Marr Veronica Lexa, Stewart Lauren Grace, Hung Man, Cheever Val Joseph
College of Dental Medicine, Roseman University of Health Sciences, 10894 S. River Front Parkway, South Jordan, UT 84095, USA.
Dent J (Basel). 2025 Sep 8;13(9):414. doi: 10.3390/dj13090414.
: The maxillary labial frenum (MLF) is a connective tissue structure attaching the upper lip to the maxillary alveolar process. Its morphology varies significantly among individuals and is often most prominent during early childhood. While hypertrophic or low-attaching frena have been associated with diastemas, feeding issues, and speech impairments, there is no causal evidence supporting early surgical intervention. This review aims to examine current evidence regarding the timing and necessity of frenectomy procedures and to evaluate the implications of early versus delayed intervention. : A narrative review was conducted using twenty peer-reviewed articles published in the past 10 years, with one additional article from 2012 included for its ongoing relevance. Databases searched included PubMed, the NIH database, the Reference Manual of Pediatric Dentistry, and journals from the American Academy of Pediatrics. Inclusion criteria were English-language, peer-reviewed studies that addressed the morphology, classification, diagnosis, management, and outcomes of MLFs across age groups. Excluded were studies focusing solely on mandibular, buccal, or lingual frena; non-English publications; case reports; and articles lacking full-text availability. : The literature suggests that premature frenectomy, prior to the eruption of permanent maxillary canines, typically between 9 and 12 years of age, is associated with frenum regrowth, surgical complications, and orthodontic relapse. Additionally, a lack of standardized diagnostic criteria contributes to inconsistent clinical decision-making. Conservative management, including monitoring, is strongly recommended as the frenum often migrates apically as the maxilla develops. Factors such as airway obstruction and developmental delays should be ruled out before considering surgery. : There is insufficient evidence to support early surgical intervention for MLF-related concerns. A conservative, individualized approach, delaying frenectomy until after permanent canine eruption, may minimize complications, improve long-term outcomes, and allow the frenum to migrate apically as the patient develops. Standardized diagnostic tools are urgently needed to guide clinical decision-making.
上颌唇系带（MLF）是一种将上唇与上颌牙槽突相连的结缔组织结构。其形态在个体之间差异很大，在儿童早期通常最为明显。虽然肥厚或附着位置过低的系带与牙间隙、喂养问题和言语障碍有关，但尚无因果证据支持早期手术干预。本综述旨在研究有关唇系带切除术时机和必要性的现有证据，并评估早期干预与延迟干预的影响。
采用叙述性综述方法，检索了过去10年发表的20篇同行评议文章，并纳入了2012年发表的一篇仍具相关性的文章。检索的数据库包括PubMed、美国国立卫生研究院数据库、《儿童牙科学参考手册》以及美国儿科学会的期刊。纳入标准为针对各年龄组MLF的形态、分类、诊断、管理和结果的英文、同行评议研究。排除的研究包括仅关注下颌、颊或舌系带的研究；非英文出版物；病例报告；以及缺乏全文的文章。
文献表明，在恒牙上颌尖牙萌出之前过早进行唇系带切除术，通常在9至12岁之间，会导致系带再生、手术并发症和正畸复发。此外，缺乏标准化的诊断标准导致临床决策不一致。强烈建议采用保守管理，包括监测，因为随着上颌骨的发育，系带通常会向根尖方向迁移。在考虑手术之前，应排除气道阻塞和发育迟缓等因素。
没有足够的证据支持对与MLF相关的问题进行早期手术干预。一种保守的、个体化的方法，将唇系带切除术推迟到恒牙尖牙萌出之后，可能会将并发症降至最低，改善长期效果，并使系带随着患者的发育向根尖方向迁移。迫切需要标准化的诊断工具来指导临床决策。
