{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T17:37:12Z","timestamp":1787506632426,"version":"build-2736575974"},"reference-count":40,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2024,1,11]],"date-time":"2024-01-11T00:00:00Z","timestamp":1704931200000},"content-version":"vor","delay-in-days":10,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2024,1,1]],"date-time":"2024-01-01T00:00:00Z","timestamp":1704067200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["International Journal of Dentistry"],"published-print":{"date-parts":[[2024,1]]},"abstract":"<jats:p>\n                    <jats:italic>Objective<\/jats:italic>\n                    . Frenum attachments are folds of mucous membrane that connect the lips to the alveolar mucosa and underlying periosteum. Aberrant positioning of the maxillary and mandibular labial frenum can lead to various clinical issues, including mucogingival problems and midline diastema. The objective of this study was to assess the prevalence of maxillary and mandibular frenal attachments and their association with age, gender, and oral hygiene status in the Nepalese population seeking dental treatment.\n                    <jats:italic>Materials and Methods<\/jats:italic>\n                    . This descriptive cross\u2010sectional study was conducted over a period of 6 months, from February 2023 to August 2023, among patients visiting the Department of Periodontology and Oral Implantology, aged 6 years and above, after obtaining official permission from the Institutional Review Committee (IRC\u2010KUSMS Approval No. 8\/23). The study collected data on morphological variations of frenal attachment and various periodontal parameters such as Oral Hygiene Index\u2010Simplified (OHI\u2010S), pocket depth, recession, and midline diastema in both arches. Descriptive statistics, including frequency and percentage, were used to analyze the data. The\n                    <jats:italic>\u03c7<\/jats:italic>\n                    <jats:sup>2<\/jats:sup>\n                    \u2010test was employed to determine the correlation between gender and types of frenulum attachment, while analysis of variance was used to assess the association of frenal attachments with oral hygiene status.\n                    <jats:italic>Results<\/jats:italic>\n                    . Among 380 patients, the prevalence of frenal attachment was as follows: gingival 248 (65.30%), mucosal 71 (18.70%), papillary 42 (11.10%), and papillary penetrating 19 (5.00%) in the maxilla, and mucosal 225 (59.20%) and gingival 155 (40.78%) in mandible. Among the different morphological variations of frenal attachments, normal frenum was the most common, accounting for 231 cases (60.80%), followed by frenum with a nodule, with 101 cases (26.60%).\n                    <jats:italic>Conclusions<\/jats:italic>\n                    . The study found significant associations between frenal attachment and gender, as well as oral hygiene status. The prevalence of frenal attachments in this study was comparable to findings from previous research.\n                  <\/jats:p>","DOI":"10.1155\/2024\/4870253","type":"journal-article","created":{"date-parts":[[2024,1,11]],"date-time":"2024-01-11T14:20:06Z","timestamp":1704982806000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Prevalence of Maxillary and Mandibular Frenal Attachment and Its Association with Age, Gender, and Oral Hygiene Status in Nepalese Population Seeking Dental Treatment"],"prefix":"10.1155","volume":"2024","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2216-5220","authenticated-orcid":false,"given":"Arjun Hari","family":"Rijal","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6853-547X","authenticated-orcid":false,"given":"Manoj","family":"Humagain","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1997-9987","authenticated-orcid":false,"given":"Simant","family":"Lamichhane","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0230-5903","authenticated-orcid":false,"given":"Pratistha","family":"Ghimire","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-3590-0764","authenticated-orcid":false,"given":"Sachita","family":"Thapa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,1,11]]},"reference":[{"key":"e_1_2_11_1_2","volume-title":"Prosthodontic Treatment for Edentulous Patients: Complete Dentures and Implant-Supported Prostheses","author":"Zarb G. A.","year":"2003"},{"key":"e_1_2_11_2_2","doi-asserted-by":"publisher","DOI":"10.4103\/0972-124X.107467"},{"key":"e_1_2_11_3_2","doi-asserted-by":"publisher","DOI":"10.3290\/j.qi.a28925"},{"key":"e_1_2_11_4_2","doi-asserted-by":"publisher","DOI":"10.1902\/jop.1974.45.12.891"},{"key":"e_1_2_11_5_2","doi-asserted-by":"publisher","DOI":"10.3109\/00016357109026535"},{"key":"e_1_2_11_6_2","doi-asserted-by":"publisher","DOI":"10.33314\/jnhrc.v19i1.3475"},{"key":"e_1_2_11_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cegh.2020.03.026"},{"key":"e_1_2_11_8_2","doi-asserted-by":"publisher","DOI":"10.1002\/ca.23973"},{"key":"e_1_2_11_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.tripleo.2004.08.008"},{"key":"e_1_2_11_10_2","doi-asserted-by":"publisher","DOI":"10.1177\/2333794X17718896"},{"key":"e_1_2_11_11_2","first-page":"443","article-title":"The superior labial frenum: a histologic observation","volume":"22","author":"Gartner L. P.","year":"1991","journal-title":"Quintessence