Lingual Frenectomy Research Articles

Double-Advance Technique for the Closure of Inferior Cleft Lip

The Objective is present a case of a medial cleft of the lower lip with associated ankyloglossia and a proposal for a double-advance local flap technique for its closure who attended the Oral and Maxillofacial Surgery Service of the Madre Rafols Hospital, Venezuela. A 4-month-old female patient, presenting a medial cleft of the lower lip with an associated aberrant frenulum of the tongue causing ankyloglossia (Tessier 30). Lingual frenectomy and primary cheiloplasty were performed with a double-advance local flap technique to close the lower labial cleft. A wedge-shaped incision along the labial cleft, with lateral extensions towards the mentolabial sulcus extending bilaterally were performed in order to advance both flaps and place the wound at the limit of the esthetic subunit, as well as a Z-plasty in the vermilion of the lower lip. Postoperative follow-ups did not reveal local complications or tissue dehiscence. Due to the rarity of this entity, relevant surgical techniques for this type of anomaly have not been established or evaluated. The technique presented here proved its usefulness, achieving harmonious and favorable functional and aesthetic results in our patient.

Ankyloglossia and its management: A case series

Ankyloglossia or tongue-tie is the result of a short and thick lingual frenulum that causes limited tongue movement. Eventually, it may lead to a series of problems such as difficulties in breastfeeding during infancy, abnormal swallowing pattern, speech impairment, malocclusion, and gingival recession. In this case series, three adult patients with ankyloglossia were treated by performing lingual frenectomy using a scalpel under local anesthesia without any complications. This was followed by post-operative recall and speech therapy sessions. A marked improvement in tongue movement and speech was observed at follow-up visits in all the treated cases.

Abstracts from the World Federation for Laser Dentistry—Asia Pacific Division Virtual Conference July 16–17, 2021

Abstracts from the World Federation for Laser Dentistry—Asia Pacific Division Virtual Conference July 16–17, 2021

Comparative Study on the Treatment of Ankyloglossia by Using Er:YAG Laser or Traditional Scalpel.

The aim of this study was to compare, respectively, postoperative pain, wound healing, and patient satisfaction following lingual frenum extension treated with the Erbium Yttrium aluminum garnet. (Er:YAG) laser or the conventional scalpel. Twenty-eight patients receiving lingual frenectomy were randomly assigned to the Er:YAG laser group (n = 15) or the traditional scalpel group (n = 13). The surgical parameters were set to 3W or 4W basing on types of the lingual frenum when the Er:YAG laser was working. The same procedure was applied to the traditional scalpel group with transverse incision and longitudinal suture. The postoperative pain, wound healing and patient satisfaction were evaluated at 3 hours, 3, 7, and 30 days after operation. The visual analog scale score of postoperative pain in Er:YAG laser group was lower than that in traditional scalpel group at each time point. The wound healing score of the laser group were significantly lower than that of the traditional scalpel group at 3 and 7 days after surgery. There was no significant difference in mental, diet, and language satisfaction between the 2 groups at different time points after operation. In conclusion, Er:YAG laser was superior to the scalpel regarding minor soft-tissue surgery, and it could relieve the pain and discomfort of patients in the early stage of wound.

Efficacy of Surgical Laser Diode Therapy in the Management of Labial and Lingual Frenectomy

A frenum, a triangle-shaped fold of tissue connects the lip, tongue and buccal musculature to the alveolar bone in the oral cavity. Any abnormalities in the size and location of the frenum can cause functional and esthetic problems which require surgical excision. Frenectomy can be accomplished either by the routine scalpel technique, or by using lasers such diode laser. The 1st case is an 8-year-old healthy boy with the chief complaint of spacing between his upper front teeth and a palatoversion of the left central incisor. Intraoral clinical examination revealed the presence of midline diastema (1 mm) with high, fibrous labial frenal attachment. The 2nd case is a 6-year-old boy consulted with the complaint of difficulty in speech associated to the limitations of the lingual movements. Intraoral examination revealed partial ankyloglossia. The 2 cases, the frenectomy was then made with 980 nm diode laser.

The Efficacy of Lingual Laser Frenectomy in Pediatric OSAS: A Randomized Double-Blinded and Controlled Clinical Study.

