Association of Frenum Attachments with Age and Gender in a Sample of Iraqi People: A Cross-Sectional Study

Abdulkareem Hussain Alwan

doi:10.54133/ajms.v7i1.1169

Authors

Abdulkareem Hussain Alwan Department of Periodontics, Faculty of Dentistry, Al-Rafidain University College, Baghdad 10052, Iraq https://orcid.org/0009-0001-6966-9488

DOI:

https://doi.org/10.54133/ajms.v7i1.1169

Keywords:

Age, Attachment, Frenum attachment, Gender, Gingival mucosa

Abstract

Background: The labial frenum is a thin fold of oral mucosa that contains muscle fibers. It connects the lips to the tissues and bones around the upper and lower teeth. Objective: To assess the various types of labial frenal attachments in the upper and lower jaws, as well as their relationship with age and gender, in a sample of the Iraqi population. Methods: The study includes 1,939 subjects (978 males and 961 females) with an age range of 10 to 70 years. These individuals visited the Periodontics Department of Dentistry at Al-Rafidain University College in Baghdad, Iraq, from October 2021 to April 2023. The patients were categorized into age subgroups: 10–30 years, 31–50 years, and 51–70 years. Descriptive statistics estimate frequencies and percentages, and the Chi-square test compares the results. Results: The total number of labial frenum attachments, encompassing both upper and lower attachments, varies between males and females. There are 1397 gingival attachments (36.02%), 1793 mucosal attachments (46.24%), 567 papillary attachments (14.62%), and 121 papillary penetrating attachments (3.12%) in both sexes. In both sexes, there is a significant correlation between age and different upper and lower labial frenum attachment categories. Additionally, there is a significant correlation between gender and the upper and lower labial frenum attachment categories. Conclusions: In the maxilla, the gingival attachment was more prevalent, followed by the mucosal attachment. However, we detect the mucosa attachment in the mandible, followed by the gingiva attachment. There was a significant relationship between frenum attachment, age, and gender.

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References

Gupta A, Shirbhate U, Paul P, Bajaj P, Bharti L, Panchal S, GUPTA A. Management of aberrant frenum and gingival overgrowth in orthodontic patients: A case report. Cureus. 2024;16(6). doi: 10.7759/cureus.62055. DOI: https://doi.org/10.7759/cureus.62055

Rijal AH, Humagain M, Lamichhane S, Ghimire P, Thapa S. Prevalence of maxillary and mandibular frenal attachment and its association with age, gender, and oral Hygiene status in Nepalese population seeking dental treatment. Int J Dent. 2024;2024(1):4870253. doi: 10.1155/2024/4870253. DOI: https://doi.org/10.1155/2024/4870253

Mirko P, Miroslav S, Lubor M. Significance of the labial frenum attachment in periodontal disease in man. Part 1. Classification and epidemiology of the labial frenum attachment. J Periodontol. 1974;45(12):891-894. doi: 10.1902/jop.1974.45.12.891. DOI: https://doi.org/10.1902/jop.1974.45.12.891

Kotian N, Jeevanandan G. Maxillary labial frenum morphology in children in chennai population: A cross-sectional study. Drug Invent Today. 2020;14(5):769-761. doi: 10.21786/bbrc/13.7/66. DOI: https://doi.org/10.21786/bbrc/13.7/66

Sapkota SM, Thakur SN, Chaulagain R. Assessment of number and level of attachment of buccal frenum in the edentulous old age people in a tertiary care center of Nepal. J Chitwan Med Coll. 2024;14(1):20-222. doi: 10.54530/jcmc.1480. DOI: https://doi.org/10.54530/jcmc.1480

Delli K, Livas C, Sculean A, Katsaros C, Bornstein MM. Facts and myths regarding the maxillary midline frenum and its treatment: a systematic review of the literature. Quintessence Int. 2013;44(2). doi:10.3290/j.qi.a28925.

Northcutt ME. The lingual frenum. J Clin Orthod. 2009;43(9):557-565; quiz 581. PMID: 19904047.

Singh K, Nautiyal A, Bali S, Aggarwal P, Garg A. Frenectomy: A literature review. J Survey Fisheries Sci. 2023:871-875.

