14 REFINEMENT OF PHONETICS AND.cdr

The lingual frenum is a mucosal fold that connects the bottom of the body of the tongue to the floor of the mouth and to the mandibular bone. Ankyloglossia results when the frenum is thick and very tight and/or its place of insertion limits the mobility of the tongue. If the anomaly is relatively severe and generates mechanical limitations and functional challenges, surgical reduction of the frenum is indicated, followed by speech therapy for an immediate rehabilitation of the lingual musculature. This case report shows the conventional scalpel surgical technique for the correction of tongue-tie. The surgery followed by speech therapy resulted in wider range of tongue mobility with no discomfort to the patient. 1 2 3 4 Neha Joshi, K.K. Chaubey, V.K. Arora, Ellora Madan Neha Joshi Department of Periodontics, Kothiwal Dental College 2 and Research Centre and Hospital, Moradabad, K.K. Chaubey (MDS, Professor) Department of Periodontics, Kothiwal Dental College and Research Centre 3 and Hospital, Moradabad, V.K. Arora (MDS, Professor) Department of Periodontics, 4 othiwal Dental College and Research Centre and Hospital, Moradabad, Ellora Madan (MDS, Reader) Department of Periodontics, Kothiwal Dental College and Research Centre and Hospital, Moradabad INTRODUCTION : In this fast moving world, speech defect now-a-days has become a social stigma, so all the etiological factors and conditions causing it must be very carefully dealt with. One such condition, in which due to limited mobility of the tongue, speech problems occur is, Ankyloglossia, commonly referred to as tongue-tie. Ankyloglossia is a congenital oral anomaly which is not common in occurrence. It shows its presence right from birth, in some, causing problems in breast-feeding, and while in most, in speech articulation. This has been a very controversial subject with several views regarding its management. Some of such cases resolve spontaneously without showing any symptoms, whereas, others require surgical intervention, for the removal of tongue-tie. This is followed by speech therapy, if required. In some cases, individuals learn to compensate efficiently for their decreased lingual mobility without any surgical means. Although most tongue-tie cases are seen in people with no other congenital anomalies, ankyloglossia has been found to be associated with some rare syndromes like Kindler syndrome,1 Opitz syndrome,,2 van der Woude syndrome,3 X-linked cleft palate syndrome. 4 Ankyloglossia limits the tongue's range of motion. Because of limited mobility of the tongue in such patients, the tongue is in a low position and causes forward and downward pressure favoring the development of mandibular prognathism with maxillary hypo development.5 More studies, especially controlled clinical trials, are needed to establish a clear correlation between malocclusion and ankyloglossia. CASE REPORT: A 27-year old male patient reported to the department of Periodontics with the chief complaint of difficulty in speech from birth. The ENT and general physical examination was normal. On intraoral examination, it was found that the patient had a short lingual frenum which limited the protrusion of the tongue to a little beyond the vermillion zone of the lower lip and on protrusion, a clear W-shaped appearance of the tongue was seen (FIGURE 1). Crowding was present in the lower anteriors but no recession lingual to mandibular incisors, a gingival finding commonly related with this condition (FIGURE 2). REFINEMENT OF PHONETICS AND ESTHETICS BY LINGUAL FRENECTOMYTHE PROVEN CURE FOR ANKYLOGLOSSIA Journal of Dental Sciences University