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Figure 1.87. Lingual ankyloglos-sia ("tongue tie") in a premature infant (birthweight 1700 g). Note the indentation of the tip of the tongue. The lingual frenulum limits the movement of the tip of the tongue. True tongue tie is rare. If the tongue can be protruded beyond the lips, no intervention is necessary as the tongue grows more rapidly than the frenulum and soon becomes freely mobile.

Figure 1.87. Lingual ankyloglos-sia ("tongue tie") in a premature infant (birthweight 1700 g). Note the indentation of the tip of the tongue. The lingual frenulum limits the movement of the tip of the tongue. True tongue tie is rare. If the tongue can be protruded beyond the lips, no intervention is necessary as the tongue grows more rapidly than the frenulum and soon becomes freely mobile.

Figure 1.88. The lingual frenulum may be thick and short, and may be continuous dirough an alveolar notch to produce a dimpled or bifid tongue. Usually diis is of no consequence. In diis infant with orofaciodigital syndrome, in addition to die short frenulum, diere is gum hypertrophy and a hamartoma. There was syndactyly of die second and diird toes. A thickened lingual/labial frenulum may result in a wide space (diastema) between die central incisors. As die canines begin to erupt at 9 to 11 years of age, division of die thickened frenulum allows die gap to close.

Figure 1.89. In Ellis-van Creveld syndrome (chondroectodermal dysplasia) one of the typical findings is present in the mouth. There is a defect in the upper lip due to fusion of the labiogingival margins of the upper lip so that there is no mucobuccal sulcus. Note the compartments for the individual tooth buds can be seen on the alveolar ridges.

Figure 1.90. Another infant with Ellis-van Creveld syndrome showing the typical changes in the mouth. On the left, note the defect particularly in the middle of die upper lip in which there is fusion at the maxillogingival margin to the upper lip so that diere is no mucobuccal sulcus. Also note the hypoplastic neonatal teeth in the upper jaw in the figure on the left and in the lower jaw in the figure on the right.

Figure 1.88. The lingual frenulum may be thick and short, and may be continuous dirough an alveolar notch to produce a dimpled or bifid tongue. Usually diis is of no consequence. In diis infant with orofaciodigital syndrome, in addition to die short frenulum, diere is gum hypertrophy and a hamartoma. There was syndactyly of die second and diird toes. A thickened lingual/labial frenulum may result in a wide space (diastema) between die central incisors. As die canines begin to erupt at 9 to 11 years of age, division of die thickened frenulum allows die gap to close.

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