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Pediatric Dentistry Jan 2022Ankyloglossia is a congenital anomaly that restricts tongue movements and can interfere in breastfeeding. The purpose of this study was to compare two protocols for...
Ankyloglossia is a congenital anomaly that restricts tongue movements and can interfere in breastfeeding. The purpose of this study was to compare two protocols for ankyloglossia diagnosis: (1) the Neonatal Tongue Screening Test (NTST); and (2) the Bristol Tongue Assessment Tool (BTAT). This was a cohort study involving live births at the University Hospital of Brasilia, Brasilia, Brazil, from August 2017 to July 2018. The gathered data were based on clinical examinations and interviews with mothers. The Stata software program was applied to conduct the analyses using the chi-square test, Spearman's correlation and the receiver operating characteristic (ROC) curve, and sensitivity, specificity, and positive and negative predictive values. A total of 972 mother-baby dyads were evaluated. The protocols showed agreement (P ≤ 0.001) for an ankyloglossia diagnosis, according to Spearman's correlation. The prevalence of ankyloglossia was 5.5 percent (NTST) and 5.1 percent (BTAT) and was greater in the male gender in both protocols. According to the ROC curve, the four cutoff point showed better sensitivity and specificity (98.4 percent and 64.2 percent, respectively). The BTAT was highly accurate in comparison with the NTST. Both protocols showed similar low ankyloglossia prevalence. The Bristol Tongue Assessment Tool protocol is potentially more viable as a screening instrument than the Neonatal Tongue Screening Test protocol because it is simpler and more concise.
Topics: Ankyloglossia; Breast Feeding; Cohort Studies; Female; Humans; Infant; Infant, Newborn; Lingual Frenum; Male; Tongue
PubMed: 35232537
DOI: No ID Found -
Children (Basel, Switzerland) Nov 2022Ankyloglossia is a condition of limited tongue mobility caused by a short lingual frenulum. The diagnosis and treatment of ankyloglossia are still controversial. The...
Ankyloglossia is a condition of limited tongue mobility caused by a short lingual frenulum. The diagnosis and treatment of ankyloglossia are still controversial. The main clinical problems encountered during breastfeeding are difficulty in sucking and its clinical reflections. This study aims to evaluate the infant population born with ankyloglossia and to determine the results of frenotomy. We conducted an observational, cross-sectional study among infants born in a tertiary hospital. We included all infants born between 1 January and 30 June 2022. The neonatal follow-up protocol for ankyloglossia was determined before the defined dates, and data were recorded during the screening period. The recorded data were retrospectively collected from the files. Within six months, 705 infants were born. Due to additional problems and other conditions that prevent breastfeeding, evaluable data of 207 (29.3%) infants could not be provided. Of the remaining 498 infants, 234 (33.2%) had ankyloglossia. While none of the infants without ankyloglossia had a breastfeeding problem after appropriate training, 28.6% of the ankyloglossia group had a breastfeeding problem (p < 0.001). The need for frenotomy differed significantly between Coryllos groups (p < 0.001). Breastfeeding was unsuccessful before frenotomy in 12 Coryllos type-1 patients, and all had difficulty in sucking. Frenotomy was performed within the three-month follow-up period in all patients with complaints of inability to firmly grasp the breast, nipple slipping from the mouth, and nipple biting during the first 24 h. In terms of breastfeeding problems, regardless of the anatomical typology, frenotomy can be performed safely in early life with successful results. If deficiencies or difficulties in breastfeeding are noticed in ankyloglossia patients even at the first control, frenotomy should be recommended in clinical conditions.
PubMed: 36553304
DOI: 10.3390/children9121860 -
Breastfeeding Medicine : the Official... Feb 2020Ankyloglossia is characterized by abnormal tongue movements that can possibly interfere with breastfeeding due to incorrect latching, pain, nipple fissure, and...
