Frenectomia lingual com laser de diodo de alta potência: relato de caso / Lingual frenectomy with high-power diode laser: a case report / Frenectomía lingual con láser de diodo de alta potencia: informe de un caso

Introdução: A laserterapia de alta potência tem estabelecido proporções satisfatórias na odontologia e se tornando a primeira opção de conduta cirúrgica para procedimentos, trazendo qualidade de vida aos pacientes e praticidade aos Cirurgiões. Objetivo: Relatar caso clínico de frenectomia lingual com uso do laser de diodo de alta potência ressaltando os benefícios da conduta. Relato de caso: Paciente sexo feminino, leucoderma, sem alterações sistêmicas, chega à Clínica Escola de Odontologia da Universidade Federal de Campina Grande, com queixa principal de alterações na sua fonologia. No exame intraoral observou-se dificuldade de movimentação lingual e em formato de coração devido a inserção fibrosa do freio, sendo observado a Anquiloglossia. Após explicações da alteração, do tratamento, e assinatura do Termo de Consentimento, foi iniciado a cirurgia: antissepsia, anestesia com vasoconstrictor, e em modo contínuo utilizou-se o laser de diodo de alta potência (TW Surgical- MMO®) configurado em 2W de potência, fibra 600µm, no comprimento de onda infravermelho, de modo que as fibras fossem separadas uniformemente e promovesse mobilidade imediata da língua, por fim realizou-se uma sutura em ponto simples com fio reabsorvível. Para o pós-operatório foi prescrito Dipirona em caso de dor, e estabelecido o acompanhamento. No retorno de 7 dias observou-se cicatrização normal e não ingestão do medicamento, em 30 dias foi visto a completa cicatrização e mobilidade sem desconforto, além de relato da paciente de melhoria na condição de relacionamentos sociais, autoestima e deglutição. Conclusão: O resultado apresentado neste artigo ratifica a benefício da escolha do laser em comparação ao convencional, demonstrando que não há sangramento no trans e pós cirúrgico, além de favorecer o processo de reparação tecidual, da redução do tempo cirúrgico, aumento do conforto, e diminuição de uso de medicamento, desta forma associando o laser cirúrgico a melhoria da qualidade de vida.

Introduction: High-power laser therapy has established satisfactory proportions in dentistry and has become the first choice for surgical procedures, bringing quality of life to patients and convenience to surgeons. Objective: To report a clinical case of lingual frenectomy using high-power diode laser, highlighting the benefits of this approach. Case report: A female patient, leucoderma, without systemic alterations, arrived at the Dental School Clinic of the Federal University of Campina Grande with the main complaint of alterations in her phonology. In the intraoral examination, difficulty in lingual movement and a heart-shaped tongue due to fibrous insertion of the frenum were observed, indicating Ankyloglossia. After explanations of the condition, treatment, and signing of the Informed Consent Form, the surgery was initiated: antisepsis, anesthesia with vasoconstrictor, and continuous mode using a high-power diode laser configured at 2W of power, 600µm fiber, at an infrared wavelength, with the aim of uniformly separating the fibers and promoting immediate tongue mobility. Finally, a simple suture was performed using absorbable thread. For the postoperative period, Dipyrone was prescribed for pain relief, and follow-up was established. At the 7-day follow-up, normal healing was observed, and the patient did not require the medication. At 30 days, complete healing and discomfort-free mobility were observed, along with the patient's testimony of improvement in social relationships, self-esteem, and swallowing. Conclusion: The results presented in this article confirm the benefits of choosing laser therapy over conventional methods, demonstrating the absence of bleeding during and after surgery, promoting tissue repair, reducing surgical time, increasing comfort, and decreasing the use of medication. Therefore, the use of surgical laser is associated with an improvement in quality of life.

