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.

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)

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.

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 .