Frenum Blanching Test — ORE Part 1 MCQ

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EasyOrthodonticsFrenum Blanching TestORE Part 1

A patient presents with a midline diastema between the maxillary central incisors. The maxillary labial frenum inserts into the incisive papilla, and the papilla blanches when the upper lip is retracted. The permanent canines have erupted. What does this finding indicate?

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Correct answer: A — A frenum that may be maintaining the diastema

The blanching test is positive when traction on the upper lip causes blanching of the interdental papilla. In this context it indicates tension from a high maxillary labial frenum, which may be contributing to or maintaining the maxillary midline diastema. Eruption of the permanent canines is relevant because spontaneous reduction of physiological midline spacing would usually be expected by this stage. Gingival inflammation would more typically be identified by redness, swelling and bleeding rather than traction-induced blanching. Pulp vitality cannot be inferred from a frenum test. A nasopalatine duct cyst requires compatible symptoms and radiographic findings, not simply a blanched papilla. The finding therefore supports assessment of a potentially diastema-associated frenum.

Reference: Faculty Dental Journal (Royal College of Surgeons of England), "Are upper labial frenectomies in children aged 11 and under appropriate?" 2014. https://publishing.rcseng.ac.uk/doi/10.1308/204268514X13859766312557