Introducción: La terapia láser de alta potencia se ha establecido en proporciones satisfactorias en odontología y se ha convertido en la primera elección para procedimientos quirúrgicos, aportando calidad de vida a los pacientes y practicidad a los cirujanos. Objetivo: Relatar un caso clínico de frenectomía lingual con láser de diodo de alta potencia, destacando los beneficios de este procedimiento. Relato del caso: Paciente del sexo femenino, leucoderma, sin alteraciones sistémicas, llegó a la Clínica de la Facultad de Odontología de la Universidad Federal de Campina Grande con la queja principal de alteraciones en su fonología. El examen intraoral reveló dificultad en el movimiento lingual y lengua en forma de corazón debido a la inserción fibrosa del freno, observándose anquiloglosia. Tras explicar la alteración, el tratamiento y firmar el consentimiento, se inició la cirugía: antisepsia, anestesia con vasoconstrictor y uso continuado de un láser de diodo de alta potencia (TW Surgical- MMO®) configurado a 2W de potencia, fibra de 600µm, a longitud de onda infrarroja, para que las fibras se separaran uniformemente y favorecieran la movilidad inmediata de la lengua, y finalmente una sutura de punto único con hilo reabsorbible. En el postoperatorio, se prescribió dipirona en caso de dolor y se estableció un seguimiento. En el seguimiento a los 7 días, se observó una cicatrización normal y no se tomó medicación. A los 30 días, se observó una cicatrización completa y movilidad sin molestias, así como el informe del paciente de una mejora de las relaciones sociales, la autoestima y la deglución. Conclusión: Los resultados presentados en este artículo confirman el beneficio de la elección del láser frente a la cirugía convencional, demostrando que no hay sangrado durante ni después de la cirugía, además de favorecer el proceso de reparación tisular, reducir el tiempo quirúrgico, aumentar el confort y reducir el uso de medicación, asociando así el láser quirúrgico a una mejor calidad de vida.

Apport de la technique combinée gingivectomie-frénectomie dans la prise en charge d'un accroissement gingival associé à un frein pathologique: à propos d'un cas / contribution of the combined gingivectomy-frenectomy technique in the management of gingival growth associated with a pathological frenulum: about a case

Introduction : La prise en charge de l'accroissement gingival repose sur un entretien médical bien mené, un examen clinique rigoureux, un diagnostic bien posé et une exérèse chirurgicale. Cependant, une récidive de la lésion peut être observée avec un rendu gingival souvent inesthétique. L'objectif de ce travail était d'illustrer, à travers un cas clinique, l'apport de la gingivectomie et de la frénectomie dans la prise en charge d'un accroissement gingival associé à un frein pathologique. Observation : Il s'agissait d'un patient âgé de 27 ans, venu consulter pour un problème esthétique lié à une excroissance gingivale. L'examen exo-buccal a mis en évidence, une asymétrie faciale dans le sens horizontal. La lésion gingivale était visible au sourire et évoluant depuis plus de 5 ans. L'examen endo-buccal a relevé la présence d'une gingivite induite par le biofilm, d'un frein de type 4 de Placek associés à un accroissement gingival pédonculé saignant au contact et siégeant entre la 11 et la 21. Après la thérapeutique initiale et une réévaluation, une gingivectomie à biseau interne (GBI) associée à une frénectomie ont été réalisées. L'examen anatomo-pathologique a mis en évidence un épulis fibreux ou fibrome périphérique avec absence de signes histologiques de malignité. L'évolution après 6 mois est marquée par une muqueuse gingivale cliniquement saine avec absence de récidive. Conclusion : L'apport de la gingivectomie et de la frénectomie est un atout important en termes de résultat clinique et de limitation de récidives dans l'exérèse des excès gingivaux combinés à un frein labial pathologique.

