Frenal attachment and its association with oral hygiene status among adolescents in Dakshina Kannada population: A cross-sectional study

Abstract

Background and Objective:Frenum is a mucous membrane fold that attaches the lip and the cheek to the alveolar mucosa, gingiva, and the underlying periosteum. The frena may jeopardize the gingival health when they are attached too closely to the gingival margin, either due to interference in the plaque control or due to muscle pull. Identifying labial frenum attachment and its association with oral hygiene helps in primary prevention of gingival health. The purpose of this study was to examine the prevalence of the various types of maxillary labial frenum attachment and its association with oral hygiene status in adolescent population.Methodology:A total of 300 adolescents between 13 and 18 years were selected randomly. They were clinically examined for maxillary frenum attachment. Placek's classification of the labial frenum attachments was used to check the origin of frenum. Oral hygiene index (simplified) was recorded and results were subjected to statistical analysis.Results:Among 300 examined children 53% were males and 47% were females. The prevalence of the maxillary labial frenum was gingival type (39%) followed by mucosal (28.3%), papillary (23.7%), and papillary penetrating type (9.0%). The gingival type of frenal attachment was statistically significant among different age of children and also between different types of frenal attachment and oral hygiene status (p value < 0.001). There was no significance between frenum attachment and gender.Conclusion:The type of frenal attachment is strongly associated with oral hygiene status. as the age progresses the frenum tends to migrate apically. However, our study did not reveal any relationship between the gender and type of frenal attachment.

Prevalence of Maxillary Labial Frenal Attachments Types and Midline Diastema in Egyptian Children with Fully Erupted Maxillary Permanent Canines: A Cross Sectional Study

“…The distribution of frenal attachment types according to age showed that mucosal and gingival frenal types were noticed in patients aged between 13-15 y, while 12 years old children had a higher distribution of papillary frenal types. These results conformed with Divater et al, 2019;Zakirulla et al, 2021 and can be related to the tendency of the labial frenum to migrate more apically with aging (Pandiyan and Hedge, 2018).…”

“…In the current study, the mean and SD of age among the participants was (13.85 ± 1.48) years which was in accordance with Rashid and Khalifa, 2021 and can be attributed to the age of eruption of maxillary permanent canine (Divater et al, 2019). Regarding the gender distribution, 50.7% of participants were females and 49.3% were males which were consistent with Khursheed et al, 2015 and can be attributed to females tend to seek dental treatment more than males (Hamasha et al, 2018;Songur et al, 2019).…”

“…Regarding the distribution of frenal attachment types, the mucosal frenal type was the most common attachment type, followed by the gingival, the papillary, and the papillary penetrating types which were in agreement with Jonathan et al, 2018;Rajani, Biswas and Emmatty, 2018;Alwan, 2020 and can be justified by the tendency for the frenal attachment to move to a more apical location from age 9 to 16 years (Divater et al, 2019).…”

“…Besides, it leads to functional problems involving feeding and speech, and esthetic problems related to midline diastema that necessitates surgical intervention. Therefore, an early diagnosis and treatment of abnormal frenum attachment can prevent the development of future problems and improve treatment prognosis (Divater et al, 2019).…”

“…Abnormal maxillary labial frenum has been associated with a variety of clinical problems, such as plaque retention and accumulation, and difficulty with efficient brushing of teeth that may cause the development and advancement of periodontal disease, making it even more difficult to control gingival recession. In addition to problems related to feeding and denture fit and retention (Divater et al, 2019).…”