*Paulo Floriani Kramer, DDS, PhD, Associate Professor, Department of Pediatric Dentistry, Universidade Luterana do Brasil, Canoas, Brazil; Associate Professor, Department of Pediatric Dentistry, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil.
**Lívia Mund de Amorim, DDS, PhD Student, Graduate Program in Dentistry, Universidade Luterana do Brasil, Canoas, Brazil.
J Clin Pediatr Dent. 2022 Jan 1;46(1):51-57. doi: 10.17796/1053-4625-46.1.9.
To investigate the prevalence of morphological and attachment variations of the maxillary labial frenum (MLF) and associated factors in preschool children.
A cross-sectional study was conducted with 1,313 children aged between zero and five years of age attending public nurseries in the city of Canoas in southern Brazil. Data were collected through a questionnaire addressing demographic, socioeconomic, and behavioral characteristics and a clinical examination of the MLF. Assessments of MLF morphology and attachment were based on the classification systems proposed by Sewerin and Mirko et al., respectively.
The most prevalent patterns were simple MLF (63.8%) and gingival attachment (51.1%). Morphological abnormalities were found in 21.6% of the preschoolers and 25.4% exhibited abnormal frenal attachment. Abnormalities in MLF morphology were more prevalent among girls (p = 0.003) and a significant reduction was found with the increase in age (p < 0.001). Attachment abnormalities were significantly more prevalent among girls (p < 0.001), the white ethnic group (p = 0.005), and children who used a pacifier (p = 0.007) and also reduced significantly with the increase in age (p < 0.001).
Demographic and behavioral characteristics were associated with MLF morphology and attachment. The reduction in the prevalence of the outcomes with the increase in age suggests that surgical interventions in the first years of life may constitute overtreatment.
调查学龄前儿童上唇系带（MLF）形态和附着的变异及其相关因素的流行情况。
这是一项横断面研究，共纳入了 1313 名年龄在 0 至 5 岁之间的巴西卡诺阿斯市公立托儿所的儿童。通过问卷调查收集了有关人口统计学、社会经济和行为特征的数据，并对 MLF 进行了临床检查。MLF 形态和附着的评估分别基于 Sewerin 和 Mirko 等人提出的分类系统。
最常见的模式是单纯的 MLF（63.8%）和龈附着（51.1%）。21.6%的学龄前儿童存在形态异常，25.4%表现为异常系带附着。女孩（p=0.003）和年龄增加（p<0.001）与 MLF 形态异常的发生率更高相关。附着异常在女孩（p<0.001）、白种人（p=0.005）、使用奶嘴的儿童（p=0.007）中更为常见，且随年龄增加而显著降低（p<0.001）。
人口统计学和行为特征与 MLF 形态和附着有关。随着年龄的增长，这些结果的发生率降低，这表明在生命的最初几年进行手术干预可能构成过度治疗。
