Inclusion and Exclusion Criteria

Study populationInclusion: Children ages 0–18 with ankyloglossia or ankyloglossia with concomitant tight labial frenulum (lip-tie);
Exclusion: Studies with participants with Van der Woude syndrome, Pierre Robin syndrome, Down syndrome, or craniofacial abnormalities were excluded, as were studies of premature infants (<37 wk of gestation60)
Publication languagesInclusion: English
Exclusion: Non-English
Admissible evidence (study design and other criteria)Included study designs:
 RCTs, prospective and retrospective cohort studies, nonrandomized controlled trials, prospective and retrospective case series, and crossover studies
 Case reports to assess harms
Other criteria:
 Original research studies providing sufficient detail regarding methods and results to enable use and aggregation of the data and results
 Studies must address 1 or more of the following:
  • Surgical interventions (simple anterior frenectomy, laser frenulectomy, posterior frenulectomy, Z-plasty repair)
  • Nonsurgical treatments include complementary and alternative medicine (CAM) therapies (eg, craniosacral therapy, myofascial release, and other chiropractic therapies), lactation intervention, speech therapy, physical therapy, oral motor therapy, and stretching exercises/therapy
  • Baseline and outcome data (including harms) related to interventions for ankyloglossia
 Relevant outcomes must be able to be extracted from data in the papers
 Data must be presented in the aggregate (versus individual participant data)