Study |
Country |
Sample size |
Age (years) |
Location of frenum |
Frenal attachment (%) |
Diastema (%) |
1 |
2 |
3 |
4 |
Placek et al. (1974) [1717 Placek M, Miroslav S, Mrklas L. 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. https://doi.org/10.1902/jop.1974.45.12.891 https://doi.org/10.1902/jop.1974.45.12.8...
] |
Czech Republic |
465 |
15-40 |
UL and LL |
46.5 |
34.3 |
3.1 |
16.1 |
- |
- |
- |
- |
Ruli et al. (1997) [1111 Ruli LP, Duarte CA, Milanezi LA, Perri SHV. Frênulo labial superior e inferior: estudo clínico quanto a morfologia e local de inserção e sua influência na higiene bucal. Rev Odontol Univ São Paulo. 1997;11(3). https://doi.org/10.1590/S0103-06631997000300008 https://doi.org/10.1590/S0103-0663199700...
] |
Brazil |
100 |
19-26 |
UL and LL |
15 |
77 |
7 |
1 |
- |
- |
- |
- |
Braga et al. (2006) [1212 Braga AT, Quelemes PV, Moura WL, Moura WL. Descrição da morfologia dos frênulos labiais superiores em escolares de Teresina. Rev Cir Traumatol Buco-Maxilo-facial. 2006;7(3):59-64.] |
Brazil |
300 |
7-10 |
UL |
46 |
32 |
18.6 |
3.3 |
|
|
|
|
Gusmão et al. (2009) [1313 Gusmão ES, Souza PFJC, Vasconcelos RB, Claus RP, Cimões R, Coelho RS. Inserção e morfologia dos freios labiais. Odontol Clínico Científ. 2009; 8(2):133-139.] |
Brazil |
261 |
18- 72 |
UL and LL |
60.9 |
34.1 |
4.2 |
0.8 |
- |
- |
- |
- |
Boutsi & Tatakis (2011) [3333 Boutsi EA, Tatakis DN. Maxillary labial frenum attachment in children. Int J Paediatr Dent. 2011 Jul;21(4):284-8. https://doi.org/10.1111/j.1365-263X.2011.01121.x https://doi.org/10.1111/j.1365-263X.2011...
] |
Greece |
226 |
1-18 |
UL |
10.2 |
41.6 |
22.1 |
26.1 |
- |
- |
- |
- |
Upadhyay & Ghimire (2012) [1919 Upadhyay S, Ghimire N. Attachment of maxillary labial frenum in nepalese children. Orthod J Nepal. 2012;2(1):28-31. https://doi.org/10.3126/ojn.v2i1.9291 https://doi.org/10.3126/ojn.v2i1.9291...
] |
Nepal |
198 |
1-14 |
UL |
13.6 |
61.1 |
17.2 |
8.1 |
- |
- |
- |
- |
Christabel & Gurunathan (2015) [2121 Christabel SL, Gurunathan D. Prevalence of type of frenal attachment and morphology of frenum in children, Chennai, Tamil Nadu. World J Dent. 2015;6(4):203-207. https://doi.org/10.4103/jisp.jisp_294_17:10.4103/jisp.jisp_294_17. https://doi.org/10.4103/jisp.jisp_294_17...
] |
India |
931 |
3-12 |
UL |
38.8 |
49.5 |
9.8 |
1.9 |
|
|
|
|
Khursheed et al. (2015) [3535 Khursheed DA, Zorab SS, Zardawi FM, Ali AJ, Talabani RM. Prevalence of labial frenum attachment and its relation to diastema and black hole in kurdish Young population. J Dental Medical Sci. 2015;14(9):97-100. https://doi.org/10.9790/0853-149197100 https://doi.org/10.9790/0853-149197100...
] |
Iraq |
279 |
10-30 |
UL |
12.5 |
68.8 |
16.4 |
2.1 |
- |
- |
- |
- |
Ribeiro et al. (2015) [1414 Ribeiro ILA, Fernandes TL, Trigueiro DA, Souza CFM, Medeiros JMD. Avaliação dos padrões de morfologia e inserção dos freios labiais em pacientes da clínica-escola de odontologia do Centro Universitário de João Pessoa - PB. Rev Odontol UNESP. 2015;44(5):268-272. https://doi.org/10.1590/1807-2577.1081 https://doi.org/10.1590/1807-2577.1081...
] |
Brazil |
385 |
10-72 |
UL and LL |
75.8 |
19.2 |
1.8 |
3.2 |
- |
- |
- |
- |
Bervian et al. (2016) [1515 Bervian J, Cazarotto F, Perussolo B, Patussi EG, Pavinatto LCB. Description of the Upper Labial Frenulum Characteristics in Preschool Children of Passo Fundo, Brazil. Braz Res Pediatric Dent Integr Clinic. 2016;16(1):351-357. http://dx.doi.org/10.4034/PBOCI.2016.161.37 https://doi.org/10.4034/PBOCI.2016.161.3...