Introduction: Gingival growth is a change in the size and/or multiplication of cells, the gingival vascular system and the extracellular matrix. Management is based on a wellconducted medical interview, a rigorous clinical examination, a well-made diagnosis and surgical excision. However, a recurrence of the lesion can be observed with an often unsightly gingival rendering. The objective of this work was to illustrate, through a clinical case, the contribution of gingivectomy and frenectomy in the management of gingival growth associated with a pathological frenulum. Observation: It was a patient aged 27 who came to consult for an aesthetic problem related to a gingival growth. The exo-oral examination highlighted, a facial asymmetry in the horizontal direction. The gum lesion was visible on the smile and had been evolving for more than 5 years. The endooral examination noted the presence of biofilm-induced gingivitis, a type 4 Placek frenulum associated with pedunculate gingival growth bleeding on contact and sitting between 11 and 21. After initial therapy and reassessment, an internal bevel gingivectomy (IGG) combined with frenectomy was performed. The anatomo-pathological examination revealed fibrous epulis or peripheral fibroid with absence of histological signs of malignancy. The evolution after 6 months is marked by a clinically healthy gingival mucosa with no recurrence. Conclusion: The contribution of gingivectomy and frenectomy is an important asset in terms of clinical outcome and limitation of recurrence in the excision of excess gingival combined with a pathological labial frenulum.

Longitudinal evaluation of diastema closure in patients submitted to labial frenectomy in different phases of the mixed dentition A historical cohort

Background: There is a controversy in the literature concerning the indications for frenectomy to treat interincisal diastema. Aims and Objectives: The aim of this study was to evaluate the spontaneous closure of the interincisal diastema in patients submitted to upper labial frenectomy (ULF) during the mixed dentition. Materials and Methods: Records from patients treated between 2009 and 2014 in the course of Pediatric Dentistry Surgery at Fundecto–USP were evaluated to select those that were submitted to ULF during the mixed dentition using the Chelotti technique. Initial clinic characteristics and radiographic data related to the abnormal upper labial frenum were collected. The patients were called for a return visit to evaluate the diastema closure. The prevalence of children with diastema reduction after the frenectomy was determined by descriptive analysis. Logistic regression was used to evaluate the association between exposure factors and diastema reduction. Results: From 449 eligible records, 53 were selected and 25 were in a return visit. It was not possible to find association between the exposure factors and diastema closure. Conclusion: There is no relation between the time of surgery intervention and diastema closure. However, the intervention during the mixed dentition led to a partial diastema reduction in 80% of the cases.

Manejo interdisciplinario para una óptima rehabilitación oral / Interdisciplinary management for optimal oral rehabilitation

Las estrategias para el éxito en la rehabilitación bucal requieren de la interrelación de varias disciplinas que en conjunto logren resultados predecibles y duraderos. La visión individualizada de cada área de especialidad puede conllevar a no ofrecer la mejor alternativa de tratamiento, es por ello que la valoración, el diagnóstico y la planificación del caso clínico debe ser realizada por un equipo interdisciplinario para evitar esta situación y crear una sinergia en donde el «todo sea mayor que la suma de sus partes¼. El objetivo de este trabajo es presentar un caso clínico en el cual intervinieron varias áreas de especialidad: periodoncia, prostodoncia, cirugía oral y patología bucal, logrando devolver la función y la estética a través del manejo interdisciplinario (AU)

The strategies for success in oral rehabilitation require the interrelation of several disciplines, which together, achieve predictable and lasting results. The individualized view of each specialty area may lead to not offering the best treatment alternative, which is why the assessment, diagnosis, and planning of the clinical case must be carried out by an interdisciplinary team to avoid this situation and create a synergy in where the «whole is greater than the sum of its parts¼. The objective of this work is to present a clinical case where several areas of specialty intervened: periodontics, prosthodontics, oral surgery, and oral pathology, thus achieving the return of function and aesthetics through interdisciplinary management (AU)

Management of a patient with angle class I Malocclusion with Anterior Crossbite and Maxillary Central Diastema caused by high attachment of the Maxillary Labial Frenulum

@#Maxillary Central diastema is common and normal for the growth and development of the anterior segment. If the central diastema persists after the eruption of the permanent cuspids, the orthodontist should clarify the etiology and establish a treatment plan. This case report discusses a 22-year-old woman with anterior crossbite and central diastema due to a high maxillary labial frenulum attachment. Treatment was performed using a fixed orthodontic appliance with a posterior bite raiser. Frenectomy was performed at the end of the orthodontic treatment.

