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Cureus Apr 2024A lingual frenectomy is a surgical procedure aimed at addressing "tongue-tie" or ankyloglossia, where a strip of tissue restricting tongue movement is removed....
A lingual frenectomy is a surgical procedure aimed at addressing "tongue-tie" or ankyloglossia, where a strip of tissue restricting tongue movement is removed. Typically, this strip extends from the bottom of the mouth to the underside of the tongue. The procedure, often performed using a diode laser, offers several advantages including simplicity and safety for patients. It can significantly improve speech articulation and eating for individuals with ankyloglossia. This case report highlights the successful treatment of a female patient experiencing speech difficulties with diode laser therapy for tongue-tie.
PubMed: 38826594
DOI: 10.7759/cureus.59412 -
American Journal of Speech-language... Jul 2023To deepen our understanding of the effects of ankyloglossia on articulation, the purpose of this study is to examine consonant production and the perceived accuracy of...
PURPOSE
To deepen our understanding of the effects of ankyloglossia on articulation, the purpose of this study is to examine consonant production and the perceived accuracy of Mandarin-speaking children with ankyloglossia.
METHOD
Ten tongue-tie (TT) and 10 typically developing (TD) children produced nine Mandarin sibilants that contrast in three places of articulation. Their speech productions were analyzed from six acoustic measurements. To further examine the perceptual consequences, an auditory transcription task ( = 21) was conducted.
RESULTS
The acoustic analyses discovered that the TT children failed to distinguish the three-way place contrast and produced significant acoustic deviations compared with the TD peers. The perceptual transcription results found that TT children's production was significantly misidentified, suggesting severely affected intelligibility.
CONCLUSIONS
The preliminary findings provide strong support for a correlation between ankyloglossia and distorted speech signals and suggest important interactions between sound errors and linguistic experience. We also propose that ankyloglossia should not be a purely appearance-based diagnosis and that speech production is a crucial index of tongue function in clinical decision making and monitoring.
Topics: Humans; Child; Ankyloglossia; Speech; Acoustics; Linguistics; Clinical Decision-Making; Phonetics
PubMed: 37195693
DOI: 10.1044/2023_AJSLP-22-00231 -
Otolaryngology--head and Neck Surgery :... Oct 2023The past 2 decades have seen a rapid increase in the diagnosis of ankyloglossia. Patients are often managed by lingual frenotomy. The objective is to define the clinical...
OBJECTIVE
The past 2 decades have seen a rapid increase in the diagnosis of ankyloglossia. Patients are often managed by lingual frenotomy. The objective is to define the clinical and socioeconomic factors that determine which patients receive frenotomy.
STUDY DESIGN
A retrospective analysis of commercially insured children.
SETTING
Optum Data Mart database.
METHODS
Trends in frenotomy including provider and setting were described. Multiple logistic regression was used to determine predictors of frenotomy.
RESULTS
Diagnosis of ankyloglossia increased from 2004 to 2019 (from 3377 in 2004 to 13,200 in 2019), while lingual frenotomy similarly increased from 1483 in 2004 to 6213 in 2019. The proportion of inpatient frenotomy procedures increased from 6.2% to 16.6% from 2004 to 2019, with pediatricians having the highest odds of performing inpatient frenotomies (odds ratio: 4.32, 95% confidence interval: 4.08, 4.57). Additionally, during the study period, the proportion of frenotomies performed by pediatricians increased from 13.01% in 2004 to 28.38% in 2019. In multivariate regression analyses, frenotomy was significantly associated with the male sex, white non-Hispanic ethnicity, higher parental income and education, and a greater number of siblings.
CONCLUSION
Ankyloglossia has been increasingly diagnosed in the past 2 decades, and among patients with ankyloglossia, frenotomy is increasingly performed. This trend was driven at least in part due to increasing rates of pediatricians as proceduralists. After accounting for maternal and patient-level clinical factors, socioeconomic differences in the management of ankyloglossia were observed.
Topics: Child; Humans; Male; United States; Infant; Ankyloglossia; Retrospective Studies; Lingual Frenum; Inpatients; Parents
PubMed: 36994937
DOI: 10.1002/ohn.332 -
Minerva Pediatrics Mar 2024Ankyloglossia is an anatomical variation of the lingual frenulum that negatively interferes with the functionality of the tongue. This condition can affect breastfeeding...
