الفهرس 
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Abstract
Aim: The present study aimed to evaluate the prevalence of maxillary labial frenal attachment types
and midline diastema in a group of Egyptian children with fully erupted maxillary permanent canines.
Subjects and Methods: A total of 264 patients aged from 12 to 18 years were examined by the
principal investigator to evaluate the type of frenal attachment using the direct visual method, the
blanching test, and the pull test. Midline diastema, simplified oral hygiene index, gingival index, and
attachment loss were evaluated for all participants.
Results: The mucosal frenal attachment type was the most prevalent frenal type (74.6%) followed by
the gingival type (23.1%). Regarding the midline diastema, 15.7% of the participants presented with
a midline diastema while assessment of oral hygiene and gingival condition revealed that 80.6% had
satisfactory oral hygiene, 48.5% had mild gingivitis, and only 2.2% of patients had a clinical
attachment loss. Patients with mucosal and gingival frenal types showed no midline diastema in 90%
and 71% of patients, respectively with a statistically significant difference.
Conclusions: Mucosal and gingival frenal attachment types were the most common type of maxillary
labial frenum attachment types among the study sample with a low incidence of midline diastema and
attachment loss.
Keywords: Attachment, children, Fully erupted canines, Maxillary labial frenum, Midline diastema.