I have seen the code for the OneToManyLabels developer sample. If anybody could find me a screen shot of the property page form layout from the original VB6 project I may be able to convert it to an Add-In extension for ArcGIS 10.1 using VB.Net. I have never had VB6 and I have never seen the original code in use, so I currently I would have to attempt to reverse engineer the property page form based on the code without a screen shot. I have not attempted to create property pages using VB.Net add-ins before, so I don't know what challenges updating the code will cause, but in theory this code should be able to be converted to an add-in. Additionally, reviewing the comments on the tool it looks like some bugs were already appearing by ArcGIS 9.2 sp4. I am not sure if the bug in the ArcObjects class has been resolved by 10.1 or not.
However, for those with an advanced license, performance of the Pivot table approach is likely to perform much better, since the 1:1 join should be faster than the multiple queries run using the OneToManyLabels tool. For end users that only view data that is not being updated live, the Pivot table approach is better. If an editor can live with labels that are not refreshed until he does the above script as part of the editing process, the Pivot Table approach is probably also better. However, if an editor needs labels generated on the fly as they create features or related records, the OneToManyLabel approach is the only one that would maintain a live label association.
The Pivot Table approach also generates better labels in my opinion, because it always sorts the records of the related table with many records into a meaningful order. The OneToManyLabels script does not do this step, because a sort would significantly slow down the labeling process. As a result the many related records are labeled only in the order they are stored in the related table when that script is used, which can be entirely arbitrary and random. The only way to correct that behavior effectively with the OneToManyLabels script would be to replace the original related table with a permanently sorted version that is updated from time to time (which would involve a process identical to that part of my process for the Pivot Table).