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Ankyloglossia and Its Management PDF
Ankyloglossia and Its Management PDF
2]
Case Report
Department of Abstract:
Periodontics, Nair Ankyloglossia or tongue-tie is the result of a short, tight, lingual frenulum causing difficulty in speech articulation
Hospital Dental College, due to limitation in tongue movement. In this article, we have reported a 24-year-old male with tongue-tie who
Mumbai, Maharashtra, complained of difficulty in speech following which he underwent frenectomy procedure under local anesthesia
India without any complications. Finally, he was given speech therapy sessions.
Key words:
Ankyloglossia, frenectomy, Kotlow
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Figure 1: Pre-operative view showing ankyloglossia Figure 2: Pre-operative view showing extension of tongue
Figure 7: Post-operative view 6 months Figure 8: Post-operative view 6 months showing adequate extension of tongue
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be speculated that some milder forms of ankyloglossia may also during infancy, if the individuals have a history of speech,
resolve with growth, explaining this age-related difference. feeding, or mechanical/social difficulties surgical intervention
There is some evidence that ankyloglossia can be a genetically should be carried out. Therefore, surgery should be considered
transmissible pathology. It is unknown which genetic at any age depending on the patient’s history of speech, feeding,
components regulate the phenotype and penetrance in the or mechanical/social difficulties. Surgical techniques for the
patients affected. More basic research is needed to clarify the therapy of tongue-ties can be classified into three procedures.
exact etiopathogenesis of ankyloglossia. Ankyloglossia was Frenotomy is a simple cutting of the frenulum. Frenectomy
also found associated in cases with some rare syndromes such is defined as complete excision, i.e., removal of the whole
as X-linked cleft palate syndrome,[6] Kindler syndrome,[7] van frenulum. Frenuloplasty involves various methods to release
der Woude syndrome,[8] and Opitz syndrome.[9] Nevertheless, the tongue-tie and correct the anatomic situation. There is
most ankyloglossias are observed in persons without any no sufficient evidence in the literature concerning surgical
other congenital anomalies or diseases. Speech problems can treatment options for ankyloglossia to favor any one of the
occur when there is limited mobility of the tongue due to three main techniques.
ankyloglossia. The difficulties in articulation are evident for
consonants and sounds like “s, z, t, d, l, j, zh, ch, th, dg”[10] CONCLUSION
and it is especially difficult to roll an “r”. Localization of the
frenum insertion on the gingiva seemed to be of importance To conclude, it is important to agree upon one examination
for gingival sequelae because insertion of the lingual frenulum method, definition and classification of tongue-ties to enable
in the area of the papilla had the highest association with comparisons between future observational and intervention
gingival recession. The term free-tongue is defined as the studies. If severe/complete ankyloglossia is present in an
length of tongue from the insertion of the lingual frenum adult, there is usually an obvious limitation of the tongue
into the base of the tongue to the tip of the tongue. Clinically protrusion, elevation and speech problems which can be
acceptable, normal range of free tongue is greater than 16 mm. improved following surgical intervention.
The ankyloglossia can be classified into 4 classes based on
Kotlow’s assessment as follows; Class I: Mild ankyloglossia: REFERENCES
12 to 16 mm, Class II: Moderate ankyloglossia: 8 to 11 mm,
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clear correlation between malocclusion and ankyloglossia. If
there is no feeding difficulty in the infant, it would be best to How to cite this article: Chaubal TV, Dixit MB. Ankyloglossia and
have a wait-and-see approach since the frenulum naturally its management. J Indian Soc Periodontol 2011;15:270-2.
recedes during the process of an individual’s growth between
Source of Support: Nil, Conflict of Interest: None declared.
six months and six years of age. After completion of growth and
272 Journal of Indian Society of Periodontology - Vol 15, Issue 3, Jul-Sep 2011