BACKGROUND
Ankyloglossia is an anatomical variation of the lingual frenulum that negatively interferes with the functionality of the tongue. This condition can affect breastfeeding negatively. The aim of this study is to assess the prevalence of ankyloglossia among healthy babies born in Siena Hospital and the correlation between ankyloglossia and breastfeeding difficulties.
METHODS
We performed an observational prospective study conducted on healthy and breastfed newborns born in Siena Hospital in the period between January and June 2022. The evaluation of lingual frenulum in the first few days of life was performed by Martinelli's Lingual Frenulum Protocol with scores for Infants (MLFPI), while the clinical assessment of breastfeeding initiation was performed by the Breastfeeding Observation and Evaluation Form according to WHO-UNICEF guidelines. We also compared the reliability in predicting breastfeeding of a tool that measured the features of the tongue frenulum: the Bristol Tongue Assessment Tool (BTT). Breastfeeding at one and six months of babies' age was assessed by telephone interview, and information among children's nutrition, weight growth and difficulties found in breastfeeding was also collected. This study was approved by the Pediatric Ethics Committee for Clinical Trials of the Tuscany Region.
RESULTS
One hundred and ninety infants were included in the study; 21 (11.05%) had a MLFPI score ≥13. Data at one month of age showed a statistically higher MLFPI score (P value <0.001) in babies with breastfeeding difficulties (median score 13.0, IQR 5.5-14), than in those without (median score 5.0, IQR 2.0-7.5). Data at 6 months of age showed a similar difference in babies with and without breastfeeding difficulties (median 12.0, IQR 4.0-14.0 vs. 5.0, IQR 2.0-8.0 respectively). A MLFPI score ≥13 is positively associated with breastfeeding difficulties at 1 and 6 months. Also, the BTT was positively a risk factor for problems in breastfeeding at 1 and 6 months.
CONCLUSIONS
A high MLFPI score is a risk factor of breastfeeding difficulties. In these cases, a referral to experienced personnel is advisable: they can provide the emotional and professional support to the mother-child dyad, and/or refer for surgical evaluation and frenotomy. In our cohort, the usefulness of either MLFPI score or BTT was evident in predicting breastfeeding difficulties; the rate of surgical removal of the frenulum was nonetheless low.
PubMed: 38536057
DOI: 10.23736/S2724-5276.23.07357-3 -
Current Opinion in Otolaryngology &... Jun 2024The purpose of this review is to examine the current research of the posterior tongue tie and how it relates to breast feeding, solid feeding, and speech.
PURPOSE OF REVIEW
The purpose of this review is to examine the current research of the posterior tongue tie and how it relates to breast feeding, solid feeding, and speech.
RECENT FINDINGS
Recent findings show that the posterior tongue tie may play a role in effective breast feeding.
SUMMARY
Ankyloglossia is the term used for the restriction of the movement of the tongue that impairs certain functions such as breastfeeding or bottle feeding, feeding with solids, and speech. Cadaver studies have shown that there can be a restriction of the tongue and oral tissues in some people relative to others. In some breast-feeding studies, releasing the posterior tie has been shown to improve certain aspects of tongue movement. There is little evidence for or against posterior tongue ties contributing to other problems such as speech and solid feeding. This article goes into depth about the current studies on posterior ankyloglossia.
PubMed: 38869616
DOI: 10.1097/MOO.0000000000000982 -
CMAJ : Canadian Medical Association... Oct 2023
Topics: Infant; Humans; Female; Ankyloglossia; Breast Feeding; Tongue
PubMed: 37816524
DOI: 10.1503/cmaj.230151 -
International Journal of Pediatric... Aug 2023Tongue-tie, or ankyloglossia, is a common condition characterized by an abnormally short or tight lingual frenulum and is known to cause breastfeeding difficulties,...
OBJECTIVE
Tongue-tie, or ankyloglossia, is a common condition characterized by an abnormally short or tight lingual frenulum and is known to cause breastfeeding difficulties, leading to damage to the nipple, early discontinuation of breastfeeding, and delayed infant growth. In addition to tongue-tie, abnormal frenulums such as the labial frenulum and buccal frenulum can cause lip-tie and cheek-tie, respectively. While both of these conditions have been reported to potentially cause similar issues related to breastfeeding as tongue-tie, limited research has been conducted to understand their effects and how we should treat these conditions.