Resultados clínicos del tratamiento de frenillos labiales; frenectomía y frenotomía / Clinical results of the treatment of labial frenulums; frenectomy and frenotomy

OBJETIVO: El propósito de esta revisión fue evaluar sistemáticamente la literatura científica sobre los resultados clínicos que se obtienen al remover los frenillos aberrantes al utilizar los procedimientos quirúrgicos convencionales y el láser. MATERIALES Y MÉTODOS: Búsqueda detallada en las bases de datos PubMed, ScienceDirect, Cochrane y SciELO para obtener la información más actualizada los resultados clínicos (dolor posoperatorio, dolor al hablar, dolor al masticar y complicaciones posquirúrgicas) entre las técnicas convencionales (uso del escalpelo) y las técnicas de remoción con el láser (búsqueda de ensayos clínicos). RESULTADOS: De los 501 archivos identificados inicialmente, se excluyeron reportes clínicos, revisiones, estudios observacionales, comentarios, estudios con pacientes pediátricos, etc. Se incluyeron cuatro ensayos clínicos que contrastaron las variables entre la técnica convencional y las técnicas con el láser Nd: YAG y láser CO2 CONCLUSIÓN: La percepción del dolor posoperatorio, el dolor al hablar y el disconfort al masticar luego de la frenectomía es menor en las técnicas que utilizan el láser de Nd: YAG y CO2 frente a las técnicas que utilizan el escalpelo. El tiempo quirúrgico con el uso del láser es significativamente menor que al utilizar el escalpelo. La heterogeneidad de los estudios limita la realización de un metanálisis con respecto a los resultados.

OBJECTIVE: The purpose of this review was to evaluate systematically the scientific literature on the clinical results obtained by removing aberrant frenulums using conventional surgical procedures and laser. MATERIALS AND METHODS: A detailed search was performed in the PubMed, ScienceDirect, Cochrane and SciELO databases to obtain the most up-to-date clinical results (postoperative pain, pain when speaking, pain when chewing and postoperative complications) among conventional (scalpel use) and laser removal techniques (search for clinical trials). RESULTS: Of the 501 records initially identified, clinical reports, reviews, observational studies, comments, studies with pediatric patients, etc. were excluded. We included four clinical trials that contrasted the variables between the conventional technique and the techniques with the Nd: YAG laser and CO2 laser. CONCLUSION: The perception of postoperative pain, pain when speaking and chewing discomfort after frenectomy is lower in the techniques using the Nd: YAG and CO2 laser versus the techniques using the scalpel. The surgical time when using of laser is significantly lower than when using the scalpel. The heterogeneity of the studies limits the performance of a meta-analysis with respect to the results.

Frenectomía lingual láser asistida como coadyuvante del tratamiento de ortopedia maxilar / Laser-assissted lingual frenectomy as a coadjuvant to maxillary orthopedic treatment

La aplicación del LÁSER (light amplification of stimulation emision of radiation) en las áreas de la medicina y la odontología viene demostrando una constante evolución, brindándonos alternativas a los tratamientos convencionales. Los láseres quirúrgicos de tejidos blandos muestran grandes ventajas comparados a los procedimientos habituales de corte, ya sea con bisturí frío o electrobisturí. La mínima necesidad de anestesia, la analgesia intra y postoperatoria, la coagulación inmediata, la cicatrización por segunda, el efecto bactericida, la ausencia de puntos de sutura, el confort postoperatorio, son algunas de las ventajas que hacen que la cirugía con láser sea una opción indiscutible que está ganando terreno entre los profesionales de la salud (AU)

Repercussão da anquiloglossia em neonatos: diagnóstico, classificação, consequências clÍnicas e tratamento / Repercussion of ankyloglossia in neonates: diagnosis, classification, clinical consequences and treatment

