Lingual Frenectomy Research Articles

Skeletal Class I with Open-Bite Malocclusion Treated with Anterior Vertical Elastics (AVE)

Enhancing aesthetics, occlusion and functions is a primary motivation for individuals with open-bite malocclusion seeking orthodontic treatment. Open-bite malocclusion, characterized by a lack of vertical overlap of the anterior teeth, can be effectively treated using anterior vertical elastics. It’s a common, non-surgical orthodontic approach to correct open-bite issues. In this case report, we present the treatment of a male patient with anterior open-bite malocclusion. Initially, the patient underwent a lingual frenectomy followed by an active and passive phase of swallowing rehabilitation by wearing a nocturnal lingual envelope (NLE). Subsequently, a fixed orthodontic appliance was bonded to achieve well-aligned arches, normalize the overjet and overbite with the use of anterior vertical elastics (AVE) and enhance both aesthetics and functions.

Management of Ankyloglossia with different severity: a case series in dental surgery

Introduction: The lingual frenulum is an important oral structure that plays an important role in the act of suction, speech, and feeding. Ankyloglossia (tongue tie) is a congenital anomaly that results when lingual frenulum is too short and adhere to tip of tongue, limiting the tongue movement. This case report aimed to explain management of Ankyloglossia with different severity. Case Report: This case report reported three cases of ankyloglossia with different ages and complaints of difficulty in feeding and speech. The patients were treated for lingual frenectomy procedure under general anesthesia using one haemostats method. The haemostats were used to clamp the upper aspect of frenulum which might have been helpful to guide the incision close to ventral surface of tongue. Care had to be taken not to injure the submandibular ducts when making incision at lower part of tongue. The result after 1 week of surgery: the wound was completely healed. Conclusion: Ankyloglossia will impair the function of suction, speech and feeding that affecting a considerable number of infants and children. It is important that accurate information and guidance are given to parents with regard to the indications and potential benefit of tongue tie revision. These case series offer guidelines which can be used by general and pediatric dentist for examination, diagnosis and treatment of ankyloglossia in different severity.KeywordAnkyloglossia, congenital, lingual frenulum

Ankyloglossia-Related Speech Articulation Correction in Orthodontics: A Case Report

The ability of the tongue to protrude and elevate is the most crucial characteristic for activities like eating, speaking, nursing, and the development of dental arches. When the lingual frenum is short and tight, it can hinder the movement of the tongue, leading to malalignment of anterior teeth and Speech Articulation. This article discusses a case report of a 20-year-old male patient with a chief complaint of speech difficulty, maxillary anterior teeth spacing, and mandibular anterior teeth crowding. There was lingual frenum attachment suggestive of mild ankyloglossia. Patient underwent a lingual frenectomy pro- cedure under local anaesthesia which resulted in speech correction and relief of lower anterior crowding. Maxillary anterior spacing and midline diastema was corrected with orthodontic mechanotherapy and labial frenectomy, re- spectively. In cases where the frenulum anomaly is severe enough to result in both mechanical and functional limitations, surgery to reduce the frenulum (frenulectomy) is recommended. In consequence, it is fair to state that the chief complaint of inappropriate speech of the patient need to be resolved by an interdisciplinary approach.

Lingual frenectomy in a pediatric patient with oppositional defiant disorder: case report

Lingual frenectomy in a pediatric patient with oppositional defiant disorder: case report

Management of Ankyloglossia in a Non-Syndromic Patient Using a Super Pulsed Laser: A Life-Changing Treatment- A Case Report

Objective: Ankyloglossia affects a person’s overall well-being and life, from malnutrition due to poor feeding and mechanical problems to psychological stress and low self-esteem, thus affecting social life. This case reports the use of non-scalpel techniques, such as a super pulsed laser, to manage ankyloglossia in a non-syndromic patient suffering from speech incompetence and restricted tongue mobility and highlights its advantages over other conventional techniques. Case Report: A 17-year-old male patient presented with a complaint of restricted tongue mobility, due to which he could not pronounce certain words clearly. As the patient was apprehensive about the use of a scalpel, it was decided to manage ankyloglossia using a diode laser against the conventional scalpel technique. Thus, the laser-assisted lingual frenectomy using GaAs super pulsed laser was used to excise the lingual frenulum. Conclusion: This case report suggests that ankyloglossia can be successfully treated by using laser-assisted surgery and gives superior results specifically in terms of lesser pain and bleeding

Orofacial-Myofunctional therapy after lingual frenectomy in patient with tongue-tie: a systemic postural approach with mezieres method and postural bench.

