# The Effectiveness of Frenotomy on Speech in Adults
## 4 Discussion  
The presented study proved that ankyloglossia is, in most cases, a condition which needs to be treated surgically, as it may cause developmental consequences for the maxillofacial skeleton and function. The group consisted of adults who did not have freetornomy, frenectomy, or Z-plasty in childhood. As [PERSON] [10] stated, during the last 60 years, there has been a dramatic increase in TT diagnoses, which may indicate why the tested group did not get proper treatment in the past. [PERSON] et al. [14] presented a new way of assessing posterior tongue mobility using lingual palatal suction, which may be an answer for those researchers who overdiagnose TT. Moreover, it has been suggested that the mandible grows to a predetermined size and shape accompanied by some extrinsic factors. [PERSON] [15], in his theory on the influence on teeth positioning, stated that the teeth and the alveolar ridge lie in some balance position between cheeks, lips, and tongue, while the tongue is the most powerful, and in this way, cause the malocclusion. This research proved a relationship between ankyloglossia and laterogenia and, in general, any types of prognathism, similar to [PERSON] [16] and [PERSON] and [PERSON] [17], who indicated that most Class III patients had geniojossus muscle fibers that are too short or have an abnormal position. Moreover, [PERSON] [16], who studied the tongue posture, pointed out that the tongue position was the highest in Class II, the lowest in Class III, and intermediate in Class I malocclusions. In addition to that, [PERSON] [18] pointed out that the equilibrium between bones and muscles is vital to keep the arch widths, and an incorrect tongue's position may cause the wrong mandible position. Another significant result is the restriction of tongue mobility in all directions. Such condition may affect the primary functions such as swallowing (here may be a particular link, however, due to a small sample, the study did not bring to light a strong relationship), chewing, cleaning the oral cavity of food, improper breathing patterns, and the tongue's most crucial resting position. As seen, the vertical-horizontal position of the tongue, known in logopaedics as resting position, was much better in those patients who had undergone the fronotomy. All upward movements improved, as well as the total tongue efficiency. \begin{table}
\begin{tabular}{c c c c c} \hline \hline
**Phoneme** & **Improvement** & **Improvement** & **Improvement** & **Significance** \\
**Tested** & **Mild Class** & **Moderate Class** & **Severe Class** & **_p_ **< 0.05** \\ \hline /s/ & 0.60 \(\pm\) 0.55 & 0.43 \(\pm\) 0.65 & 0.48 \(\pm\) 0.75 & n.s. \\ /c/ & 0.40 \(\pm\) 0.55 & 0.57 \(\pm\) 0.76 & 0.52 \(\pm\) 0.81 & n.s. \\ /z/ & 0.60 \(\pm\) 0.55 & 0.57 \(\pm\) 0.76 & 0.57 \(\pm\A statement about a relationship with tongue thrust may be found in plenty of articles [9; 11; 15; 16; 18]. However, the present study did not prove any relationship due to the small sample of patients with tongue thrust and the coexisting TT. It also did not verify any relation between the abnormal size of tonsils and adenoids and restricted mobility of the tongue or any indication that these factors may be relevant with ankyloglossia. As far as speech is concerned, the results show that tongue-tie is one of the most critical factors of phonemes\({}^{\prime}\) quality of pronunciation across most languages, followed by a malocclusion. Several researchers such as [PERSON] [15], [PERSON] [19], [PERSON] [20], [PERSON] [2], [PERSON] and [PERSON] [21], proved that the short lingual frenum seriously affects speech. However, most of them covered childhood or puberty problems and did not follow the state of adults. This research focused on the quality of speech of Polish adults in whom TT coexisted with different malocclusion of varying severity. Generally, worldwide literature points out that alveolar plosives, palatal, dental, or trill phonemes are deformed, missed, or mispronounced most frequently. In the presented paper, 19 phonemes were examined.