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Maxillary Labial Frenulum: A Scoping Review of Classification, Diagnosis and Evidence-Based Treatment
Gina Weissman1, Francis B Mimouni2, Evelina Kratunova3
1Dr. Miriam and Sheldon G. Adelson School of Medicine, Ariel University, Ariel, Israel.
Journal of Dentistry for Children (Chicago, Ill.)
|December 10, 2025
Summary
The maxillary labial frenulum (MLF) has varied classifications, leading to inconsistent clinical decisions. Evidence-based guidelines are needed to ensure appropriate intervention for MLF-related issues, avoiding unnecessary procedures.
Area of Science:
- Dentistry
- Oral Surgery
Background:
- The maxillary labial frenulum (MLF) is linked to breastfeeding issues, midline diastema, and hygiene challenges.
- Current classification systems for MLF lack consensus on clinical significance and surgical indications.
Purpose of the Study:
- To review MLF classification systems, diagnostic methods, and treatment considerations.
- To establish an evidence-based framework for clinical decision-making regarding MLF.
Main Methods:
- A comprehensive literature search was performed across PubMed, Scopus, and EMBASE.
- Studies underwent multi-phase screening and quality assessment using the Critical Appraisal Skills Program.
Main Results:
- Sixteen studies were included, revealing diverse classification systems with limited clinical utility.
- Midline diastema often resolves spontaneously; frenectomy is recommended only if MLF impairs oral hygiene or causes orthodontic relapse.
Conclusions:
- Inconsistent MLF classification and management practices contribute to varied clinical decisions.
- Development of evidence-based guidelines is crucial for appropriate MLF intervention and prevention of overtreatment.