Introdução: A anquiloglossia é uma anomalia congênita que envolve alterações morfofuncionais no frênulo lingual e que pode estar atrelada às condições genéticas; apresentando-se em maior frequência no sexo masculino; e caracteriza-se por limitar os movimentos linguais. Com isso, pode contribuir na disfunção do sistema estomatognático, desencadear prejuízos na amamentação e comprometer o desenvolvimento craniofacial do neonato. Objetivo: As divergentes opiniões encontradas promovem um quadro de incerteza na escolha do protocolo de avaliação ou na intervenção, impulsionando assim a realização deste artigo. O presente artigo objetivou revisar a literatura de modo a desenvolver o conhecimento nos protocolos de avaliação para o diagnóstico da anquiloglossia, analogamente verificar as interferências condicionadas por esta anomalia no sistema estomatognático e observar as formas de tratamento para liberação do frênulo lingual. Materiais e Métodos: Foi realizada uma revisão de literatura de estudos anteriores com acesso possibilitado pelo PubMED/Medline, Lilacs, Scielo, Scopus; estabelecido o critério de artigos recém-publicados, no intervalo de 2015-2019. Conclusão: Assim, a ausência de um método de identificação que se enquadre em um padrão ouro revela a necessidade de realização de mais estudos sobre um protocolo mais eficaz para diagnóstico e classificação dessa anomalia, pois um método com maior nível de exatidão evitará intervenções inoportunas, e promoverá o conhecimento básico para realização do tratamento adequado para cada quadro de anquiloglossia.

Introduction: Ankyloglossia is a congenital anomaly involving morphofunctional changes in the lingual frenulum and which may be linked to genetic conditions; presenting more frequently in males; it is characterized by limiting lingual movements, which can contribute to the dysfunction of the stomatognathic system, triggering losses in breastfeeding and compromising the craniofacial development of the newborn. Objective: The divergent opinions found promote a picture of uncertainty in the choice of the evaluation protocol or intervention, thus driving the realization of this article. This article aimed to review the literature in order to develop knowledge in the assessment protocols for the diagnosis of ankyloglossia, similarly to verify the interferences conditioned by this anomaly in the stomatognathic system and to observe the forms of treatment for release of the lingual frenulum. Materials and Methods: A literature review of previous studies with access made possible by PubMED / Medline, Lilacs, Scielo, Scopus; the criterion for newly published articles in the 2015-2019 range was established. Conclusion: Thus, the absence of a gold-standard identification method reveals the need for further studies on a more effective protocol for diagnosing and classifying this anomaly, as a more accurate method will avoid inappropriate interventions, and will promote the basic knowledge for carrying out the appropriate treatment for each ankyloglossia picture.

Aplicación del Láser de Baja Potencia (LLLT) en Pacientes Pediátricos: Revisión de Literatura a Propósito de una Serie de Casos / Application of Low Power Laser (LLLT) in Pediatric Patients: Review of the Literature in a Series of Cases

RESUMEN: El uso del láser de baja potencia en odontología está siendo cada vez más frecuente y con excelentes resultados, los equipos más modernos traen pre-establecidos la dosimetría de los parámetros para las diferentes acciones clínicas. El objetivo de esta revisión fue encontrar evidencia científica que permita al clínico tener como una alternativa de tratamiento el uso del láser de baja potencia en patologías orales de tejidos blandos y duros en pacientes pediátricos. Se realizó una revisión de la literatura por medio de buscadores como PubMed, LILACS y SciELO. Después de leer a texto completo todos los trabajos es posible señalar que el láser de baja frecuencia es una buena alternativa terapéutica en la resolución de signos y síntomas en patologías orales que aquejan al paciente pediátrico, puesto que, presenta un rápido control del dolor, la inflamación, el sangrado y acelera los procesos de reparación celular.

ABSTRACT: Low Level Laser Therapy in dentistry is becoming more frequent and has had excellent results, with state of the art equipment having pre-established dosimetry parameters for the various clinical actions. The objective of this review was to find scientific evidence that allows the clinician to have the use of low power laser as treatment alternative, in oral soft tissue and hard pathologies in pediatric patients. A review of the literature was performed through search engines such as PubMed, LILACS and SciELO. After reading the texts, it was possible to point out that low frequency laser is a good therapeutic alternative in the resolution of signs and symptoms in oral pathologies of the pediatric patient. This alternative allows for rapid pain control, reduces inflammation and bleeding, and accelerates cellular repair processes.