In this study we present the new postoperative oro-myofunctional protocol following frenectomy by atmospheric plasma associated with a systemic postural approach, which determines functional recovery through body symmetry restoration based on the concepts of the French "Mezieres Method" and postural bench. A total of 130 patients (76 female, 54 male) affected by ankyloglossia of class III/IV, according to Kotlow's Tongue Tie Classification have been treated with atmospheric plasma followed by oro-myofunctional therapy associated with a systemic postural approach. The overall change, improved/worsened speech, feeding, or sleep has been evaluated through the 10 points Parents Speech Satisfaction (PSS) Score after one week and two months. Based on the findings of the current investigation, myofunctional therapy in tongue-tie results in a consistent significant functional ameliorating of feeding capability, speech and sleeping of subject treated as reported with traditional oro-myofunctional therapy.

The Effect of Lingual Frenectomy on Pain Relief during Breastfeeding

The Effect of Lingual Frenectomy on Pain Relief during Breastfeeding

A rare presentation of recurrent tongue tie

Ankyloglossia or tongue-tie is the result of a short, tight, lingual frenulum causing difficulty in speech articulation due to limitation in tongue movement. Ankyloglossia is a common finding in infants. Prevalence ranges between 4.2% and 10.7%. Although lingual frenectomy is a common technique it is a sensitive surgical procedure, the anatomic and topographic lingual frenulum makes the site vulnerable to various intraoperative and postoperative complications. In this case study, we have reported a 2-year-old male child with prior history of a frenectomy, presented with difficulty in speech and restricted tongue movements. On examination, a 1x1cm, solitary swelling was noted in the region of the lingual frenulum, firm, cystic, and non-tender. Tongue movements were restricted with an inability to perform protrusion beyond the vermillion border of the lips.Under general anesthesia, the child underwent revision frenectomy, excision of the swelling, and release of fibrous tissue adjacent to the swelling .Intraoperatively protrusion of the tongue was examined and found to have improved .The specimen was sent for histopathology which was reported as organizing mucocele. The Child was reviewed after 6 months, tongue movements were seen to have improved substantially in all ranges of motion.

LINGUAL PHRENECTOMY WITH THE USE OF IODINE LASER IN INFANT PATIENT

Objective: to approach the surgical process better known as frenectomy to solve Ankyloglossia, a condition that restricts the movement of the tongue. This change is characterized as congenital, consisting of fibrous connective tissue, which affects the tip of the tongue to the floor of the mouth. Case report: A 3-year-old female patient attended the Children’s Dental Clinic at the University Center of the State of Pará, presenting the Linguinha Test report proving the ankyloglossia. In the preoperative period, Ibuprofen 50mg / ml was prescribed, 18 drops 1 hour before the surgical procedure and 6/6 hours after surgery for 2 days. However, surgery was performed for the better development of the patient using high intensity iodine laser therapy ((2300mW-0: 00-continuous Surgery-DMC), successfully finishing the procedure. After 24h and 48h, the laser was applied low intensity (66 NM, 100 mW, 2J-DMC) to enhance the benefit of iodine laser. Conclusion: The present case indicates the use of the laser as a safe and effective technique for performing lingual frenectomy in a child patient.

Management of a case of ankyloglossia using diode laser in a patient of underlying systemic condition/syndrome

Background Tongue-tie or ankyloglossia is a rare congenital anomaly. It is a short, thick, and fibrosed lingual frenulum which causes restriction in function of the tongue and also in speech. For its management laser has some advantages over other techniques like less operative time, haemostasis, less postoperative complications. Result Uneventful healing was observed in 7 days as laser is less invasive, resulting in better healing. Conclusion Tongue being highly vascular and mobile structure, laser-assisted lingual frenectomy is the simplest, safest and less traumatic of all the treatment modalities available. Keywords: Ankyloglossia, Diode laser, Tongue-tie

Atmospheric Plasma Lingual Frenectomy Followed by Post Operative Tongue Exercises: A Case Series.

