Upper labial frenulum

The upper labial frenulum is an anatomical structure formed by a mucous membrane and connective tissue. It extends from the inner aspect of the upper lip to the alveolar ridge between the central incisors.

The short upper labial frenulum is described as a "low connection" between the upper lip and the alveolar ridge. There is an inversely proportional relationship between the level of gingival insertion of the frenulum and the central diastema (space between two teeth). This means that the lower the frenulum insertion, the wider the diastema.

Upper lip frenectomy should be delay until the eruption of the permanent teeth since there may be a spontaneous resolution of the diastema as the patient grows.

SCIENTIFIC EVIDENCE
* ME Díaz-Pizán, MO Lagravère, R Villena. Midline diastema and frenum morphology in the primary dentition. J Dent Child (Chic). 2006;73:11-4.
* S Shah, P Allen, R Walker. Upper lip tie: Anatomy, effect on breastfeeding, and correlation with ankyloglossia. Laryngoscope. 2021;131:1701-6. 
* S Tadros, T Ben-Dov, EO Catháin. Association between superior labial frenum and maxillary midline diastema - a systematic review. Int J Pediatr Otorhinolaryngol. 2022;156:111063.