The presence of a maxillary midline diastema is a normal characteristic in development of stomatognathic system in the mixed dentition period, especially in the initial phase of eruption of permanent maxillary central incisors (Ugly duckling stage). During the …show more content…
There is a remarkable consensus among scientists concerning the cause - effect relationship between the presence of hypertrophic or malposed maxillary labial frenum and maxillary midline diastema. Shashua and Artun (1999)91 found that there is a correlation between the width of the diastema and the presence of an abnormal frenum.
Considering diagnosis, sometimes, when frenum fibers are inserted quite deeply, the presence of an abnormal labial frenum can be diagnosed by observation alone or by stretching the upper lip and observing the ischemia caused to the interdental papilla. Numerous authors supported that the maxillary labial frenum is associated with the pathogenicity of the maxillary midline diastema. The frenum fibers can sometimes be attached to the periosteum and the connective tissue of the residual intermaxillary suture that might be present, while others may simply interrupt the continuity of, particularly, the interdental gingiva. It seems that the deeper within the tissues and the closer to the incisive papilla the frenum is attached, the more likely it is for it to cause a diastema. Miller et al (1985)58 recommended that the frenum should be characterized as pathologic when it is unusually wide or there is no apparent zone of attached gingiva along the midline, or the interdental papilla shifts when the frenum is