Lingual Frenectomy Using 810nm Diode Laser- A Case Report

Ankyloglossia or tongue tie is a congenital oral anomaly characterised by a short lingual frenum limiting the movement of the tongue which may lead to impaired phonetics and other complications. The procedure that involves the removal of this extended band of tissue freeing the tongue is known as lingual frenectomy .Traditionally this procedure was carried out surgically but advances in dentistry today have made frenectomy by lasers possible. This case reports highlights the advantages of laser frenectomy over the surgical procedure using an 810 Diode laser.

The Age Effects on the Prognosis of Patients with Dysarthria after Lingual Frenectomy / 听力学及言语疾病杂志

Objective To explore the age effects on the prognosis of patients with dysarthria after lingual fre-nectomy ,to provide clinical basis for the corresponding speech evaluation and treatment of the patients .Methods 154 patients with dysarthria one month after lingual frenectomy were recruited as the research objects ,83 cases of preschool ,52 cases of school-age ,adolescent 11 cases and 8 cases of adult were included .Their articulation was re-corded after postoperative recovery one month by the computer speech lab (Model 4500) according to the test table , then the recording materials were analyzed .After the patients' phonetic intelligibility(PI) was evaluated ,the corre-lation and simple linear regression analysis for age and PI were carried on .Results The PI of patients with dysar-thria one month after lingual frenectomy was positively correlated with age (r=0 .467 ,P<0 .05) .That indicates PI has an increasing trend with the growth of age .The result of simple linear regression analysis showed that the deter-mination coefficient of age to PI was 0 .270 .It showed that age had an influence on the prognosis of patients with PI after lingual frenectomy .Conclusion Aging was one of the important factors for the prognosis of patients with dys-arthria after lingual frenectomy ,but it is not the only factor .The patients with dysarthria one month after lingual fre-nectomy should be received treatment in time ,speech training must be corrected at about 4 to 8 years old with dysarthriawithout surgery .

The Articulation Characteristics of Abnormal Supradental and Rehabilitation Training in Patients with Dysarthria after Lingual Frenectomy / 听力学及言语疾病杂志

Objective To investigate articulation characteristics and rehabilitation training methods of abnor-mal supradental of patients with dysarthria after lingual frenectomy.Methods A total of 107 patients with dysar-thria after lingual frenectomy were studied for articulation characteristics.Then 32 patients with dysarthria were re-cruited from those 107 patients for further research of the training methods.Results The articulation disorders of/z/and/s/were replaced by/d/when/z/and/s/were combined with/a/,/o/,/e/,/u/or the vowels whose head vowels were them,/z/and/s/were replaced by/j/and/x/when they were combined with/i/.The proportion of these disorders were 32.71%,26.17%,30.84% and 40.19%,respectively.The articulation disorders of/c/was re-placed by/d/or/t/when/c/was combined with/a/,/o/,/e/,/u/or the vowels whose head vowels were them. The proportions were 5.61% and 25.23%,respectively.When/c/was replaced by/q/and/j/.When/c/was com-bined with/i/,the proportions respectively were 42.06% and 14.02%.Then/z/,/c/,/s/were totally replaced to/zh/,/ch/and ,/sh/or lateralization.The proportions of these disorders were 14.02%,15.89%,13.08% and 10.28%,9.35%,11.21%,respectively.After the speech training,the patients made less mistakes about supradental consonant,the number changed from 34.53±6.08 to 7.97±2.52.The differences were statistically significant(t=30.035,P<0.001).Conclusion The main articulation disorders were replacement and lateralization.The training methods that this research has established are significantly effective,and is worth receiving further study and possi-ble clinical application.

Maxillary Labial Frenectomy Using 810nm Diode Laser- A Case Report

Frenectomy is one of the common oral surgical procedures performed in Pediatric dentistry. This case report presents the management of a maxillary high labial frenum attachment in a child patient using 810nm Diode laser.

