Effect of median oral frenulums at gingival reccesion
Ilma Robo, Saimri Heta, Kliton Malaj, Luan Mavriqi
Introduction: The median frenulum plays an important clinical role in the exercise of the movement of the lip movements to the fixed gingiva, which modifies its width to fit within its limits in dealing with these forces. Their way of positioning in the creation or not of the contact point makes it possible for the frenulum to fit into the interdental space, exerting strength over the fixed gingiva and beyond, over the interdental papilla, which, as a structure is more fragile, tangible, sensitive, rather than fixed gingiva. The study aims to find a possible correlation between the incidence of various types of median labial frenulum and gingival recession on vestibular incisors surfaces. Materials and methods: Types of frenulum varies in different age and gender ranges, giving a functional aesthetic harmony of the oral tooth in the oral cavity. Of the total of 311 patients, 124 did not meet the 2 criteria for patient selection: they had less than 20 teeth in oral cavity and included within the age of 20 years. According to age groups, the patients were divided as follows: group 1 - age 20-39, group 2 - age 40-59, group 3 - age 60 and above. Three categories were defined for the assessment of gingival recession: minimal recession - less than 3mm of exposed root, average recession - 3-4mm of exposed root and advanced recession more than 4mm root area exposed to oral cavity. Results: If the prevalence of recession in the 30-39 age range was 37.8% and the median reach 8.6%, in the 40-64 age range, these figures reached 90.4% prevalence and 56.3% coverage on the affected teeth. Gingival recession has been found to be the highest in the gingival type (17.5%) and at least with the mucous membrane type (2.45%), while the mandibular papila type showed the maximum percentage (71.5%) with the penetration type papilla (1.5%) that shows the least. The buccal recession was found to be higher than the labial recession. The mandibular frenulums of both gingival (51.5%) and mucosal (36.1%) had gingival recession. The correlation analysis found that since the level of frenulum binding extends to the gingiva crown recession, it results to be higher in papillary frenum type and at least in the papillar type. Conclusions: The documented data showed that among the most common frenulum types encountered in normal morphology of oral cavity, are the simple frenulum and frenulum with a labial medial attachment. Regarding the age and distribution of these frenulums, the highest percentage was for the simple fever at age 60 and for the supplement frenulum at the age of 40-59 years. Simple frenulums are commonly encountered in female patients, while frenulums with supplements in male patients. Gingival recession, both for simple and supplemental frenulum cases, was under the 3mm value, measurable in the vestibular surface. The correlation of the appearance of gingival recession and the type of frenulum, speaks for statistically significant correlation, with p <0.001. The papila index of the frequency with most types of frenulum, ranged from class I and class II, in values of the approximate proportion to each other.