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Association of Maxillary Labial Frenum Attachment and Insertion With Midline Diastema in Children With Primary
Zainab Khan1, Akash Bhatnagar1, Zakiya Perveen1
1Department of Pedodontics and Preventive Dentistry, Teerthanker Mahaveer Dental College and Research Centre, Moradabad, IND.
Introduction:
Midline diastema, a prevalent dental anomaly in young children, is often associated with labial frenum characteristics, including attachment type and insertion level. Despite its clinical significance, the relationship between these frenum features and midline diastema in primary dentition remains unexplored. This cross-sectional study aimed to investigate the prevalence of labial frenum variations and their impact on midline diastema in children aged 3-6 years, providing insights into their developmental and clinical implications.
Materials And Methods:
This cross-sectional study included 432 children aged 3-6 years with complete primary dentition and midline diastema. Maxillary labial frenum attachment types were categorized as mucosal, gingival, papillary, or papillary-penetrating. Frenal insertion levels were assessed as mid-attached gingiva, mucogingival junction, or inferior margin of the alveolar papillae. Intraoral examinations were performed by calibrated examiners using visual and tactile methods, with midline diastema measured to the nearest 0.1 mm and classified according to severity. Data were analyzed using descriptive statistics and chi-square tests for association. The Spearman correlation test was used to assess the correlation between frenum characteristics, age, and midline diastema.
Results:
Maxillary frenum attachment and insertion levels showed significant age-dependent patterns, with gingival and mid-gingival insertions increasing with age, whereas papillary and alveolar papilla insertions decreased. Midline diastema was more prevalent and larger in younger children, decreased with age, and showed negative correlations with specific frenum attachments and insertion levels.
Conclusion:
This study demonstrated that maxillary frenum attachment and insertion levels shifted with age, favoring gingival and mid-attached gingival insertions. These findings advocate for age-specific evaluations and a conservative approach to managing midline diastema in primary dentition.
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