An investigation into the correlation between frenal attachment position and severity of midline diastema

Introduction. The relationship between midline diastema (MD) and the level of frenal attachment (LFA) remains a subject of ongoing debate. Some studies suggest a correlation between a higher frenal attachment and an increased width of the midline diastema. Materials and methods. The MD width was measured to the adjacent millimeter in a cohort of one hundred sixty-four dental surgeons. The LFA was estimated and categorized into three groups as follow: papillary, gingival, and mucosal. The mean MD width was compared across the LFA groups using a t-test, with statistical significance set at p ≤ 0.05. Results. A total of 164 students participated in the study, including 16 males (9.8%) and 148 females (90.2%). Among the participants, a higher proportion of those with a papillary LFA (12 out of 18) exhibited a MD exceeding 1 millimeter, whereas no individuals with a mucosal LFA demonstrated a MD. A statistically significant correlation was identified between the presence of MD and the height of the LFA (p ≤ 0.000). A parallel result of statistical significance was detected (p-value = 0.000), when associating the mean MD width with LFA, Moreover, significant differences were noted when examining the mean MD across the various LFA categories, further emphasizing the relationship between LFA and MD width. Conclusions. The height of the LFA is significantly correlated with both the incidence and severity of MD. This relationship plays a crucial role in the management of MD, especially in orthodontic interventions aimed at closing the space. In some cases, frenectomy may be required to address and correct this malocclusion characteristic, particularly when it contributes significantly to the persistence of the MD.