Morphological and attachment site variations of maxillary labial frenulum

Introduction Maxillary labial frenulum (MLF) is a mucous membrane fold that shows diversity in morphology, position and clinical significance throughout life. The aim of the study was to evaluate different morphological variations and MLF attachment site prevalence in elementary school children. Material and methods the study included 110 children of "Ljutica Bogdan" Primary School in Kalinovik, Bosnia and Herzegovina. Clinical examinations were performed visually under natural light. The upper lip was lightly elevated with the forefingers and thumbs of both hands in horizontal alignment from alveolar ridge. Morphological variations were registered in accordance with Sewerin classification and attachment site according to Placek et al. Results the study included 49 (44.6%) male and 61 (55.4%) female subjects. Mucosal MLF was registered in 57.3%, gingival in 17.3%, papillary in 20.9% and papilla penetrating in 4.5% of examined children. Frenulum simplex was registered in 64.6%, persistent tectolabial frenulum in 4.5%, frenulum with appendix in 9.1%, frenulum with nodule in 14.5%, duplication of frenulum in 5.5%, frenulum with two or more variations was registered in 1.8% of respondents. No difference was observed in morphological variations and attachment site positions between genders. Conclusion Most prevalent MLF morphological type was frenulum simplex and mucosal attachment site. Familiarity with MLF morphology, attachment site position as well as prevalence of different variations is very important in everyday clinical practice from the aspect of proper oral hygiene maintenance, periodontal disease prevention, orthodontic treatment and proper surgical therapy.