Ankyloglossia is characterized by abnormal tongue movements that can possibly interfere with breastfeeding due to incorrect latching, pain, nipple fissure, and ineffective suction. To determine the prevalence of ankyloglossia in newborns and its association with exclusive breastfeeding and early breastfeeding difficulties. This is an analytical cross-sectional study conducted in seven public maternity hospitals in the city of Recife, PE, Brazil. The study sample consisted of 822 mothers/newborns of both genders. The diagnosis of ankyloglossia was confirmed by comparing two previously standardized and validated lingual frenulum assessment tools. Information on the mother's socioeconomic profile and breastfeeding difficulties were also collected. The data were analyzed using bivariate and multivariate logistic regression models. The prevalence of ankyloglossia was 2.6% when using the Bristol Tool and 11.7% with the Assessment Tool for Lingual Frenulum Function (Neonatal Tongue Screening Test-NTST). The agreement between the two assessment tools was 2.2%, with a significant difference between them ( < 0.001). There was an association between the occurrence of ankyloglossia and breastfeeding difficulties (odds ratio = 1.99), but no association with exclusive breastfeeding practice was found. The diagnostic tools used herein revealed different prevalence rates of ankyloglossia in newborns. This condition was associated with breastfeeding difficulties, and the NTST was more effective in determining such an association.
Topics: Adolescent; Adult; Ankyloglossia; Brazil; Breast Feeding; Cross-Sectional Studies; Diagnostic Tests, Routine; Female; Hospitals, Public; Humans; Infant, Newborn; Infant, Newborn, Diseases; Male; Prevalence; Young Adult
PubMed: 31916855
DOI: 10.1089/bfm.2019.0199 -
Compendium of Continuing Education in... May 2022An association between ankyloglossia and periodontitis has not previously been reported. This case series describes three sisters who each had ankyloglossia and a...
An association between ankyloglossia and periodontitis has not previously been reported. This case series describes three sisters who each had ankyloglossia and a molar/incisor pattern of localized periodontitis. The concurrent presentation of both conditions within the family suggests that further investigation of genetic factors that might concurrently affect the pathogenesis of both disorders may be warranted.
Topics: Ankyloglossia; Humans; Incisor; Molar; Periodontitis
PubMed: 35589147
DOI: No ID Found -
International Journal of Pediatric... Nov 2020Anecdotally, there has been an increase in ankyloglossia referrals and frenotomy procedures performed in recent years. Many studies have characterized frenotomy...
OBJECTIVES
Anecdotally, there has been an increase in ankyloglossia referrals and frenotomy procedures performed in recent years. Many studies have characterized frenotomy indications and outcomes, but none have quantified how the frequency of referrals and interventions have changed over time in the outpatient setting. This study analyzes temporal trends in the diagnosis and intervention of ankyloglossia in a pediatric otolaryngology practice to further clarify how patterns of management of this condition have changed over time.
METHODS
This study was a retrospective chart review of patients evaluated for ankyloglossia in an outpatient pediatric otolaryngology clinic between 2008 and 2018. The chi-square test for trend was used to assess yearly changes in the referral numbers, surgical interventions, and procedure indication prevalence proportions of interest.
RESULTS
Referral numbers and frenotomy procedures increased as a percentage of total office visits from 2008 to 2018 (P = 0.0026, P < 0.0001). The trend in frenotomies was especially pronounced in the 0 to 2-month age group (P < 0.0001) but was not observed in the 2 months to 1-year (P = 0.30) or 1- to 4-year (P = 0.40) age groups. Frenotomy performed for concerns of feeding (P < 0.0001) increased over the study period, but there was no significant increase in procedures performed for speech concerns (P = 0.13).
CONCLUSION
Significant increases in referrals for frenotomy and number of frenotomy procedures performed are demonstrated, especially in young infants for feeding concerns. It is unlikely representative of a true increase in the incidence of ankyloglossia, but rather the result of cultural and clinical factors driving referrals and intervention.
Topics: Ankyloglossia; Breast Feeding; Child; Female; Humans; Infant; Infant, Newborn; Lingual Frenum; Outpatients; Retrospective Studies; Speech
PubMed: 33152977
DOI: 10.1016/j.ijporl.2020.110386 -
Journal of Orthodontic Science 2023Ankyloglossia or tongue-tie is a condition present since birth that results in restricted movement of the tongue due to the attachment of the lingual frenulum. The...
