From Bound to free: Exploring Laser Technique for Management of Ankyloglossia

The tongue is an important oral structure which helps in speech, the positioning of teeth, nutrition, swallowing and nursing to name a few. The Lip, tongue and buccal musculature are connected to the alveolar bone by a triangular-shaped fold of tissue known as frenum. Ankyloglossia, commonly known as Tongue Tie, is a condition present since birth that results in restricted tongue movement due to the high lingual frenum attachment. Problems associated with ankyloglossia are difficulties in breastfeeding among neonates, malocclusion, gingival recession, improper oral hygiene, and speech difficulties in the pronunciation of consonants. Various treatment modalities have been suggested in literature like conventional frenectomy, z-plasty, electrocautery and lasers. A 15-year-old female, with no systemic illness reported to Dr A.P.J. Abdul Kalam Education Centre with the complaint of difficulty in speech since childhood. After a thorough examination, she was diagnosed with ankyloglossia which was classified as Kotlow’s Class II tongue tie. Preoperative orofacial and myofunctional therapy followed by lingual frenectomy was planned using a soft tissue diode laser of 940nm followed by postoperative orofacial and myofunctional therapy were carried out. The surgical procedure was uneventful. The patient showed satisfactory and uneventful healing at 2 days and 2 weeks post-operative recall visit. The use of laser showed better patient perception in terms of pain and function, and improved tongue mobility with faster healing. Key Words - Ankyloglossia, Diode Laser 940nm, Hazelbecker Score, Kotlows Classification, Myofunctional Therapy