Khan Zainab, Bhatnagar Akash, Perveen Zakiya, Rajput Deepshikha, Mishra Palak, Yeluri Ramakrishna
Department of Pedodontics and Preventive Dentistry, Teerthanker Mahaveer Dental College and Research Centre, Moradabad, IND.
Department of Pedodontics and Preventive Dentistry, Sharad Pawar Dental College and Hospital, Wardha, IND.
Cureus. 2025 Aug 12;17(8):e89892. doi: 10.7759/cureus.89892. eCollection 2025 Aug.
Midline diastema, a prevalent dental anomaly in young children, is often associated with labial frenum characteristics, including attachment type and insertion level. Despite its clinical significance, the relationship between these frenum features and midline diastema in primary dentition remains unexplored. This cross-sectional study aimed to investigate the prevalence of labial frenum variations and their impact on midline diastema in children aged 3-6 years, providing insights into their developmental and clinical implications.
This cross-sectional study included 432 children aged 3-6 years with complete primary dentition and midline diastema. Maxillary labial frenum attachment types were categorized as mucosal, gingival, papillary, or papillary-penetrating. Frenal insertion levels were assessed as mid-attached gingiva, mucogingival junction, or inferior margin of the alveolar papillae. Intraoral examinations were performed by calibrated examiners using visual and tactile methods, with midline diastema measured to the nearest 0.1 mm and classified according to severity. Data were analyzed using descriptive statistics and chi-square tests for association. The Spearman correlation test was used to assess the correlation between frenum characteristics, age, and midline diastema.
Maxillary frenum attachment and insertion levels showed significant age-dependent patterns, with gingival and mid-gingival insertions increasing with age, whereas papillary and alveolar papilla insertions decreased. Midline diastema was more prevalent and larger in younger children, decreased with age, and showed negative correlations with specific frenum attachments and insertion levels.
This study demonstrated that maxillary frenum attachment and insertion levels shifted with age, favoring gingival and mid-attached gingival insertions. These findings advocate for age-specific evaluations and a conservative approach to managing midline diastema in primary dentition.
中线间隙是幼儿中常见的牙齿异常，通常与唇系带特征有关，包括附着类型和插入水平。尽管其具有临床意义，但这些系带特征与乳牙列中线间隙之间的关系仍未得到探索。本横断面研究旨在调查3至6岁儿童唇系带变异的患病率及其对中线间隙的影响，以深入了解其发育和临床意义。
本横断面研究纳入了432名3至6岁、乳牙列完整且有中线间隙的儿童。上颌唇系带附着类型分为黏膜型、牙龈型、乳头型或乳头穿透型。系带插入水平评估为附着于牙龈中部、黏膜牙龈交界处或牙槽乳头下缘。由经过校准的检查者使用视觉和触觉方法进行口腔检查，将中线间隙测量至最接近的0.1毫米，并根据严重程度进行分类。使用描述性统计和卡方检验进行关联分析。使用Spearman相关检验评估系带特征、年龄和中线间隙之间的相关性。
上颌系带附着和插入水平呈现出显著的年龄依赖性模式，牙龈型和牙龈中部插入随年龄增加，而乳头型和牙槽乳头插入减少。中线间隙在较年幼的儿童中更为普遍且更大，随年龄增长而减小，并与特定的系带附着和插入水平呈负相关。
本研究表明，上颌系带附着和插入水平随年龄变化，有利于牙龈型和附着于牙龈中部的插入。这些发现提倡针对年龄进行特定评估，并采用保守方法处理乳牙列中的中线间隙。