METHODS
In this systematic review, we conducted a comprehensive search of MEDLINE to analyze the trend in publications of all three of these conditions and their impact on breastfeeding for the past 36 years. Keywords included, "tongue-tie", "lip-tie", "cheek-tie", and "breastfeeding outcomes".
RESULTS
We found that publications describing the effect of only tongue-ties on breastfeeding have increased exponentially over time while less focus has been on other oral ties. It was also discovered that the majority of studies describing only lip-tie or tongue-tie were editorials, commentary, perspectives, or consensus statements. Finally, we found that articles describing more than one abnormal frenulum were more likely to be cited and articles describing tongue-tie only were published in the highest impact factor journals.
CONCLUSION
This study revealed a significant increase in publications discussing tongue-tie and a lack of research on lip-tie and cheek-tie in relation to breastfeeding. The findings highlight the need for more comprehensive research and attention to lip-tie and cheek-tie, as well as standardized diagnostic criteria. Ongoing debate surrounding management of these conditions stem from the lack of investigations on the impact of these abnormal frenulums and outcomes post-frenectomy. Future high-quality studies, specifically prospective cohort studies and randomized controlled trials, are necessary to provide more robust evidence and guide clinical practice.
Topics: Infant; Female; Humans; Ankyloglossia; Breast Feeding; Lingual Frenum; Prospective Studies; Cheek; Lip
PubMed: 37352592
DOI: 10.1016/j.ijporl.2023.111638 -
Journal of Clinical Medicine Nov 2023(1) Background: The incidence of ankyloglossia is 0.02-10.7%. Its effect on selected dysfunctions has been described; however, no studies report its impact on several...
(1) Background: The incidence of ankyloglossia is 0.02-10.7%. Its effect on selected dysfunctions has been described; however, no studies report its impact on several disorders in a group of subjects. The aim of this study was to assess the effect of ankyloglossia on swallowing, speech, occlusion and periodontium. (2) Methods: The study group consisted of 86 patients with ankyloglossia, and the control group (n = 86) had a normal tongue frenulum. Type of swallowing, tongue mobility, speech, occlusion and periodontium were assessed. (3) Results: Ankyloglossia pertained to 75.6% patients with infantile swallowing and 41.3% patients with mature swallowing. Limited tongue mobility was found in 29.4% subjects with moderate ankyloglossia and 70.6% subjects with severe ankyloglossia. All subjects with mild ankyloglossia and all the controls had normal tongue mobility. The relationship between dysglossia and ankyloglossia severity was statistically significant. Malocclusion or crowding was diagnosed in 62% subjects with ankyloglossia and 21.6% subjects in the control group. No periodontal abnormalities were found in any subject. (4) Conclusions: (1) A short tongue frenulum negatively influences swallowing and is associated with an "infantile swallowing pattern". (2) Moderate or severe ankyloglossia significantly limits tongue mobility. (3) A short tongue frenulum negatively influences speech. (4) Ankyloglossia is associated with higher prevalence of malocclusion.
PubMed: 38068467
DOI: 10.3390/jcm12237415 -
Breastfeeding Medicine : the Official... Jan 2024
Topics: Female; Humans; Infant; Ankyloglossia; Breast Feeding; Lingual Frenum
PubMed: 38241132
DOI: 10.1089/bfm.2024.29263.editorial -
Journal of Esthetic and Restorative... Jul 2023This article will provide an overview of the clinical presentation, treatment considerations, and sequencing of treatment for a patient with amelogenesis imperfecta...
OBJECTIVES
This article will provide an overview of the clinical presentation, treatment considerations, and sequencing of treatment for a patient with amelogenesis imperfecta (AI). The different types and subgroups of AI will be described, focusing on Type I hypoplastic form of the condition.
OVERVIEW
Patients with AI all have abnormal enamel formation but some may also present with vertical dysgnathia, anterior open bite, and posterior crossbite. A case report demonstrates the sequencing and implementation of necessary orthodontic and prosthodontic treatments, beginning in the mixed dentition and ending with esthetic and functional permanent restorations in the permanent dentition.
CLINICAL SIGNIFICANCE
AI is a disorder of tooth enamel formation but may also affect the face, jaw relationship, occlusion, compromised esthetics, and can potentially cause psychological damage due to the appearance of the teeth. Treatment of AI should be initiated at a young age.
Topics: Humans; Amelogenesis Imperfecta; Dental Enamel; Tooth; Malocclusion
PubMed: 37158443
DOI: 10.1111/jerd.13063