoid oversampling in either sex, a proportionate sampling procedure was used. Thereafter, a thorough intra-oral examination was carried out using a mouth mirror under artificial or natural light with the children lying on a supine position. Presence or absence of midline interdental spaces unusually bigger than other interdental spaces were noted and recorded on a prepared dateacollection form. Accurate location of the origin of the frenum was done using Placek et al Morphological-functional classification of the labial frenum attachments. Data was analyzed manually by tally method. Results showed that 35% had upper and lower midline diastema. 55% were females and 45% were males. Their mean age was 7.6 years. 0.2% had a high lingual frenum. The commonest location of frenum attachment amongst children with lower midline diastema was the mucogingival junction (86%) whereas amongst those with upper midline diastema it was attached gingiva (50%). None of the children had frenum attachment on the interdental papilla. It was concluded that the maxilla had a higher prevalence of midline diastema than the mandible and that papillary penetrating frenum attachments amongst these patients were higher in the maxilla than the mandible.
This is the second of two articles discussing the minor oral surgery/orthodontic interface. The vital role played by the general dental practitioner in monitoring the normal development of the occlusion and the early diagnosis of the local causes of malocclusion was emphasized in the first article. Part 2 discusses the problems associated with the prominent labial frenum, supernumerary teeth and submerged deciduous molars.