The lingual frenulum is a submucosal component significantly involved in the mobility of the tongue. In the case of short lingual frenulum, different surgical approaches have been proposed. Atmospheric plasma is a thermal technique of vaporization or sublimation of the superficial tissues, without going deep, and the resulting fine carbonized layer avoids bleeding. The aim of the present investigation was to evaluate the effectiveness of atmospheric plasma (voltaic arc dermabrasion) for the frenectomy of a short lingual frenulum. A total of 30 patients with an age range between 6-11 years old and a class III/IV Kotlow's ankyloglossia classification were included in the study. The Kotlow's free-tongue, maximal interincisal mouth opening (MIO, mm) and interincisal mouth opening with tongue tip to maxillary incisive papillae at roof of mouth (MOTTIP, mm) were calculated at the baseline, immediately postoperatively (T0), at one week (T1), one month (T2) and two months (T3). A significant increase of Kotlow's measurements, MOTTIP and MIO were detected when comparing the baseline and the T0 (p < 0.05). No significant difference was detected between the T0, T1 and T2 (p > 0.05). The atmospheric plasma demonstrated a very minimal invasive approach for frenectomy, without important or fibrotic complications and with very low recurrence rates.

On the reasons for ankyloglossia relapse. Part 2. Laser technique pitfalls

The paper presents typical complications after laser lingual frenectomy. Laser and scalpel frenectomy are comparable in terms of functional results. Laser technique has some advantages (less pain and discomfort during the procedure and in the early postoperative period, less need for local anesthesia, lower average surgery time) but the exact knowledge of laser technical features is mandatory for optimal surgery results. Laser technique methodology is described allowing to avoid the complications.

Sleep Disordered Breathing in Children

Sleep disordered breathing (SDB) is a disease characterized by repeated hypopnea and apnea during sleep due to complete or partial obstruction of upper airway. The prevalence of pediatric SDB is approximately 12 - 15%, and the most common age group is preschool children aged 3 - 5 years. Children show more varied presentations, from snoring and frequent arousals to enuresis and hyperactivity. The main cause of pediatric SDB is obstruction of the upper airway related to enlarged tonsils and adenoids. If SDB is left untreated, it can cause complications such as learning difficulties, cognitive impairment, behavioral problems, cardiovascular disease, metabolic syndrome, and poor growth. Pediatric dentists are in a special position to identify children at risk for SDB. Pediatric dentists recognize clinical features related to SDB, and they should screen for SDB by using the pediatric sleep questionnaire (PSQ), lateral cephalometry radiograph, and portable sleep monitoring test and refer to sleep specialists. As a therapeutic approach, maxillary arch expansion treatment, mandible advancement device, and lingual frenectomy can be performed. Pediatric dentists should recognize that prolonged mouth breathing, lower tongue posture, and ankyloglossia can cause abnormal facial skeletal growth patterns and sleep problems. Pediatric dentists should be able to prevent these problems through early intervention.

Beckwith-Wiedemann syndrome with long QT caused by a deletion involving KCNQ1 but not KCNQ1OT1:TSS-DMR