This randomized, double-blind and controlled clinical trial investigates how a diode laser lingual frenectomy can improve obstructive sleep apnea syndrome (OSAS) in pediatric patients. Background: Several authors have shown that a short lingual frenulum causes a reduction in incoming air flow and the relationship between OSAS and a short lingual frenulum. Methods: Thirty-two pediatric patients were equally randomly divided into a Study Group (SG) and a Control Group (CG). On each SG patient a polysomnography 1 (PSG1) and a lingual frenectomy were performed using a diode laser via Doctor Smile Wiser technology, power 7 W. After three months, a new polysomnography (PSG2) was performed to evaluate the lingual frenectomy efficacy in pediatric patients. The pain was assessed by a numerical rating scale (NRS) before and after surgery. The CG followed the same protocol without a lingual frenectomy but myofunctional and speech therapy were conducted to qualitatively and quantitatively improve the lingual functionality. In the SG, eight subjects (50%) had severe OSAS and eight had moderate (50%) while in the CG, three subjects had severe OSAS (18.8%) and thirteen had moderate (81.2%). Results: In the SG, 93.8% were classified as mild OSAS and 6.2% as moderate. In contrast, in the CG, 18.75% were classified as mild OSAS, 62.5% as moderate and 18.75% as severe. Conclusion: The study demonstrates how a lingual laser frenectomy can improve OSAS in pediatric patients.

Tratamento cirúrgico de frenectomia lingual: Relato de caso

Anquiloglossia, também conhecida popularmente como ¨língua presa¨ é uma anomalia congênita, definida como uma prega mediana localizada no dorso da língua e próximo ao assoalho bucal, que se estende até face lingual da crista alveolar. É constituído por pregas da membrana mucosa, tecido conjuntivo rico em fibras colágenas e elásticas, tecido gorduroso e fibras musculares, além de vasos sanguíneos protegidos por tecido epitelial pavimentoso estratificado. Tem a função de auxiliar na movimentação tridimensional da língua, deglutição, dicção e sucção. Nos casos de alterações congênitas, observa-se limitações dos movimentos linguais, interferências periodontais, ortodônticas, protéticas, além da socialização. A indicação cirúrgica geralmente é diagnosticada por dentistas, fonoaudiólogos e pediatras, podendo ser tratada cirurgicamente em qualquer idade através de técnicas convencionais e outras técnicas descritas na literatura, com auxílio de lâminas frias, eletrocautérios ou laser cirúrgico. O objetivo desse trabalho é relatar o caso de frenectomia lingual de um paciente do gênero masculino de 15 anos de idade.

Three Cases with Lingual Frenectomy in Brothers

Three Cases with Lingual Frenectomy in Brothers

Lingual Frenectomy to Improve Stability of Mandibular Denture: Case Report

Lingual Frenectomy to Improve Stability of Mandibular Denture: Case Report

Lingual Frenectomy: Interdisciplinary Treatment with Speech Therapy and Paediatric Dentistry: A Literature Review.

Dentistry has been demonstrating concern with the quality of life of human beings, understanding that oral health is part of the whole in which one seeks to know specific needs and prevention. Ankyloglossia is a congenital oral anomaly which can cause difficulties in performing orofacial functions in which the mouth opening is affected and the tongue’s tip has a rectangular or heart shape. Speech therapy and paediatric dentistry are essential as they can avoid surgical procedure in the child. The objective of this literature review was to study the importance and interaction of paediatric dentistry with speech therapy in the treatment of patients with ankyloglossia. Therefore, it is believed that the current model of healthcare should be more integralised in order to provide a less interventive and more preventive treatment.

Management of ankyloglossia using electrosurgery: A case series

Ankyloglossia, or tongue tie, is a congenital oral anomaly with short, tight and thick lingual frenum which may restrict mobility of tongue and may subsequently lead to a range of problems such as difficulties in breast feeding during infancy, difficulty in mastication, speech impairment, poor oral hygiene, malocclusion, behaviour problems during childhood, adolescence and even adulthood. In this case series, four adult patients with ankyloglossia were treated by performing lingual frenectomy using electrosurgery followed by post-operative recall and speech therapy. A marked improvement in tongue movement and speech was observed at follow-up visits in all the treated cases. Electrosurgery proved to be a safe, reliable, effective and patient-friendly alternative treatment option for ankyloglossia.