] |
Brazil |
304 |
0-6 |
UL |
21.4 |
51 |
21 |
6.6 |
- |
- |
- |
- |
Jindal et al. (2016) [2222 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 Periodont. 2016;20(3):320-323. https://doi.org/10.4103/0972-124X.182598 https://doi.org/10.4103/0972-124X.182598...
] |
India |
500 |
16-40 |
UL |
66 |
28.4 |
2.4 |
3.2 |
- |
- |
- |
- |
Sękowska & Chałas (2016) [66 Sękowska A, Chałas R. Diastema size and type of upper lip midline frenulum attachment. Folia Morphol. 2017; 76(3):501-505. https://doi.org/10.5603/FM.a2016.0079 https://doi.org/10.5603/FM.a2016.0079...
] |
Poland |
102 |
- |
UL |
41.1 |
28.4 |
14.7 |
15.6 |
17.3 |
25 |
26.9 |
30.8 |
Niazi et al. (2017) [2525 Niazi M, Manzoor N, Sajjad S, Qazi HS. Morphological and attachment variations of median maxillary labial frenum. J Pakistan Orthop. 2017;9(1):19-23.] |
Pakistan |
600 |
5-63 |
UL |
38.8 |
58.5 |
2.1 |
0.5 |
- |
- |
- |
- |
Karam et al. (2018) [3636 Karam BM, Ahmed AG, Kadir SK, Qasim HJ, Mohammed GN. Upper labial frenum attachment and medium diastema; comparative study between Kurdish and arab teenagers in Zakho city, Kurdistan, Iraq. Duhok Med J. 2018;12(1):31-40. https://doi.org/10.31386/dmj.uod.18.12.1.4 https://doi.org/10.31386/dmj.uod.18.12.1...
] |
Iraq |
307 |
15-19 |
UL |
35.1 |
57.9 |
4.8 |
1.9 |
- |
- |
- |
- |
Rajkarnikar et al. (2018) [3434 Rajkarnikar J, Khanal S, Acharya J. Prevalence and variations of the maxillary labial frenum in children, adolescents and adults. Nepal Med College J. 2018;20(1-3):94-97.] |
Nepal |
356 |
1 - > 35 |
UL |
70.5 |
28.4 |
0.8 |
0.3 |
- |
- |
- |
- |
Jonathan et al. (2018) [88 Jonathan PT, Himani T, Abhiruchi G, Virat G, Neha G. Maxillary labial frenum morphology and midline diastema among 3 to 12-year-old schoolgoing children in Sri Ganganagar city: a cross-sectional study. J Indian Soc Pedod Prev Dent. 2018; 36(3):234-239. https://doi.org/10.4103/JISPPD.JISPPD_51_18. https://doi.org/10.4103/JISPPD.JISPPD_51...
] |
India |
1200 |
3-12 |
UL |
47.5 |
38.1 |
0 |
14.2 |
12.2 |
22.2 |
0 |
65.5 |
Nandita et al. (2018) [3737 Nandita S, Bhat V, Hedge C. A survey to assess the Number, shape and attachment of the freni in the maxillary and mandibular arches in south Indian population. J Health Sci. 2018;8(2): 19-24. https://doi.org/10.1055/s-0040-1708749 https://doi.org/10.1055/s-0040-1708749...
] |
India |
100 |
18-40 |
UL and LL |
70 |
30 |
0 |
0 |
- |
- |
- |
- |
Manjunath (2018) [2626 Manjunath N, George AM, Mathew NML. The frenum and the diastema: a clinical observational study. Int J Innov Sci Res Technol. 2018;3(9):560-563.] |
India |
100 |
18-50 |
UL |
16 |
15 |
24 |
9 |
56.2 |
66.6 |
62.5 |
100 |
Rajani et al. (2018) [2828 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. https://doi.org/10.4103/jisp.jisp_294_17. https://doi.org/10.4103/jisp.jisp_294_17...
] |
India |
150 |
13-30 |
UL |
42 |
34 |
20 |
4 |
- |
- |
- |
- |
Pandiyan et al. (2018) [2727 Pandiyan NJ, Hedge A. Clinical assessment of frenum morphology and attachment in malaysian children. Pesq Bras Odontoped Clinica Integr. 2018;18(1):1-9. http://dx.doi.org/10.4034/PBOCI.2018.181.20 https://doi.org/10.4034/PBOCI.2018.181.2...
] |
Malaysia |
152 |
2-15 |
UL |
76 |
12 |
7.5 |
4.5 |
- |
- |
- |
- |
Varghese et al. (2018) [4646 Varghese T, Kalburgi V, Dodani K, Parihar A, Prashant MC, Nagpal N. Various morphological variations in attachment of maxillary labial frenum: an observational study. J Res Adv Dent. 2018;8(1):189-92.] |
India |
90 |
15-30 |
UL |
42.2 |
33.33 |
21.11 |
3.33 |
- |
- |
- |
- |
Bowsiyaand & Arjunkumar (2019) [4141 Bowsiya S, Arjunkumar R. Prevalence of labial frenum attachment and frenal morphology among patients reporting to Saveetha Dental College. J Clinical Dent. 2019;12(3):181-89. https://doi.org/10.4103/jisp.jisp_294_17 https://doi.org/10.4103/jisp.jisp_294_17...