International"},{"key":"e_1_2_11_12_2","first-page":"233","article-title":"Histologic survey of the frena of the oral cavity","volume":"21","author":"Ross R. O.","year":"1990","journal-title":"Quintessence International"},{"key":"e_1_2_11_13_2","doi-asserted-by":"publisher","DOI":"10.1902\/jop.1974.45.12.895"},{"key":"e_1_2_11_14_2","first-page":"536","article-title":"Attachment of maxillary frenum and occurrence of midline diastema in children","volume":"8","author":"Deepa","year":"2016","journal-title":"Journal of Pharmaceutical Sciences and Research"},{"key":"e_1_2_11_15_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-263X.2011.01121.x"},{"key":"e_1_2_11_16_2","doi-asserted-by":"publisher","DOI":"10.30621\/jbachs.880475"},{"key":"e_1_2_11_17_2","doi-asserted-by":"publisher","DOI":"10.5005\/jp-journals-10024-2794"},{"key":"e_1_2_11_18_2","doi-asserted-by":"publisher","DOI":"10.3126\/jkmc.v11i2.48668"},{"key":"e_1_2_11_19_2","doi-asserted-by":"publisher","DOI":"10.4034\/PBOCI.2018.181.20"},{"key":"e_1_2_11_20_2","doi-asserted-by":"publisher","DOI":"10.4103\/jisp.jisp_294_17"},{"key":"e_1_2_11_21_2","doi-asserted-by":"publisher","DOI":"10.4103\/0972-124X.182598"},{"key":"e_1_2_11_22_2","first-page":"2079","article-title":"Prevalence of types of labial frenum attachment and frenectomy with conventional scalpel technique in a sample of Iraqi population","volume":"25","author":"Alwan A. H.","year":"2020","journal-title":"Prevalence"},{"key":"e_1_2_11_23_2","first-page":"769","article-title":"Maxillary labial frenum morphology in children in Chennai population: a cross-sectional study","volume":"14","author":"Kotian N.","year":"2020","journal-title":"Drug Invent Today"},{"key":"e_1_2_11_24_2","first-page":"336","article-title":"Variations in the attachment and morphology of maxillary labial frenum in diverse population of Gujarat: an observational study","volume":"11","author":"Patel J.","year":"2021","journal-title":"Journal of Research and Advancement in Dentistry"},{"key":"e_1_2_11_25_2","doi-asserted-by":"publisher","DOI":"10.3126\/jnspoi.v5i1.38181"},{"key":"e_1_2_11_26_2","first-page":"181","article-title":"Prevalence of labial frenum attachment and frenal morphology among patients reporting to Saveetha dental college","volume":"12","author":"Bowsiya S.","year":"2019","journal-title":"International Journal of Clinical Dentistry"},{"key":"e_1_2_11_27_2","first-page":"189","article-title":"Various morphological variations in attachment of maxillary labial frenum: an observational study","volume":"8","author":"Varghese T.","year":"2018","journal-title":"Journal of Research and Advancement in Dentistry"},{"key":"e_1_2_11_28_2","doi-asserted-by":"publisher","DOI":"10.1055\/s-0040-1708749"},{"key":"e_1_2_11_29_2","first-page":"94","article-title":"Prevalence and variations of the maxillary labial frenum in children, adolescents and adults","volume":"21","author":"Rajkarnikar J.","year":"2018","journal-title":"Nepal Medical College Journal"},{"key":"e_1_2_11_30_2","doi-asserted-by":"publisher","DOI":"10.4103\/JISPPD.JISPPD_51_18"},{"key":"e_1_2_11_31_2","doi-asserted-by":"publisher","DOI":"10.36106\/GJRA"},{"key":"e_1_2_11_32_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jormas.2017.06.018"},{"key":"e_1_2_11_33_2","doi-asserted-by":"publisher","DOI":"10.3126\/jnspoi.v5i1.38178"},{"key":"e_1_2_11_34_2","doi-asserted-by":"publisher","DOI":"10.4103\/jfmpc.jfmpc_611_19"},{"key":"e_1_2_11_35_2","doi-asserted-by":"publisher","DOI":"10.3126\/jnspoi.v4i2.34315"},{"key":"e_1_2_11_36_2","first-page":"32","article-title":"Non-surgical management of localized gingival enlargement in maxillary anterior region","volume":"2","author":"Rijal A. H.","year":"2021","journal-title":"Journal of Kantipur Dental College"},{"key":"e_1_2_11_37_2","volume-title":"Newman and Carranza\u2019s Clinical Periodontology E-Book","author":"Newman M. G.","year":"2018"},{"key":"e_1_2_11_38_2","volume-title":"Atlas of Cosmetic and Reconstructive Periodontal Surgery","author":"Cohen E. S.","year":"2007"},{"key":"e_1_2_11_39_2","doi-asserted-by":"publisher","DOI":"10.54530\/jcmc.1183"},{"key":"e_1_2_11_40_2","doi-asserted-by":"publisher","DOI":"10.21203\/rs.3.rs-3210331\/v1"}],"container-title":["International Journal of Dentistry"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1155\/2024\/4870253","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1155\/2024\/4870253","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1155\/2024\/4870253","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T20:45:31Z","timestamp":1785444331000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1155\/2024\/4870253"}},"subtitle":[],"editor":[{"given":"Sivakumar","family":"Nuvvula","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2024,1]]},"references-count":40,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2024,1]]}},"alternative-id":["10.1155\/2024\/4870253"],"URL":"https:\/\/doi.org\/10.1155\/2024\/4870253","archive":["Portico"],"relation":{},"ISSN":["1687-8728","1687-8736"],"issn-type":[{"value":"1687-8728","type":"print"},{"value":"1687-8736","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,1]]},"assertion":[{"value":"2023-10-15","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-12-26","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-01-11","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"4870253"}}