Healing Efficacy of Diode Laser in Lingual Frenectomy

Participant Allocation: Participants meeting the inclusion criteria (aged 3-6, diagnosed with Kotlow grade 3 or 4 ankyloglossia) are randomly assigned to one of two groups using a simple randomization method (drawing lots):

• Group 1 (Laser Group): Lingual frenectomy performed using a 940 nm Diode Laser (Epic X, Biolase) with a power of 1W (average) and 2W (peak) in pulsed mode (CP2).
• Group 2 (Electrosurgery Group): Lingual frenectomy performed using a high-frequency electrosurgical unit (ERBE-VIO 100C) in continuous contact mode.

Surgical Procedure: Both groups follow a standardized surgical protocol:

• Anesthesia: Local anesthesia with 2% Lidocaine/Adrenaline (0.45 ml).
• Technique: Transverse incision without suturing or muscle dissection to release the lingual frenum.
• Safety Measures: Use of protective eyewear for the laser group and electrode grounding pads for the electrosurgery group.

Data Collection and Blinding:

• Blinding: This is a single-blind study where the participants and their guardians are unaware of the assigned treatment group. The evaluator measuring post-operative outcomes is also blinded to the surgical method used.
• Follow-up Schedule: Evaluations are conducted at five specific intervals:

• Baseline (T0): Pre-operative measurements.
• Post-operative: At 24 hours (T1), 3 days (T2), 1 week (T3), and 1 month (T4).

Evaluation Criteria:

• Wound Healing: Assessed by the Early Wound Healing Score (EHS), focusing on re-epithelialization (CSR), haemostasis (CSH), and inflammation (CSI).
• Pain Intensity: Self-reported by patients using the Wong-Baker FACES Pain Rating Scale.
• Tongue Function: Measuring the increase in free tongue length (mm) using a Quick Tongue-Tie (QTT) tool.

Inclusion criteria

• Patients aged between 3 and 6 years.
• Diagnosed with grade 3 or grade 4 ankyloglossia according to Kotlow's classification (1999).
• Parents or legal guardians provide informed consent for the child to participate in the study.
• Patients and guardians agree to follow the follow-up schedule (24 hours, 3 days, 1 week, and 1 month post-surgery).

Exclusion criteria

• History of allergy to local anesthetics (e.g., Lidocaine, Adrenaline).
• Patients with systemic diseases or high-risk surgical factors (e.g., cardiovascular disease, bleeding disorders, hemophilia, epilepsy, or uncontrolled asthma).
• Uncooperative patients who are unable to undergo the procedure under local anesthesia or fail to follow post-operative instructions.
• Patients who withdraw from the study before completion.