A study of the association of fraenal attachment, lip coverage, and vestibular depth with plaque and gingivitis

The effects of fraenal attachment, upper lip coverage, and mandibular vestibular depth on plaque and bleeding indices in the maxillary and mandibular anterior segments were studied in a group of 1015 school children aged 11.5 to 12.5 years. The position of the mandibular labial fraenum was relatively unimportant to plaque and mandibular gingivitis, but anterior fraenal attachment in the maxilla appeared to affect the retention of plaque and the degree of gingivitis. Maxillary and mandibular plaque and bleeding scores increased with decreasing upper lip coverage at rest. In the mandibular anterior segment, plaque and bleeding indices decreased with increasing vestibular depth. Further analysis demonstrated that fraenal attachment and vestibular depth and fraenal attachment and lip coverage were significantly associated. However, two-way analysis of variance indicated that the influence of fraenal attachment, vestibular depth, and lip coverage on plaque and gingivitis was independent. The influences of these soft tissue variables on plaque accumulation and gingivitis were of small clinical significance and not in themselves a justification for mucogingival surgery.