2019 Volume 57 Issue 4 Pages 444-450
With the aim of contributing to decision-making regarding resection of the upper labial frenum, we studied the morphology of upper labial frenum attachment and changes in its position in 448 children (age 3-5 years) attending nursery schools and kindergartens in Japan. The morphology and upper labial frenum attachment position were classified as normal or abnormal (Type I-V) type. The following results were obtained.
1.The prevalence of normal-type upper labial frenum was greater than that of the abnormal types in all age groups, though the difference decreased with age.
2.Among the abnormal types, the prevalence of Type I was the greatest in all age groups, followed by that of Type II, with no significant changes in the prevalence of those seen with age. The prevalence of Type III increased more than two-fold, whereas that of Type IV did not change with age. Type V was only noted in 5-year-old subjects.
3.When comparing the prevalence of the normal type with that of Types I and II, and the “high and thick attachment” type, the prevalence of the normal type was significantly greater and that of the “high and thick attachment” type significantly lower in the 3-year-old group. Also, the prevalence of the “high and thick attachment” type was greater in the group aged 5 years.
The most common abnormal types observed in the 3-year-old group were Types I and II, which will likely not improve, while Type IV and V were not seen. Our results suggest that treatment and follow-up examinations comprise an appropriate management strategy for children with such abnormality in the upper labial frenum. Additionally, the prevalence of the “high and thick attachment”type was high in the group aged 5 years, suggesting that this abnormality in the upper labial frenum has a persistent tendency. For affected children, it is necessary to provide treatment while taking into consideration the possibility of midline diastema and the effects of this abnormality on lip closure function at the time of permanent anterior tooth eruption.
