Prevalence and Variations of Maxillary Labial Frenal Attachment among the Patients in a Tertiary Health Care Center: An Analytical Cross-sectional Study

Abstract

Introduction
A high frenal attachment can cause diastema, distend the gingival sulcus, increasing plaque accumulation, gingival recession, bone loss, poor lip mobility while smiling and speaking, along with speech and esthetic issues. The objective of this study was to assess the prevalence of maxillary labial frenum and its’ variations among patients visiting a tertiary care hospital.
Methods
This analytical cross-sectional study was conducted from July 2022 to March 2023 among 385 patients. The demographic details of the participants were recorded and the types of frenal attachment and its’ morphological variations were assessed using the classification by Mirko et al. and Sewerin. Pearson Chi-square test was used to determine the association between categorical variables where p-value ≤0.05 was considered statistically significant.
Results
The most prevalent frenum was found to be gingival 237(61.56%) while the least common was papillary penetrating type 29(7.53%). Only 85(22.08%) frenum showed morphological variations where, commonest variation was frenum with nodule 51(13.25%) followed by frenum with appendix 27(7.01%). The gingival frenal attachment was found to be more among younger patients while papillary and papillary frenal attachment were seen lesser among older individuals.
Conclusions
Gingival type was the commonest frenal attachment followed by mucosal, papillary and then papillary penetrating frenum in all the age groups and both sexes. Around three-fourth of the participants showed no variations in frenal morphologies.