Movimentos mandibulares durante a fala antes e depois da frenectomia lingual

O objetivo desse estudo foi analisar a velocidade e a amplitude dos movimentos mandibulares durante a fala, antes e depois da frenectomia lingual, em uma amostra composta por 10 sujeitos entre 15 e 21 anos, com diagnóstico de anquiloglossia. Inicialmente foi realizada a aferição da abertura máxima de boca com paquímetro, bem como, da velocidade de abertura e fechamento de boca e da amplitude dos movimentos mandibulares durante a fala, com eletrognatógrafo- BioEGN. Os sujeitos diagnosticados com anquiloglossia foram encaminhados para realização da frenectomia lingual. Após 30 dias do procedimento cirúrgico, novos registros foram obtidos. Para análise dos dados foram aplicados os testes Shapiro-Wilk e o teste t-Student. Quando comparados os movimentos mandibulares antes e depois da frenectomia lingual, a análise das variáveis mostrou que os sujeitos apresentaram diferença estatistica­mente significante dos movimentos mandibulares durante a fala, mostrando que a anquiloglossia interfere na realização desses movimentos. O presente estudo mostra que a velocidade e amplitude dos movimentos mandibulares durante a fala foram melhoradas após frenectomia lingual em pacientes com anquiloglossia.

Functional Improvements of Speech, Feeding, and Sleep After Lingual Frenectomy Tongue-Tie Release: A Prospective Cohort Study

Recent studies suggest that speech, solid feeding, and sleep difficulties may be linked to restricted tongue function. Children with tongue restrictions and speech, feeding, and sleep issues underwent lingual frenectomies with a CO2 laser, paired with myofunctional exercises. Questionnaires were completed before, 1 week after, and 1 month following treatment. Thirty-seven patients participated in the study (mean age 4.2 years [range 13 months to 12 years]). Overall, speech improved in 89%, solid feeding improved in 83%, and sleep improved in 83% of patients as reported by parents. Fifty percent (8/16) of speech-delayed children said new words after the procedure (P = .008), 76% (16/21) of slow eaters ate more rapidly (P < .001), and 72% (23/32) of restless sleepers slept less restlessly (P < .001). After tongue-tie releases paired with exercises, most children experience functional improvements in speech, feeding, and sleep. Providers should screen for oral restrictions in children and refer for treatment when functions are impaired.

Management of ankyloglossia by diode LASER - A case report

Ankyloglossia or tongue-tie is caused by an abnormally short, thick lingual frenum restricting the normal movements and functions of tongue. The lingual frenum may be fibrous or muscular and the tie may be complete or partial. This article describes the surgical management of an 18 year old female patient with ankyloglossia associated with reduced tongue mobility and speech difficulty. The treatment included frenectomy using a diode LASER accompanied by tongue training exercise and speech therapy. The patient showed increased tongue movements with uneventful healing after six months. Keywords: Ankyloglossia, Lingual frenectomy, Diode LASER.

Surgical treatment of ankyloglossia using an ophthalmic topical anesthetic and a tentacannula for tongue elevation: a case report

Introduction: Ankyloglossia is characterized by the presence of a short lingual frenum that can be inserted from the alveolar ridge to the lingual apex and, until promoting a true fusion of the tongue to the floor. A short lingual frenum can generate several problems such as phonetic disorders. Objective: To describe a surgical technique for the treatment of ankyloglossia using a topical ophthalmic anesthetic and a tentacannula for tongue elevation. Case report: A 15-year-old female was referred for lingual frenulum surgery due to speech impairment. Clinical examination revealed the presence of ankyloglossia which was both hindering the pronunciation of T, D, L phonemes and reducing tongue mobility. The surgical technique chosen was a lingual frenectomy. An ophthalmic topical anesthetic was initially applied to the lateral borders of the frenum with the patient in an upright position and in the presence of adequate aspiration. With the aid of a tentacannula the tongue was raised and the frenulum gradually released with a Goldman-Fox serrated scissor. The topical anesthetic was continuously trickled onto the surgical site during surgery. Results: No postoperative pain was reported by the patient, healing occurred normally and there was no recurrence of abnormal frenulum insertion. Conclusion: The advantages of this technique in comparison to conventional methods which use infiltrative anesthesia include less trauma and a more precise evaluation of tongue movements during surgery, because there will be better control of mobility for the patient when compared to infiltrative techniques.

