Assessment of Relationship Between Aberrant Maxillary Labial Frenum and Skeletal Class III Malocclusion

Abstract

Aim: To assess the relationship between an aberrant labial frenum attachment and skeletal class III malocclusion among 13 to 30-year-old subjects and thereby, to determine whether such a frenum causes retardation of the growth of the maxilla resulting in skeletal class III malocclusion. newlineResults: The study comprised of group 1 with 100 skeletal class III individuals and group 2 with 98 skeletal class I and 102 skeletal class II subjects. The sample consisted of 182 subjects with normal frenum and 112 subjects with aberrant frenum. The trade-off of the level of frenum attachment was observed to be less than or equal to 3.5 mm with the corresponding sensitivity and specificity which were estimated to be 0.864 and 0.926 respectively. It was also found that 71% of group 1 subjects had retrognathic maxilla in comparison to 44.5% of group 2 subjects. Among those with retrognathic maxilla in group 1, 57.7% had aberrant frenum. The level of frenum attachment had a significant correlation with SNA, and Nasion perpendicular to point A among group 1 subjects. The attachment level of the frenum, the distance from condylion to point A, measured maxillary length of Schwarz analysis, crossbite, and familial tendency entered into the regression equation. newlineConclusion: The class III subject in group 1 had the highest frequency of aberrant frenum than the class I and class II subjects. It is also noteworthy to state that a higher frequency of aberrant frenum was observed in those with retrognathic maxilla in group 1 subjects. This would supposedly be due to the erratic forces exerted in the labioseptopremaxillary region which tends to develop skeletal class III malocclusion. Henceforth, the present study revealed that the maxillary labial frenum indirectly regulates facial growth and supports the association between the aberrant frenum and class III malocclusion.