An assessment of a possible relationship between level of frenal attachment and the severity of midline diastema among selected group of Nigerians.

Background: There are divergent opinions concerning the coexistence of midline diastema with high frenal attachment. While some have reported high frenal attachment in association with wide midline diastema, others have reported otherwise. Objective: To assess the relationship between the level of frenal attachment and the severity of midline diastema Materials and Methods: Midline diastema was measured to the nearest millimeters in a cross sectional study among one hundred and sixty-four selected group of Nigerians. The level of attachment of the median labial frenum was assessed and classified into the mucosal, gingival and the papillary attachment types. The mean width of the midline diastema was compared with the height of the frenal attachment using t-test and level of statistical significance was set at p < 0.05. Results: One hundred and sixty-four participants consisting of 16 (9.8%) males and 148 (90.2%) females were assessed. A larger percentage (12/18) of papillary type of frenal attachment had diastema greater than 1 millimeter, while one of those with mucosal attachment had midline diastema. There was a statistically significant relationship between the presence of midline diastema and the level of frenal attachment (p<0.000). Similar findings were observed when mean width of midline diastema was compared with the frenal height (p<.000) and when mean differences of midline diastema of the various frenal heights were compared. Conclusion: Within the limitation of this study, frenal height was found to be associated with the presence and severity of midline diastema. This may be essential in the management of midline diastema, especially in its orthodontic closure as it is considered as a malocclusion trait, which may necessitate surgical excision of the frenum.