Does Ankyloglossia Surgery Promote Normal Facial Development? A Systematic Review

Area of Science:

• Dentistry
• Orthodontics
• Pediatric Medicine

Background:

• Ankyloglossia (tongue tie) is a congenital condition characterized by a restricted lingual frenulum.
• This restriction can impede tongue mobility, potentially affecting lower face morphology, occlusion, and skeletal development.

Purpose of the Study:

• To evaluate the benefits of lingual frenotomy on occlusion and lower face skeletal development.
• To understand the relationship between ankyloglossia and craniofacial abnormalities.

Main Methods:

• Systematic literature search of major databases (PubMed, Cochrane, Medline, Web of Science, Embase).
• Keywords included 'tongue tie', 'ankyloglossia', 'short lingual frenum/frenulum', 'malocclusion', 'lower face skeleton', and 'hyoid bone'.
• Quality assessment of included studies using Cochrane guidelines; risk of bias and evidence strength analysis.

Main Results:

• Seven studies involving 1349 ankyloglossia patients and 90 controls were analyzed; study quality was generally low.
• Strongest evidence links ankyloglossia to reduced intercanine/intermolar widths and increased prevalence of Class III malocclusion.
• Ankyloglossia may contribute to maxillary constriction and mandibular incisor crowding.

Conclusions:

• Despite low-quality evidence, ankyloglossia is conditionally linked to maxillary constriction, Class III malocclusion, and mandibular incisor crowding.
• Patient age is a significant factor in determining optimal timing for lingual frenotomy.
• Indications for frenotomy are contingent upon the specific malocclusion present.