Clinical Study of Median Maxillary Labial Frenum Attachment Various Types

Authors : Dr. Muhannad Abdulrhman Mohammed Halwani, Rakan Saed Safar Althobaiti

Volume/Issue : Volume 2 - 2017, Issue 12 - December

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Frenum can be defined as “a fibrous band of tissue attached to the bone of the mandible and maxillae, and is frequently superficial to muscle attachments.” [1] The frenum of the oral cavity are categorized into different types: Frenulum linguae, under the tongue; the frenulum labiisuperioris, inside the upper lip; the frenulum labiiinferioris, inside the lower lip; and the buccal frena which connect the cheeks to the gingiva. [2] The frenulum labiisuperioris or median maxillary labial frenum (MMLF) is found on the underside of the center of the upper lip that connects to the midline of the attached gingiva between the central incisors. The origin is often wide but the tissue of the frenum itself narrows in width and is inserted in the midline into the outer layer of periosteum, and into the connective tissue of the intermaxillary suture and the alveolar process. [3] A normal frenum attaches apically to the free gingival margin so as not to exert a pull on the zone of the attached gingiva and usually terminating at the mucogingival junction. However, its level may vary from the height of vestibule to the crest of the alveolar ridge and even to the incisal papilla area in the anterior maxilla. [3],[4] Several classifications for frena based on morphology have been proposed. [5],[6] However, this classification may not be adequate, especially in the aspect of the (MMLF) , as several variations in its morphology have been observed which have not been classified till date. Many dentists are not aware of the variations of (MMLF), misinterpreting them as pathological entities. Certain degree of confusion exists in classifying frena types, leading to difficulties in diagnosis and treatment planning. Aberrant frena often cause problems such as loss of papilla, recession, diastema, difficulty in brushing, alignment of teeth, and psychological disturbances. [5] Morphological variations of (MMLF) need to be addressed, differentiating them from abnormal ones during various dental procedures. The present study aims to propose a detailed and revised classification of normal (MMLF) based on morphology.


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