Comparison of the Effects of High-Power Diode Laser and Electrocautery for Lingual Frenectomy in Infants: A Blinded Randomized Controlled Clinical Trial

Abstract

The aim of the study was to evaluate the release of the lingual frenulum through frenectomy in newborns zero to 90 days of age who breastfed and had diagnosis of ankyloglossia with an indication for surgery, comparing two methods: electrocautery and a high-power diode laser. Fifty-seven patients were randomly allocated to two groups (23 submitted to electrocautery and 34 submitted to a high power diode laser). Tongue movements were evaluated based on a clinical assessment and using the Bristol Tongue Assessment Tool (BTAT) before and 15 days after the surgical procedures. The visual analog scale was administered to the mothers on the same occasions for the measurement of pain during breastfeeding. Both groups had an increased BTAT score (favorable outcome) at the post-surgical evaluation, but the anterior third of the tongue was not always free to enable the movements necessary for lingual functions. It is fundamental for surgeons to have skill and in-depth knowledge of the equipment used to avoid accidents and complications in the region of important structures. Both techniques employed in this study were safe and effective, causing little bleeding and few postoperative complications. The group submitted to a high-power diode laser exhibited less post-surgical bleeding compared to the group submitted to electrocautery and no inflammation at the edges of the surgical cut.

Atmospheric Plasma Lingual Frenectomy Followed by Post Operative Tongue Exercises: A Case Series

“…Another cause for requiring additional treatment is the re-coaptation of tissues during the healing period. The high temperature emitted at the surgical site from the diode laser accelerates the formation of fibrotic scar tissue [25]. When there is formation of fibrotic tissue, the floor-of-the-mouth (FOM) fascia-which creates a diaphragm-like structure that suspends the tongue within the arc of the mandible-is compromised, probably by fusion of the oral mucosa with the floor mouth oral fascia.…”

Frenectomy with Classical Technique

“…In classical techniques, Most patients are more comfortable and the patient's perception of pain, aesthetically, is quite good (19) . In addition to conventional techniques, a frenectomy can also be performed using electrocautery in this technique the advantages are minimal bleeding (20) , relatively faster processing time, reduced pain, and reduced discomfort due to stitches at the end of surgery (14) (21) . The disadvantage of this technique is that it tends to be more expensive than conventional techniques (14) .…”

Prevalência de anquiloglossia em bebês triados em um serviço ambulatorial público de fonoaudiologia na cidade de Salvador – Bahia

“…A anatomia do freio lingual se relaciona com espessura, elasticidade e local da fixação. Também pode ser classificado como espesso ou delgado, quando localizado na parte posterior, e, nos casos em que são recobertos por mucosa, são chamados de submucosos [9][10][11] .…”