The median maxillary labial frenum (MMLF) is a normal anatomic structure
with inherent morphologic variations. This study sought to evaluate
the prevalence of those variations in a diverse ethnic population and to
educate practitioners about the prevalence of MMLF variations to prevent
unnecessary biopsies.
This study included adult, adolescent, and child patients at the Louisiana
State University Health Science Center School of Dentistry. Among the
284 subjects examined, frenum normale was the most common frenum
classification, followed by frenum with nodule and frenum with appendix.
Most nodules were found in the intermediate third of the MMLF, while
appendices were mainly found in the labial third. The prevalence of an
appendix was significantly higher (P < 0.001) in Caucasians compared
to African-Americans. The prevalence of nodules was marginally higher
(P = 0.096) in Caucasians than in African-Americans. No other statistically
significant differences were found with regard to ethnicity. Additionally,
nodules and appendices on the MMLF were identified in all age groups,
and may become more common with increasing age.
The authors determined that variations of the MMLF are inherent and
do not represent a pathologic condition, nor do they require biopsy for
diagnostic purposes.