Aim and background: Ankyloglossia also known as tongue-tie is an uncommon congenital oral condition that can lead to challenges in breastfeeding, speech articulation, and oral hygiene maintenance, including difficulty cleaning the teeth. Ankyloglossia is marked by an unusually short and thick lingual frenulum attached to the genioglossus muscle or by the fusion of the tongue’s underside to the floor of the mouth, restricting the mobility of the tongue tip. Lingual frenectomy is considered the most effective treatment to alleviate the issues related to ankyloglossia. This case series focuses on various degrees of ankyloglossia, the clinical signs associated with it and its management using laser treatment across different age groups of pediatric patients and reports three cases in which diode laser was utilized for lingual frenectomy. The diode laser has proven to be an outstanding choice for these procedures, offering superior bleeding control, enhanced precision, reduced discomfort and faster healing time.
Case description: Pediatric patient with limited tongue mobility complained of speech difficulties, including challenges in articulating certain sounds, reduced efficacy in mechanically cleaning the oral cavity due to restricted tongue movement, as well as potential gingival recession or malocclusion. Therefore, surgical intervention for ankyloglossia was considered  based on the patient's history of speech, mechanical, and social challenges. This report presents a case series with a 1-year follow-up of three lingual frenectomy procedures conducted using a diode laser. In Case 1, Class IV ankyloglossia was observed; in Case 2, Class II ankyloglossia; and in Case 3, Class III ankyloglossia according to Kotlow was noted. The lingual frenectomy was performed under local anaesthesia utilizing a diode laser. Healing progress was evaluated at 1 week, 1 month, 3 months, and 1-year post-procedure followed by post operative speech therapy.
Conclusion: The anatomical structure and positioning of the lingual tissue make it prone to various intraoperative and postoperative complications, despite the relatively simple nature of the lingual frenectomy procedure. Hence using laser to manage ankyloglossia in pediatric patients is efficient and safe alternative treatment considering the need to limit the operating time in uncooperative pediatric patient.
  Clinical significance: Concerning the anatomy of the lingual frenulum, no significant morphological alterations occur over time in its thickness or its attachment to the tongue and the floor of the mouth. Therefore, in the absence of substantial evidence regarding the optimal timing and approach for surgical intervention, procedures such as lingual frenotomy or frenectomy for functional impairments should be evaluated on an individual basis. Pediatric ankyloglossia, which may result in breastfeeding challenges and disruptions in orofacial and oro-functional development, is typically identifiable early in life. Timely diagnosis can help avert early cessation of breastfeeding and mitigate potential complications later on