Assessment of Diverse Frenal Morphology in Primary, Mixed, and Permanent Dentition: A Prevalence Study

The maxillary labial frenum is a normal anatomic structure with inherent morphological variations. It has various morphologies and types depending on the attachment of fibers. This study was conducted to access the frenal morphology and frenal attachment in primary, mixed, and permanent dentition.

This study includes 1,800 patients, in which 969 were males and 831 females, with 3-17 years of age and is equally divided into primary, mixed, and permanent according to age and dentition of patients. Morphology of maxillary labial frenum was examined and classified according to Sewerin's frenum typology and type of frenal attachment according to Placek's attachment. Data collected were entered into SPSS version 16 and were subjected to statistical analysis.

Simple frenum is most prevalent in all the age groups followed by persistent tectolabial frenum (PTF) in primary dentition, frenum with a nodule in mixed dentition, and frenum with an appendix in permanent dentition. Type III frenal attachment is found in primary dentition followed by type II and type I in mixed and permanent dentition, respectively. There is a highly statistically significant difference in the type of frenal morphology and frenal attachment in all groups of dentition.

The prevalence of simple frenum is increasing from primary dentition to permanent dentition, whereas PTF decreases as age increases. This study reveals a high prevalence of gingival attachment followed by papillary attachment.

The examination of frenal morphology and attachment is important before planning for any dental procedures to rule out the misdiagnosis and unnecessary surgical interventions.