Background: The superior labial frenum attachment may instigate or associate with the midline diastema. Previous studies on the distribution of the superior labial frenum attachment in children are limited, especially in the infantile period.
Objective: The purpose was to examine the prevalence of the superior labial frenums that are related to the occurrence of a
persisting midline diastema in the infants (0 to 6 months of age) and children (3 to 12 years of age).
Material and Method: A cross-sectional study was conducted. The study population consisted of 124 infants from the Tongue
Tie Clinic of Siriraj Hospital and 303 children from the dental clinic of Sikhiu Hospital. The patients were clinically examined
for the superior labial frenum attachment and the association with a persistent midline diastema. Descriptive statistics and
SPSS program were used for analysis.
Results: The 124 infants, mean age 11.9 days, were 58.1% male and 41.9% female. The prevalence of various forms of the
superior labial frenum attachment was as follows: gingival 29%, papillary 59.7%, and papillary penetrating 11.3%. The 303
children, mean age 8.7 years, were 54.1% male and 45.9% female. The prevalence of the superior labial frenum attachment
was as follows: mucosal 18.8%, gingival 70%, papillary 7.3%, and papillary penetrating 4%. The prevalence of the midline
diastema in the children population was 7.3% and most of it was the papillary penetrating type.
Conclusion: The papillary penetrating type of superior labial frenum should be closely monitor. If it still persist throughout
the infantile period, it should be considered for correction to prevent further anomalies especially in the midline diastema.

Keywords: Midline diastema, Maxillary midline diastema, Superior labial frenum