Phonetic rehabilitation by speech therapy following lingual frenectomy

Phonetic rehabilitation by speech therapy following lingual frenectomy

Frenectomia para restituição fono-motricial da língua

Objetivo: Relatar o caso clínico de frenectomia lingual em uma criança com anquiloglossia, visando sua restituição fono-motricial. Descrição do caso: Paciente do sexo masculino, melanorderma, sete anos de idade, com queixa de bullying no ambiente escolar devido à dificuldade na dicção. Ao exame clínico, observou-se o freio lingual curto e fixado ao ápice da língua, resultando na limitação da protrusão e da projeção da língua em direção ao palato duro, além do comprometimento na dicção de alguns fonemas, confirmando o diagnóstico de anquiloglossia. Como conduta terapêutica, optou-se pela intervenção cirúrgica convencional (frenectomia). No pós-operatório imediato foi observado o freio centralizado no ventre lingual, bem como a eficiência na elevação e protrusão da língua. Uma vez que o paciente continuava com comprometimento fonético, o mesmo foi encaminhado para fonoterapia. Durante o acompanhamento pôde-se constatar melhora na fonação e ausência de queixas relacionadas aos aspectos comportamentais e convívio escolar. Considerações finais: A frenectomia de um freio lingual curto, tardiamente diagnosticado, apresenta-se como uma técnica cirúrgica de fácil execução e com potencial para restabelecer as funções motriciais da língua. Além disso, a instituição de uma abordagem multiprofisional, associando intervenção cirúrgica à fonoaudiológica, contribuiu para a restituição fonética e reinserção social do paciente.

Lingual Frenectomy as Treatment of Ankyloglossia in Children: A case report

Background: Ankyloglossia or tongue tie is a congenital condition that results when the inferior lingual fraenulum is too short and attached to the tip of the tongue, limiting its normal movements. It causes restricted tongue mobility which in turn causes feeding difficulties and speech problems. Purpose : The article was aimed to report the treatment of an eight years old boy who came with the chief complaint of difficulty in moving his tongue freely which causes speech difficulties. Case Management : The patient was treated for a lingual frenectomy procedure under local anaesthesia using one haemostat method. The haemostats were used to delimit the area to be excised as well as to guide the incisions. One haemostat used to clamp the upper aspect of the fraenulum may be helpful to guide the incision close to the ventral surface of the tongue. After the release of the tongue, care must be taken not to injury the submandibular ducts when making the second incision at the lower aspect of the fraenulum. After 1 to 2 weeks the incision was completely healed. Discussion: Ankyloglossia occurs due to failure in cellular degeneration leading to longer anchorage between tongue and floor of the mouth. Surgical intervention for treating ankyloglossia includes conventional technique with hemostats, electrocautery and laser. In this case, patient was undertaken surgical intervention using one hemostat method. Conclusion: The ankyloglossia case showed that the frenectomy gave good healing with no post operative complications in 8 years old boy.

Etiology and clinical recommendations to manage the complications following lingual frenectomy: A critical review

Ankyloglossia, also known 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, behavioral and speech abnormalities along with the development of frontal and lateral lisps. Ankyloglossia in infants is also linked with the difficulty in breastfeeding difficulty, gagging, choking or vomiting food, delayed development or deterioration of speech and behavioral issues. A lingual frenectomy is a common oral surgical procedure done to correct an ankylosed lingual frenum by severing the abnormal frenal attachment on the ventral surface of the tongue. However, lingual frenectomy is associated with few complications that should be addressed to achieve a good overall prognosis. Though a lot of research is available on the various techniques and rationale to correct ankyloglossia, no paper has yet highlighted the surgical complications associated with lingual frenectomy. Therefore, the present paper for the first time review and highlight the common intraoperative and postoperative complications following lingual frenectomy.

Effectiveness of frenectomy for ankyloglossia correction in terms of breastfeeding and maternal outcomes: A critically appraised topic

ABSTRACTA critically appraised topic (CAT) is one form of rapid review that can be particularly useful for informing practice (White, Raghavendra, & McAllister, 2017). The purpose of this CAT was to determine whether lingual frenectomy is effective in improving breastfeeding outcomes (compared with no surgical intervention) in infants with tongue tie under the age of 4 months. The effectiveness of lingual frenectomy (frenotomy) in improving breastfeeding outcomes was considered through the critical appraisal of three systematic reviews. In addition to the methodology, the authors present and discuss the findings of this CAT. The authors propose an update to this CAT in January 2021.