Surgical Management of Aberrant Labial Frenum Using Modified Z-Frenuloplasty: A Case Report.

Frenum is a mucous membrane fold that attaches lips and cheek to the alveolar mucosa, gingiva, and the underlying periosteum. The maxillary frenum can contribute to esthetic problems and can compromise the orthodontic outcome in cases of midline diastema, thus leading to treatment relapse. In addition to this, it may jeopardize the health of the gingival, when it is attached too tightly to the gingival margin, by interference in the plaque control or owing to the muscle pull. These situations can be managed with the help of frenectomy. The presenting case report demonstrates the frenectomy of an anomalous labial frenum in a 20-year-old male using modified Z-frenuloplasty technique.

Frenectomy Using Diode Laser.

The labial frenum may impede oral hygiene and result in diastema between anterior teeth and traction of the attached gingiva. High coronal attachment is generally associated with a hypertrophy of the frenum. Labial frenectomy is a common surgical procedure in the field of oral surgery 1. Labial frenectomy is a procedure usually done for orthodontic reasons. Surgical removal of the frenum during puberty has been recommended for these patients 2. This article clinically evaluates the efficacy of a diode laser in removing the frenum in 10 patients using a diode laser at a power setting of 1.5 W or less in a continuous mode. The role of laser surgery in the oral cavity is well established. The use of diode laser in frenectomy has many advantages like no bleeding, no need for suture placement, and placement of orthodontic brackets that can be done on the same day itself.

Surgical techniques for the treatment of ankyloglossia in children: a case series

This paper reports a series of clinical cases of ankyloglossia in children, which were approached by different techniques: frenotomy and frenectomy with the use of one hemostat, two hemostats, a groove director or laser. Information on the indications, contraindications, advantages and disadvantages of the techniques was also presented. Children diagnosed with ankyloglossia were subjected to different surgical procedures. The choice of the techniques was based on the age of the patient, length of the frenulum and availability of the instruments and equipment. All the techniques presented are successful for the treatment of ankyloglossia and require a skilled professional. Laser may be considered a simple and safe alternative for children while reducing the amount of local anesthetics needed, the bleeding and the chances of infection, swelling and discomfort.

Frenectomy for improvement of a problematic conventional maxillary complete denture in an elderly patient: a case report

Maxillary labial and buccal frena are considered as normal anatomic structures in the oral cavity. However, they may exist intraorally as a thick broad fibrous attachment and/or become located near the crest of the residual ridge, thus interfering with proper denture border extension resulting in inferior denture stability, retention and overall patient satisfaction. This case report highlights the importance of clinical examination and treatment planning which may mandate preprosthetic surgery prior to fabrication of a new conventional complete denture. Adequate patient satisfaction with conventional complete dentures can be significantly increased after frenectomy.

The Effect Of Lingual Frenectomy On The Tongue Motion And Speech

We have examined 20 tongue-tie patients who had been operated the lingual frenectomy in Department of Oral & Maxillofacial surgery, Pusan National University for the effect of the lingual frenectomy on the tongue motion and speech, and divided patients into groups by age. Each group was separated as follows ; the age of 5-6, 7-9, 10-12, 13-15, and 16-18. We measured the frenal lengh, the range of tongue motion and evaluated the speech pre- and postoperatively. The preoperative patient groups have larger tongue tips and smaller lingual frenums than normal ones. In the preoperative patient group, there was significant obstacle of the protrusive and superior movement of the tongue. The exception was the laterotrusive movement on both sides. There was the lower value of the Picture Consonant Articulation Test(PCAT) in the preoperative 5 to 6 yearold group compared with normal group. In other age groups, there was no significant difference. The range of postoperative PCAT in all age groups has become as similiar as that of normal group. The 5 to 6 year-old group which had significant difference in PCAT was improved in PCAT. In conclusion, we propose that the PCAT as well as anatomical tongue size and functional tongue movement is the basis of the indication of lingual frenectomy and the 5-6 year-old is the optimal time of the lingual frenectomy for improvement of the tongue movement and the speech.