Ankyloglossia or tongue-tie is a condition present since birth that results in restricted movement of the tongue due to the attachment of the lingual frenulum. The condition affects breastfeeding, speaking, swallowing, occlusion, and proper tongue posture. Tongue ties vary in degree of severity from mild cases of mucus membrane bands to complete tongue ties where the tongue adheres to the floor of the mouth. Treatment options such as speech therapy, frenotomy,frenectomyhave all been suggested in the literature. Surgical correction often causes, bleeding,chances of infection, swelling, and relapse. A systemically healthy 23-year-old male patient who experienced difficulty in speech since childhood was referred for treatment to the dental clinic in September 2020. He was diagnosed with Kotlows class III tongue tie and angles class 3 malocclusion. Orthodontic correction and Functional frenuloplasty using a diode laser was carried out. In conjunction with it,orofacial myofunctional therapy was advised. Follow-up: The surgical procedure was uneventful. The patient was reviewed post-operatively at regular intervals every 3 months to check for relapse. This paper elaborates on the newer modes of diagnosis, orofacial myofunctional therapy, and lingual frenuloplasty with diode laser. This technique will help to overcome all the challenges of conventional tongue-tie treatments providing long-term excellent results.
PubMed: 37351399
DOI: 10.4103/jos.jos_20_22 -
Clinical Anatomy (New York, N.Y.) Sep 2019The lingual frenulum is recognized as having the potential to limit tongue mobility, which may lead to difficulties with breastfeeding in some infants. There is...
The lingual frenulum is recognized as having the potential to limit tongue mobility, which may lead to difficulties with breastfeeding in some infants. There is extensive variation between individuals in the appearance of the lingual frenulum but an ambiguous relationship between frenulum appearance and functional limitation. An increasing number of infants are being diagnosed with ankyloglossia, with growing uncertainty regarding what can be considered "normal" lingual frenulum anatomy. In this study, microdissection of four fresh tissue premature infant cadavers shows that the lingual frenulum is a dynamic, layered structure formed by oral mucosa and the underlying floor of mouth fascia, which is mobilized into a midline fold with tongue elevation and/or retraction. Genioglossus is suspended from the floor of mouth fascia, and in some individuals can be drawn up into the fold of the frenulum. Branches of the lingual nerve are located superficially on the ventral surface of the tongue, immediately beneath the fascia, making them vulnerable to injury during frenotomy procedures. This research challenges the longstanding belief that the lingual frenulum is a midline structure formed by a submucosal "band" or "string" and confirms that the neonatal lingual frenulum structure replicates that recently described in the adult. This article provides an anatomical construct for understanding and describing variability in lingual frenulum morphology and lays the foundation for future research to assess the impact of specific anatomic variants of lingual frenulum morphology on tongue mobility. Clin. Anat. 32:824-835, 2019. © 2019 The Authors. Clinical Anatomy published by Wiley Periodicals, Inc. on behalf of American Association of Clinical Anatomists.
Topics: Ankyloglossia; Cadaver; Female; Humans; Infant, Extremely Premature; Infant, Newborn; Lingual Frenum; Lingual Nerve; Male
PubMed: 31116462
DOI: 10.1002/ca.23410 -
CoDAS 2021evaluate the influence of frenotomy on the breastfeeding of newborns diagnosed with ankyloglossia.
PURPOSE
evaluate the influence of frenotomy on the breastfeeding of newborns diagnosed with ankyloglossia.
METHODS
this is an intervention study performed with 50 newborns diagnosed with ankyloglossia. It was conducted in three stages: diagnosis, intervention and reassessment. In the diagnostic phase, the Protocol for the Assessment of Speech Language with Scores for Babies was applied to diagnose ankyloglossia and a questionnaire assessing the symptoms and coordination of sucking, swallowing and breathing during breastfeeding. In the intervention, frenotomy was performed, and at reassessment, the diagnostic protocol and questionnaire in order to compare the post-surgical effects.
RESULTS
of the 50 babies participating in the study, 35 (70%) were boys and 15 (30%) girls. A total of 68% of ankyloglossia cases were reported in the family, a majority (38%) involving cousins. There was a statistically significant reduction in the average protocol score in the reassessment stage, from 8.38 (7-12 points) to 0.86 (0-5 points), as well as a statistically significant improvement in all variables related to the symptoms of breastfeeding.
CONCLUSION
surgical intervention, known as frenotomy, made it possible to improve the negative symptoms of breastfeeding in newborns diagnosed with ankyloglossia.
