Clinical Assessment of Frenum Morphology and Attachment in Malaysian Children

Objective: To determine the prevalence of various types and attachment level of maxillary frenum in Malaysian children. Material and Methods: A cross-sectional study was conducted in a total of 200 children of age ranging from 2 to 15 years. Photographs of maxillary frenum were taken and their types and level of attachment were recorded by using Placek’s classification and modified Sewerin typology. Children were divided into 3 groups based on age: between 2-5, 6-11 and 12-15 years. Descriptive analysis was carried out to determine the frequency of frenum types and level of attachment. The relationship of frenal attachment with gender, and age were studied. Data collected was analyzed using descriptive statistics (frequencies, percentages, means and standard deviation). Statistical Package for Social Sciences (SPSS) version 19.0 was used to analyze the data. Results: The most common type was mucosal type of attachment (75%) and the least common was papillary penetrating (4.5%) based on Placek’s classification whereas for modified Sewerin’s typology, simple frenum (73%) was the most prevalent, followed by simple with nodule frenum (11.5%). There was no significant difference in the frenum attachment between the two genders. Mucosal and gingival attachment was significantly higher in older age group whereas papillary and papillary penetrating was higher in younger age group. Conclusion: This study showed that attachment of frenum in children changes according to age and whereas gender plays no role in portraying the difference. Hence, clinicians must be able to identify the different types of MMLF during dental examination to avoid any unnecessary surgical interventions particularly during the period of development.