Classification and Treatment Options of Tongue-tie – a Case Report

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.
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.
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.
Key words: tongue-tie, lingual frenectomy, ankyloglossia