Upper Labial Frenectomy in Pediatric Dentistry: When to Indicate? – Literature Review

Abstract

The labial frenulum, or frenum, is one of the components of the oral mucosa that can be found in both the upper and lower mucosa. When it does not develop correctly, it can present anomalies. It is common among parents, caregivers, and even healthcare professionals to have some difficulty in managing improperly inserted labial frenula, as well as in addressing their potential consequences. The most common measure for managing this alteration is frenectomy, which is a surgery that completely removes the labial frenulum with abnormalities. However, there is still much to study to determine the best age or when to indicate frenectomy. The objective of this work is to review literature addressing when to indicate upper labial frenectomy in pediatric dental patients. To do this, the PubMed, Google Scholar, SciELO, and Virtual Health Library (BVS) databases were consulted, using the boolean operator OR for the descriptors: lip, labial frenulum, oral surgery, pediatric dentistry, and child. A period between 2013 and 2022 was also limited for article publication. A total of 2049 articles were found, with 642 from PubMed, 412 from Google Scholar, 469 from SciELO, and 526 from the Virtual Health Library (BVS). However, only 13 were chosen due to their richness of content within the theme. All articles that were duplicated or diverged from the proposed theme, as well as theses, dissertations, and monographs, were excluded from this work. In addition to the chosen articles, two books by renowned authors in dentistry, published in 2016, contributed to this work. Upon analysis of the articles and books, there was a significant discussion among professionals who treat anomalies found in frenulae; some advocate for early frenectomy, while others approach frenectomy with caution. Thus, there is an evident need for more multidisciplinary studies focused on age-related results and when to recommend upper labial frenectomy in children.