Beckwith-Wiedemann syndrome (BWS) is an imprinting disorder with characteristic features, such as overgrowth, macroglossia, and exomphalos. Hypomethylation of the KCNQ1OT1:TSS-differentially methylated region (DMR) on the 11p15.5 imprinted region is the most common etiology of BWS. KCNQ1 on 11p15.5 is expressed from the maternally inherited allele in most tissues, but is biparentally expressed in the heart, and maternal KCNQ1 transcription is required to establish the maternal DNA imprint in the KCNQ1OT1:TSS-DMR. Loss of function variants in KCNQ1 result in long QT syndrome type 1 (LQT1). To date, eight patients with BWS due to KCNQ1 splice variants or structural abnormalities involving KCNQ1 but not the KCNQ1OT1:TSS-DMR have been reported (KCNQ1-BWS), and four of them had LQT1. We report a Japanese boy with BWS and LQT1 presenting with extreme hypomethylation of the KCNQ1OT1:TSS-DMR caused by a de novo 215-kb deletion including KCNQ1 but not the KCNQ1OT1:TSS-DMR on the maternal allele. He was born by emergency cesarean section due to suspicion of placental abruption at 30 weeks of gestation. His birth weight and length were +1.6 SD and +1.0 SD, respectively. His placental weight was +3.9 SD, and histological examination of his placenta was consistent with mesenchymal dysplasia. He had BWS clinical features, including macroglossia, ear creases and pits, body asymmetry, and rectus abdominis muscle dehiscence, and BWS was therefore diagnosed. LQT1 was first noticed at three months in a preoperative examination for lingual frenectomy. The summarized data of our patient and the previously reported eight patients in KCNQ1-BWS showed more frequent and earlier preterm births and smaller sized birth weight in KCNQ1-BWS cases than those with BWS caused by epimutation of the KCNQ1OT1:TSS-DMR. In addition, in five of nine patients with KCNQ1-BWS, LQT1 was detected, and two of them were identified at school age. In our patient and in another single case with LQT1, the LQT1 was not detected early despite neonatal ECG monitoring. For BWS patients with extreme hypomethylation of the KCNQ1OT1:TSS-DMR, searching for CNVs involving KCNQ1 and mutation screening for KCNQ1 should be considered together with periodic ECG monitoring. (338/500 words)

Effectiveness of tongue-tie assessment tools in diagnosing and fulfilling lingual frenectomy criteria: a systematic review.

It is unclear how effective tongue-tie classification assessment tools are in diagnosing symptomatic tongue-tie and fulfilling lingual frenectomy criteria. The purpose of this systematic review is to determine and evaluate any association between tongue-tie severity, as measured by pre-treatment assessment tools, and post-operative outcome following tongue-tie division. PubMed, EMBASE, and the Cochrane search engines were used to retrieve articles published between 1947 and 2021. Included studies consisted of patients with symptomatic tongue-tie, assessment by either the Coryllos, Kotlow, or Hazelbaker Assessment Tool for Lingual Frenulum Function (HATLFF) classification tool, and tongue-tie division. A total of 205 abstracts were identified; 31 studies met the criteria for a full-text review, of which, only 14 studies met the criteria for data extraction and analysis. Six studies used the HATLFF, 2 studies used the Kotlow, 5 studies used the Coryllos, and 1 study used a combination of both Kotlow and Coryllos methods. Significant heterogeneity was evident across all studies. No statistical correlation between the two variables could be determined. Although tongue-tie division procedures appear to provide benefits in breastfeeding and speech, there are no data to suggest a statistically significant association between the severity of tongue-tie, and the correct identification of patients who would benefit from tongue-tie division. © 2022 Australian Dental Association.

FRENECTOMY - DIFFERENT TECHNIQUES

Introduction:-The frenum is a mucous membrane fold that attaches the lip , cheek and the tongue to the alveolar mucosa, the gingiva, and the underlying periosteum .Aesthetic problems are caused by high maxillary frenum which may compromise the orthodontic treatment results in the midline diastema cases, thus causing a recurrence after the treatment. Ankyloglossia, is also called as tongue-tie, is an embryological anatomical malformation of the tongue, characterized by an abnormally short and a thick lingual frenum. Tongue-tie restricts the physiologic movements of the tongue and results in various functional, behavioural and speech abnormalities. Material method :- The present article consists of a series of clinical cases of an aberrant frenum which were approached by various surgical frenectomy techniques. Result:- Different techniques have their own advantages and disadvantages. Laser gives advantages of less post operative pain and discomfort. Lingual frenectomy help in improvement in tongue movement and speech. Conclusion:- An aberrant frenum can be removed by any of the modification techniques that have been proposed,and a functional and an aesthetic outcome can be achieved by a proper selection of technique which is based on the type of the frenal attachment.

Comparison of the Effects of High-Power Diode Laser and Electrocautery for Lingual Frenectomy in Infants: A Blinded Randomized Controlled Clinical Trial.