Nandita S, Bhat V, Hegde C. A survey to assess the number, shape and attachment of the frenum in the maxillary and mandibular arches in south Indian population. J Health Allied Sci. NU. 2018;8(02):019-24. doi: 10.1055/s-0040-1708749. DOI: https://doi.org/10.1055/s-0040-1708749

Divater V, Bali P, Nawab A, Hiremath N, Jain J, Kalaivanan D. Frenal attachment and its association with oral hygiene status among adolescents in Dakshina Kannada population: A cross-sectional study. J Fam Med Primary Care. 2019;8(11):3664-3667. doi: 10.4103/jfmpc.jfmpc_611_19. DOI: https://doi.org/10.4103/jfmpc.jfmpc_611_19

Tadros S, Ben-Dov T, Cathain EO, Anglin C, April MM. Association between superior labial frenum and maxillary midline diastema—A systematic review. Int J Pediatr Otorhinolaryngol. 2022;156:111063. doi: 10.1016/j.ijporl.2022.111063. DOI: https://doi.org/10.1016/j.ijporl.2022.111063

Rajani ER, Biswas PP, Emmatty R. Prevalence of variations in morphology and attachment of maxillary labial frenum in various skeletal patterns-A cross-sectional study. J Indian Soc Periodontol. 2018;22(3):257-262. doi: 10.4103/jisp.jisp_294_17. DOI: https://doi.org/10.4103/jisp.jisp_294_17

Rathod S, Bawankar PV, Chikhale P, Bidwaikar A. Evaluation of variations in morphology and attachment of frenum in diverse population-A cross-sectional study. Clin Epidemiol Glob Health. 2020;8(4):1094-1097. doi: 10.1016/j.cegh. DOI: https://doi.org/10.1016/j.cegh.2020.03.026

Dahal S, Gupta SP, Baral R, Dahal S, Niroula D, Humagain M. Maxillary labial frenulum attachment among patients visiting a tertiary level hospital of Nepal: Maxillary labial frenulum attachment among patients of Nepal. J Kathmandu Med Coll. 2022 ;11(2):90-94. doi: 10.3126/jkmc.v11i2.48668. DOI: https://doi.org/10.3126/jkmc.v11i2.48668

Miller PD. The frenectomy combined with a laterally positioned pedicle graft: Functional and esthetic considerations. J Periodontol. 1985;56(2):102-106. doi: 10.1902/jop.1985.56.2.102. DOI: https://doi.org/10.1902/jop.1985.56.2.102

Laavanya M, Varshini S, Sri Ranjani T, Kumar S. Frenal attachments: An overview Volume 7. Int J Innov Sci Res Technol. 2022;11.

Ahn JH, Newton T, Campbell C. Labial frenectomy: current clinical practice of orthodontists in the United Kingdom. Angle Orthod. 2022;92(6):780-786. doi: 10.2319/011822-56.1. DOI: https://doi.org/10.2319/011822-56.1

Yang MC, Marks RG, Magnusson I, Clouser B, Clark WB. Reproducibility of an electronic probe in relative attachment level measurements. J Clin Periodontol. 1992;19(8):541-548. doi: 10.1111/j.1600-051x.1992.tb00681.x. DOI: https://doi.org/10.1111/j.1600-051X.1992.tb00681.x

Iwanaga J, He P, Fukino K, Hur MS, Kim HJ, Han A, et al. What is a superior labial frenulum? An anatomical and histological study. Clin Anatomy. 2023;36(1):161-169. doi: 10.1002/ca.23973. DOI: https://doi.org/10.1002/ca.23973

Biradar SM, Patil AY, Kotnoor SS, Bacha S, Bijjaragi SC, Kattimani PT. Assessment of diverse frenal morphology in primary, mixed, and permanent dentition: A prevalence study. J Contemp Dent Pract. 2020;21(5):562-567. doi:10.5005/jp-journals-10024-2794. DOI: https://doi.org/10.5005/jp-journals-10024-2794

Mendhe A, Muley P, Gupta H, Rajguru J. Assessment of morphological variations of frenal attachment in a diverse population of Vidarbha region. Asian J Dent Sci. 2023;6:2:1-6.

Christabel SL. Prevalence of type of frenal attachment and morphology of frenum in children, Chennai, Tamil Nadu. World J Dent. 2017; 6:203-2037. doi: 10.5005/jp-journals-10015-1343. DOI: https://doi.org/10.5005/jp-journals-10015-1343

Jindal V, Kaur R, Goel A, Mahajan A, Mahajan N, Mahajan A. Variations in the frenal morphology in the diverse population: A clinical study. J Indian Soc Periodontol. 2016;20(3):320-323. doi: 10.4103/0972-124X.182598. DOI: https://doi.org/10.4103/0972-124X.182598

Vandana KL. Association of labial and buccal frenal attachment with gingival recession–A clinical perspective. Scholars J Dent Sci. 2017;4(3):93-95. doi: 10.36347/sjds.2017.v04i03.001.