Topics: Ankyloglossia; Breast Feeding; Female; Humans; Infant; Infant, Newborn; Lingual Frenum; Male; Surveys and Questionnaires; Treatment Outcome
PubMed: 33950144
DOI: 10.1590/2317-1782/20202019026 -
The New Zealand Medical Journal Aug 2019We sought the parental experience of the effects of frenotomy in the presence of ankyloglossia by exploring the reasons for seeking frenotomy, impressions of its value...
AIMS
We sought the parental experience of the effects of frenotomy in the presence of ankyloglossia by exploring the reasons for seeking frenotomy, impressions of its value and its impact on breastfeeding.
METHOD
A prospective survey of infants receiving frenotomy in a general practice in Palmerston North was undertaken. Infants aged under six months with confirmed ankyloglossia via a GP and lactation consultant were included. One hundred and seventy-six children met the study criteria. Parents completed a pre-procedure questionnaire and received a follow-up phone call.
RESULTS
Results demonstrated that 97% of parents would seek out frenotomy again in similar circumstances. Initially, 93 mother-infant pairs (53%) were not fully breastfeeding; post frenotomy, 33 of these pairs were able to start fully breastfeeding. One hundred and thirty-two pairs showed no change in feeding method. Nine pairs deteriorated from partial breastfeeding to artificial feeding, and two pairs deteriorated from fully breastfeeding to artificial feeding. Both feeding time and nipple pain improved post-frenotomy. Eighty percent of parents reported a moderate or significant improvement in their presenting issue, and 77% reported moderate to significant improvement in feeding quality. There were no major complications.
CONCLUSION
Frenotomy was reported to be beneficial, with a high level of parental satisfaction and improvement in rates of full breastfeeding and feeding duration, as well as a reduction in nipple pain. Parents were willing to go to significant lengths to access the procedure.
Topics: Adult; Ankyloglossia; Bottle Feeding; Breast Feeding; Female; Humans; Infant; Infant, Newborn; Lingual Frenum; Male; New Zealand; Parents; Treatment Outcome
PubMed: 31415501
DOI: No ID Found -
Otolaryngology--head and Neck Surgery :... May 2022Infants with posterior tongue-tie (PTT) can have substantial difficulty with breastfeeding and bottle-feeding. This study aimed to address the dearth in investigational... (Randomized Controlled Trial)
Randomized Controlled Trial
OBJECTIVE
Infants with posterior tongue-tie (PTT) can have substantial difficulty with breastfeeding and bottle-feeding. This study aimed to address the dearth in investigational objective data surrounding PTT release to better quantify the postoperative impacts of frenotomy for ankyloglossia.
STUDY DESIGN
Prospective randomized, controlled trial.
SETTING
Private practice clinic.
METHODS
In a prospective, randomized controlled trial, infants 3 to 16 weeks of age with PTT undergoing frenotomy were examined using a bottle-feeding system capable of objectively measuring tongue function. Validated patient-reported outcome measures were also obtained simultaneously.
RESULTS
Forty-seven infants with PTT were enrolled into an observational/control arm (n = 23) or interventional/surgical treatment arm (n = 24). The total cohort consisted of 29 (61.7%) male infants with a median age of 39 days. At the day 10 time point, the interventional arm demonstrated statistically significant improvement in 11 objectively obtained feeding metrics, indicating faster tongue speed, more rhythmic and coordinated sucking motions, and a tongue more capable of adapting to varying feeding demands. Significant improvement in breastfeeding self-efficacy was reported in the interventional group while poor self-confidence persisted in the observational group. Infant reflux symptoms improved in the interventional group while not in the control group. Nipple pain also persisted in the control group but improved in the surgical cohort.
CONCLUSIONS
When measured 10 days after frenotomy for PTT, infants improve feeding parameters using an objective bottle-feeding system. Similar improvements are seen with patient-reported outcomes when PTT is released. Posterior tongue-tie is a valid clinical concern, and surgical release can improve infant and maternal symptoms.
Topics: Ankyloglossia; Breast Feeding; Female; Humans; Infant; Lingual Frenum; Male; Prospective Studies; Tongue; Treatment Outcome
PubMed: 34491142
DOI: 10.1177/01945998211039784