Frenula in the oral cavity: an overview of diagnosis, prognosis and clinical management in growing patients

Abstract

This study described the clinical complications and management of frenula. The frenula of the oralcavity are natural anatomical elements consisting of a triangular fold of mucous membrane, whichextends in the sagittal direction from the gingiva in the submucosa of the lip, cheeks and tongue.Histologically, the oral frenula consist of a fibrous tract formed by collagen fibers placed in bandsassociated with thin perivascular nerve structures. These structures are coated by a stratified squamousepithelium. There are syndromes that cause repercussions in the oral frenula: Ehlerdanlos syndrome,Pallister-Hall syndrome, Opitz syndrome, Oral-facial-digital syndrome, Pediatric hypertrophic pyloricstenosis, Ellis-van Creveld syndrome, Holoprosencephaly; there are also non-syndromic conditions.Clinical examination must include the inspection and palpation integrated by the pull of the lips andthe verification of the tongue protrusion capacity. Consequences of the upper and lower lip frenula aredescribed as well as the relative surgical procedures (frenotomy and frenectomy).