The aim of the study was to evaluate the release of the lingual frenulum through frenectomy in newborns zero to 90 days of age who breastfed and had diagnosis of ankyloglossia with an indication for surgery, comparing two methods: electrocautery and a high-power diode laser. Fifty-seven patients were randomly allocated to two groups (23 submitted to electrocautery and 34 submitted to a high power diode laser). Tongue movements were evaluated based on a clinical assessment and using the Bristol Tongue Assessment Tool (BTAT) before and 15 days after the surgical procedures. The visual analog scale was administered to the mothers on the same occasions for the measurement of pain during breastfeeding. Both groups had an increased BTAT score (favorable outcome) at the post-surgical evaluation, but the anterior third of the tongue was not always free to enable the movements necessary for lingual functions. It is fundamental for surgeons to have skill and in-depth knowledge of the equipment used to avoid accidents and complications in the region of important structures. Both techniques employed in this study were safe and effective, causing little bleeding and few postoperative complications. The group submitted to a high-power diode laser exhibited less post-surgical bleeding compared to the group submitted to electrocautery and no inflammation at the edges of the surgical cut.

Lingual Frenectomy and Surgical Techniques: A Short-Review

Lingual frenectomy techniques are surgical correction procedures for frenulum defects that seek to restore the functionality of the affected area by removing the anatomical fold using manual surgical instruments or laser [1]. Objective: To describe the different lingual frenectomy techniques reported in the literature, recurrences or complications of the surgical techniques, and to find out at what age surgical treatment is preferable. Materials and methods: Systematic review of the literature that managed to identify studies in order to gather information on lingual frenectomy techniques, the data corresponded to the results of published academic articles. Results: Describe each of the techniques reported in the literature (conventional and laser) and whether they had limitations. Conclusion: Greater predictability in the treatment, reduced risks in the surgical act, reduced work time and faster patient recovery

Diode 980 nm Laser Ablation of Ankyloglossia: A Case Report

Background: Ankyloglossia “tie tongue” is a congenital anomaly, characterized by abnormal short thick lingual frenum that causes limitation of tongue movement, which results in problems in speech, mastication and patient discomfort. Laser is an alternative for conventional surgery to treat ankyloglossia. Case Report: A 50 years old female patient presented with ankyloglossia to laser clinic in faculty of Dentistry in Misr University for Science and Technology. Lingual frenectomy was done with Diode Laser with 980 nm wavelength, fiber tip diameter 300 μm, power 1.5 Watt, continuous wave mode and contact mode. The time of procedure was only 15 minutes, with bloodless field during work. Patient dismissed without sutures or wound dressing. Results: There was no post-operative pain, discomfort or swelling. Complete healing occurred after 2 weeks. The patient was very satisfied with the quick painless procedure. Conclusion: Diode Laser 980nm treatment of Ankyloglossia is a simple, quick, painless and safe, and effective procedure. We recommend this treatment modality because of its advantages for both the patient and the operator.

Efficacy of Various Laser Wavelengths in the Surgical Treatment of Ankyloglossia: A Systematic Review.

Ankyloglossia, commonly known as tongue-tie, is the most common disorder of tongue morphology characterized by aberrant attachment of the lingual frenum. This study aimed to provide a comprehensive literature review and evaluate the effectiveness of various laser wavelengths in the surgical treatment of patients with ankyloglossia. An electronic screening of PubMed and the Cochrane Central Register of Controlled Trials (CENTRAL) databases was conducted on 8 November 2021. The following search terms were used to review the available data on the subject of interest: (ankyloglossia OR tongue tie OR short lingual frenulum OR lingual frenectomy OR lingual frenulectomy OR lingual frenotomy OR lingual frenulotomy) AND laser. The use of lasers in ankyloglossia treatment resulted in shorter procedure time, reduced indications for general anesthesia, reduced administration of postoperative analgesics, fewer sutures or none needed, reduced postoperative bleeding, and improved healing. Despite many advantages, this method has its clinical limitations: it requires the use of expensive equipment; well-trained personnel familiar with lasers; and personal protective equipment for the patient, caregiver, operator, and assistant. The laser procedure does not eliminate the need for myofunctional exercises and work with a speech therapist.