Update of the management and treatment options of tongue-tie – a case report

Background: Ankyloglossia or tongue tie is a congenital anatomical variation characterized by a short lingual
frenulum, which may result with restriction tongue’s range of motion due to a short or thick lingual frenulum
and as well as with the influence on oral function. There are several classifications that simplify this condition,
and the most used are dr Lawrence Kotlow’s classification and Coryllos’ classification.
Case report and result: Treatment options for tongue tie are frenotomy (minimal invasive oral surgical
procedure), frenuloplasty, (oral surgical procedure with reshapes the frenulum), myofunctional therapy (post-treatment exercises) and speech therapy.
A healthy 5-year-old girl was referred to the Department of Oral Surgery by her orthodontist to undergo
a frenectomy due to the restriction of tongue movements and functions. Results of general physical examination
were normal. The intraoral examination revealed that she could protrude the tongue only to the lower lip and
not beyond. The ankyloglossia was classified as Class III using Kotlow’s classification. According to the
Coryllos’ system classification (which classified tongue tie based on the tongue attachment for four different
type) the ankyloglossia was classified as type 1 - attachment at the tip of the tongue.
After a general assessment, informed consent from her parents was obtained and lingual frenectomy was
indicated. The frenectomy was performed with local anaesthesia infiltration. The postoperative period was
uneventful with no haemorrhage complications. Sutures were removed after 1 week and the girl was sent to
speech therapy sessions.
Conclusion: As a conclusion it can be emphasize that the interdisciplinary therapy is most useful treatment for
this serious oral problem. Early diagnosis and surgical intervention, short lingual frenulum resection, brings
complete success and tongue movements become normal, all language functions return, word articulation
normalizes, and social life changes.
Keyword: tongue-tie, lingual frenectomy, ankyloglossia