Rajani Elayadath Rajagopalan, Biswas Palakunnu Padmaprabha, Emmatty Rishi
Department of Public Health Dentistry, Royal Dental College, Palakkad, Kerala, India.
Department of Orthodontics and Dentofacial Orthopedics, Royal Dental College, Palakkad, Kerala, India.
J Indian Soc Periodontol. 2018 May-Jun;22(3):257-262. doi: 10.4103/jisp.jisp_294_17.
Maxillary labial frenum is a dynamic structure with a diverse morphology. Although an abnormal labial frenum is associated with syndromic and nonsyndromic conditions, it is often been neglected during the routine intraoral examination. The significance of various types of frenum (normal to abnormal), based on the attachment site and morphology in different skeletal patterns, has not been studied yet.
A cross-sectional study was conducted in a clinical setting on 150 participants (50 each in Class I, Class II, and Class III skeletal pattern) within the age group of 13-30 years. Frenum was examined by direct visual method and intraoral photographs were taken for all the participants.
Chi-square and Fisher's exact tests were used. No gender-wise differences were found among the various frenum typologies. Mucosal type was the most prevalent in Class I and II and gingival type in Class III. Simple frenum was the common type in all the three groups. However, abnormal frenum categories based on its location and morphology were more in class III and found to be statistically significant. Papillary and papillary penetrating types are significantly associated with skeletal class III pattern and midline diastema ( < 0.05).
The prevalence of papillary and papillary penetrating types of frenum are significantly more in Class III skeletal pattern. A labial frenum that is attached close to the gingival margin could be an etiological factor in midline diastema, mucogingival problems, and affect the growth of the alveolar process. Hence, an early diagnosis of abnormal frenum prevents the emergence of periodontal as well as orthodontic problems.
上颌唇系带是一种形态多样的动态结构。尽管异常唇系带与综合征性和非综合征性疾病有关，但在常规口腔检查中常常被忽视。基于不同骨骼类型中的附着部位和形态，各种类型系带（正常至异常）的意义尚未得到研究。
在临床环境中对13至30岁年龄组的150名参与者（I类、II类和III类骨骼类型各50名）进行了一项横断面研究。通过直接视觉方法检查系带，并为所有参与者拍摄口腔内照片。
采用卡方检验和费舍尔精确检验。在各种系带类型中未发现性别差异。黏膜型在I类和II类中最为常见，牙龈型在III类中最为常见。单纯系带在所有三组中都是常见类型。然而，基于位置和形态的异常系带类别在III类中更多，且具有统计学意义。乳头型和乳头穿透型与骨骼III类模式和中线间隙显著相关（<0.05）。
乳头型和乳头穿透型系带在III类骨骼模式中的患病率显著更高。附着于靠近牙龈边缘的唇系带可能是中线间隙、黏膜牙龈问题的病因，并影响牙槽突的生长。因此，早期诊断异常系带可预防牙周和正畸问题的出现。
