To assess the propriety of surgical correction of lingual frenulum, the morphology of lingual frenulum and the position of its attachment to the tongue were studied in 3-to 6-year-old children (146 with normal frenulum and 20 with frenulum contraction) seen at the Department of Pediatric Dentistry, School of Dentistry, Iwate Medical University. In the latter group of children, changes in the morphology and the position of attachment to the tongue with time were closely investigated. Of the children with normal frenulum, the morphology could be categorized as a membranous type in 74.7%, cordal type in 11.6% and intermediate type in 13.7%. The frenulum had non-root at its origin in 21.9%, a single root in 13.7%, double roots in 31.5% and triple roots in 32.9%. Thus, the fan-shaped type of origin was frequent. The distance between the top end of the marginal gingiva and the origin of the frenulum was approximately 4㎜ in any age groups. The distance between the lingual apex and the attachment showed no significant differences by ages but tended to increase with age. The distance between the sublingual caruncle and the attachment of the frenulum increased significantly from 3 years to 6 years of age.
The distance between the sublingual caruncle and the lingual apex also tended to increase with age, and especially significant differences were demonstrated between the age of 3 years and the ages of 4, 5 and 6 years. Long-term follow-up in the children with frenulum contraction showed that in 70% of them, the position of the attachment of the frenulum to the tongue became closer with the lapse of time to that found in the children with normal frenulum. In 78.6% of them, the follow-up period extended for more than 2 years. This seemed to indicate that frenotomy in young children should wait until after at least 2 years of observation, unless immediately indicated for any existing disorder.
