Oral Frenula – Anatomical variations, diagnostic and therapeutic aspects with clinical significance in orthodontics

The oral frenula – frenulum labii superioris, frenulum labii inferioris, and frenulum linguae – are connective tissue structures within the oral cavity whose clinical significance extends beyond their stabilizing role. When abnormally inserted, they may be associated with orthodontic, myofunctional, speech, and periodontal disturbances, particularly during the mixed dentition period. This review provides a comprehensive analysis of anatomical variations, diagnostic tools, and therapeutic protocols addressing morphological or positional abnormalities of the oral frenula. Well-established classification systems (Placek et al., 1974; Rui et al., 2019; Kotlow, 1999; Marchesan, 2005; Hazelbaker – ATLFF, 1993), functional tests, and standardized photographic/videographic documentation are discussed. Management algorithms for diastema, gingival recession, and ankyloglossia are reviewed, emphasizing the importance of interdisciplinary collaboration involving the orthodontist, speech therapist, surgeon, and periodontist. Special consideration is given to the timing and modality of frenotomy or frenectomy, including laser-assisted techniques.

Oral frenula should not be regarded as mere anatomical remnants but as prognostic biomarkers of potential systemic relevance, requiring an individualized and synchronized interdisciplinary approach to achieve long-term orthodontic and functional stability.

Karina Dobreva
4th-year student
Faculty of Dental Medicine
Medical University of Varna
84 Tsar Osvoboditel Blvd.
9002 Varna, Bulgaria
e-mail: karina.dobreva@gmail.com

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