] |
India |
500 |
20-70 |
UL and LL |
90.4 |
8.4 |
1.2 |
0 |
- |
- |
- |
- |
Sekar et al. (2019) [1616 Sekar R, Mungara MJ, Joseph E. To determine the prevalence of maxillary labial and mandibular lingual frenum and it’s relationship between the upper midline space and to clinically assess the maxillary labial frenum morphology in 3 to 14 years children of Chennai City. Gjra - Global J Res Anal. 2019; 8(2):136-140. https://doi.org/10.36106/GJRA https://doi.org/10.36106/GJRA...
] |
India |
951 |
03-14 |
UL and LL |
63.3 |
26.8 |
7.2 |
2.6 |
28 |
31.6 |
27.6 |
47.1 |
Seraj et al. (2019) [2929 Seraj B, Shahrabi M, Masoumi S, Jabbarian R, Manesh AA, Fini MB. Studying maxillary labial frenulum types and their effect on median diastema in 3–6-year-old children in tehran kindergartens. World J Dent. 2019;10(2): 93-97. https://doi.org/10.5005/jp-journals-10015-1611 https://doi.org/10.5005/jp-journals-1001...
] |
Iran |
639 |
3-6 |
UL |
19.9 |
52.9 |
18.8 |
8.5 |
- |
- |
- |
- |
Divater et al. (2019) [3030 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 Family Med Prim Care. 2019;8(11):3664-3667. https://doi.org/10.4103/jfmpc.jfmpc_611_19 https://doi.org/10.4103/jfmpc.jfmpc_611_...
] |
India |
300 |
13-18 |
UL |
39 |
28.3 |
23.7 |
9 |
- |
- |
- |
- |
Biradar et al. (2020) [3131 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 Dental Pract. 2020;21(5): 562-567. https://doi.org/10.5005/jp-journals-10024-2794 https://doi.org/10.5005/jp-journals-1002...
] |
India |
1.800 |
3-17 |
UL |
11.98 |
41.95 |
39.78 |
6.27 |
- |
- |
- |
- |
Rathod et al. (2020) [4343 Rathod S, Bawankar PV, Chikahale P, Bidwaikar A. Evaluation of variations in morphology and attachment of frenum in diverse population - A cross-sectional study. Clin Epidemiol Global Health. 2020;8:1094-97. https://doi.org/10.1016/j.cegh.2020.03.026 https://doi.org/10.1016/j.cegh.2020.03.0...
] |
India |
400 |
20-40 |
UL |
29.8 |
49.9 |
16.5 |
3.8 |
- |
- |
- |
- |
Chaulagain et al. (2021) [3232 Chaulagain R, Khanal N, Singh AK. Morphology of maxillary labial frenum in chepang community of Chitwan. J Nepal Health Res Council. 2021;19(50):185-188. https://doi.org/10.33314/jnhrc.v19i1.3475 https://doi.org/10.33314/jnhrc.v19i1.347...
] Joshi et al. (2021) [4444 Joshi U, Pradhan M, Neupane A, Lawanju N, Khadka N, Chaulagain R. Variations in maxillary frenal morphology in a sample of newari children of Bhaktapur. J Nepalese Soc Periodontol Oral Implantol. 2021;5(9):34-8. https://doi.org/10.3126/jnspoi.v5i1.38181 https://doi.org/10.3126/jnspoi.v5i1.3818...
] |
Nepal |
102 |
≤10-60 |
UL |
100 |
- |
- |
- |
- |
- |
- |
- |
340 |
6-16 |
UL |
60 |
29.7 |
6.2 |
4.1 |
- |
- |
- |
- |
Patel et al. (2021) [4545 Patel J, Parikkh H, Duseja S, Agrawal C, Dholakia P, Pathak V. Variations in the attachment and morphology of maxillary labial frenum in diverse population of gujarat: an observational study. J Res Adv Dent. 2021;11(3):336-41.] |
India |
1000 |
18-30 |
UL |
56.9 |
23.7 |
11.9 |
7.5 |
0 |
0 |
21.84 |
81.33 |
Kilinc et al. (2021) [4747 Kilinc G, Cetin M, Ertunc UE, Kose ZB, Atesci AA. Evaluation of median maxillary labial frenum type and morphology in different age groups. J Basic Clin Health Sci. 2021;3:30-35. https://doi.org/10.30621/jbachs.880475 https://doi.org/10.30621/jbachs.880475...
] |
Turkey |
1023 |
2-65 |
UL |
26.3 |
55.2 |
14.0 |
4.5 |
- |
- |
- |
- |
Dahal et al. (2022) [4848 Dahal S, Gupta SP, Baral S, Niroula D, Humagain M. Maxillary labial frenulum attachment among patients visiting a tertiary level hospital of Nepal. J Kathmandu Med College. 2022;11(2):90-94. https://doi.org/10.3126/jkmc.v11i2.48668 https://doi.org/10.3126/jkmc.v11i2.48668...
] |
Nepal |
140 |
12-71 |
UL |
59.3 |
32.9 |
6.4 |
1.4 |
- |
- |
- |
- |