The relationship between the shape of the maxillary labial frenulum and a gummy smile and intraoral pathology
https://doi.org/10.33925/1683-3759-2022-27-4-336-342
Abstract
Relevance. An upper lip tie causes different pathological conditions. The popular aberrant frenulum classifications are ambiguous.
The study aimed to assess different classifications of the maxillary labial frenulum in the context of a gummy smile, diastema, gingival recession and tissue ischemia relationship.
Materials and methods. Photographs documented the type of smile and the pathological conditions of 41 patients aged 9 – 39 y.o. The study measured the maxillary central incisor height on the plaster model and compared the frontal view of the smile and the teeth to the size of the central incisor and with each other. Measurements were carried out.
Results. A gummy smile is more common in individuals with a V-shaped frenulum independent of its width (61%, 14 patients, X2 = 13.06; p = 0.01) or in individuals with a wide frenulum independently of its shape (83%, 19 patients). 50% of all toothy smile cases are in the narrow frenulum group (69% in the group, nine patients). All cases with a lip tie (3 patients) showed a toothy smile (X2 = 10.29; p = 0.01). The group of the I-shaped frenulum attached at the gingival level demonstrated a diastema. Tissue ischemia is more prevalent in the group with the V-form frenulum, the frenulum ischemia and the attached gingiva or insertion point ischemia. It occurs separately from gingival recession only in V-shaped frenulum cases. The gingival recession prevails in X-shaped frenulum cases in the alveolar insertion point area (87.5%, four subjects) (p ≤ 0.05).
Conclusion. The received data are paramount for decision-making about the necessary treatment technique.
About the Author
O. V. AleksandrovaRussian Federation
Olga V. Aleksandrova, DMD, PhD Student, Department of Pediatric Dentistry and Orthod
Moscow
References
1. Devishree, Gujjari SK, Shubhashini PV. Frenectomy: a review with the reports of surgical techniques. Journal of Clinical and Diagnostic Research. 2012;6(9):1587-1592. doi:10.7860/JCDR/2012/4089.2572
2. Santa Maria C, Aby J, Truong MT, Thakur Y, Rea S, Messner A. The Superior Labial Frenulum in Newborns: What Is Normal? Global Pediatric Health. 2017;4:1-6. doi: 10.1177/2333794X17718896
3. Arifdzhanov AK, editor. Anomaliya prikrepleniya uzdechek gub i ih lechenie (metodicheskie rekomendacii). Publishing: Tashkent Medical Institute. 1989: 13 p. (In Russ.).
4. Jonathan PT, Thakur H, Galhotra A. Galhotra V, Gupta N. Maxillary labial frenum morphology and midline diastema among 3 to 12-year-old schoolgoing children in Sri Ganganagar city: A cross-sectional study. Journal of Indian Society of Pedodontics and Preventive Dentistry. 2018;36(3):234-239. doi: 10.4103/JISPPD.JISPPD_51_18
5. Ray S, Golden WC, Walsh J. Anatomic distribution of the morphologic variation of the upper lip frenulum among healthy newborns. JAMA Otolaryngology – head & neck surgery. 2019;145(10):931-938. doi:10.1001/jamaoto.2019.2302
6. Ayupova FS, Gayvoronskaya TV, Alekseenko SN. Anatomic and functional varieties of labial frenum in children during the mixed dentition period. Kubanskii nauchnyi meditsinskii vestnik (In Russ.). 2019;26(6):18-27. doi: 10.25207/1608-6228-2019-26-6-18-27
7. Telebaeva GT, Sharipova SK. Abnormal lip and tongue frenulum: classification, terminology approach to diagnostic. Vestnik of Kazakh National Medical University. 2014:2(2):107-111 (In Russ.). Available from: https://cyberleninka.ru/article/n/anomalnye-uzdechki-gub-i-yazyka-klassifikatsiya-terminologiya-spodhodom-diagnostiki
8. Sewerin I. Prevalence of variations and anomalies of the upper labial frenum. Acta Odontol Scandinavica. 1971:29(4):487-496. doi: 10.3109/00016357109026535
9. Yanushevich OO, Dmitrieva LA, editors. Parodontologiya: nacional’noe rukovodstvo. 2nd edition. Publishing: GEOTAR-Media. 2018: 752 p. (In Russ).
10. Naini FB, Gill DS. Oral surgery: labial frenectomy: indication and practical implications. British dental journal. 2018;225(3):199-200. doi: 10.1038/sj.bdj.2018.656
11. Berkheeva DS, Urazova RZ, Ksembaev SS. Comparative estimation of efficiency frenuloplastic method at children. Practical medicine. 2009;1(33):75-76 (In Russ.). Available from: https://cyberleninka.ru/article/n/sravnitelnaya-otsenka-effektivnosti-frenuloplastiki-u-detey
12. Van der Geld P, Oosterveld P, Van Heck G, Kuijper-Jagtman AM. Smile attractiveness. Self-perception and influence on personality. The Angle orthodontist. 2007;77(5):759-765. doi:10.2319/082606-349
13. De Souza Pinto EB. Relationship between tip nasal muscles and the short upper lip. Aesthetic plastic surgery. 2003:27(5):381-387. doi:10.1007/s00266-003-2070-x
14. Andreischev AR. Modern opportunities of «gummy smile» correction. Parodontologiya. 2006;38(1):26-32 (In Russ.). Available from: https://www.elibrary.ru/item.asp?id=9305317
Review
For citations:
Aleksandrova OV. The relationship between the shape of the maxillary labial frenulum and a gummy smile and intraoral pathology. Parodontologiya. 2022;27(4):336-342. (In Russ.) https://doi.org/10.33925/1683-3759-2022-27-4-336-342