Search

Ankyloglossia, commonly known as Tongue-tie, is a developmental anomaly of the tongue characterized by an abnormally short, thick lingual frenulum resulting in limited tongue movement, feeding and speech problems. It affects quite a large number of infants and children. A careful clinical examination is essential for an early diagnosis of a lingual dysfunction and to choose optimal management, by proper tongue exercises, which leads to satisfactory results in a short time. This report took into consideration a female patient aged 8 years old who was treated with soft tissue diode laser frenectomy and intra and post-surgical bleeding and wound healing were evaluated. A frenectomy can be accomplished either by the routine scalpel technique, electrosurgery or by using lasers. Among various modalities, laser is considered one of the most conservative and simple procedures with good results. They have little absorption in hard tissues, providing selective action and allowing precise cuts, coagulation and vaporization, without causing damage to dental tissues. They reduce the need for anesthesia, control bleeding and do not require sutures. The application of laser resulted in less stress and fear in patients during the procedure, also leading to a more conservative non-invasive method with minimal discomfort and bleeding, therefore making it a boon for Pediartic Dentistry. [ABSTRACT FROM AUTHOR]

Objective: The relationship between ankyloglossia and speech is controversial. The objective of this study was to determine the effect of tongue-tie release on speech articulation and intelligibility. Methods: A prospective cohort study was conducted. Pediatric patients (>2 years of age) being referred for speech concerns due to ankyloglossia were assessed by a pediatric otolaryngologist, and speech articulation was formally assessed by a speech language pathologist using the Goldman-Fristoe Test of Articulation 2 (GFTA-2). Patients then underwent a tongue-tie release procedure in clinic. After 1 month, speech articulation was reassessed with GFTA-2. Audio-recordings of sessions were evaluated by independent reviewers to assess speech intelligibility before and after tongue-tie release. Results: Twenty-five participants were included (mean age 3.7 years; 20 boys). The most common speech errors identified were phonological substitutions (80%) and gliding errors (56%). Seven children (28%) had abnormal lingual-alveolar and interdental sounds. Most speech sound errors (87.9%) were age/developmentally appropriate. GFTA-2 standard scores before and after tongue-tie release were 85.61 (SD 9.75) and 87.54 (SD 10.21), respectively, (P=.5). Mean intelligibility scores before and after tongue-tie release were 3.15 (SD.22) and 3.21 (SD.31), respectively, (P=.43). Conclusion: The majority of children being referred for speech concerns thought to be due to ankyloglossia had age-appropriate speech errors at presentation. Ankyloglossia was not associated with isolated tongue mobility related speech articulation errors in a consistent manner, and there was no benefit of tongue-tie release in improving speech articulation or intelligibility. [ABSTRACT FROM AUTHOR]

This document contains Practice Guidelines developed by the International Consortium of oral Ankylofrenula Professionals (ICAP) Consensus Committee and accepted by the Board of Directors to delineate the roles and responsibilities of healthcare professionals involved in caring for individuals with ankylofrenula. These Practice Guidelines apply to practitioners serving individuals across all age groups, from infants to adults. It aims to standardize healthcare practices concerning ankylofrenula definition, diagnosis, assessment, and management. The purpose of these Practice Guidelines is twofold: firstly, to communicate ICAP's stance on the standardization of healthcare practices for health professionals engaging with patients and families affected by ankylofrenula. Secondly, it serves as an educational resource and advocacy tool for ICAP in interactions with external stakeholders, such as multidisciplinary team members, healthcare management, government bodies, researchers, funding agencies, patients, caregivers, and their families. [ABSTRACT FROM AUTHOR]

Objective: Tongue-tie, which is also known as ankyloglossia, is a common condition where the lingual frenulum is unusually tight or short. While most literature investigates the impact of tongue-tie on breastfeeding, recent articles have examined its role in speech production in children. However, these have not previously been reviewed systematically. This study aims to determine the impact of tongue-tie on speech outcomes and assess whether frenectomy can improve speech function. Methods: In this systematic review, we conducted a comprehensive search of PubMed/MEDLINE, Cochrane Library, Embase, and speechBITE to analyze primary studies investigating the impact of frenectomy for tongue-tie on speech outcomes. We extracted data regarding patient age, male to female ratio, procedure type, follow-up time, and speech outcomes and ran statistical analyses to determine if frenectomy for tongue-tie leads to improvement in speech issues in pediatric patients. Speech outcomes extracted were subjectively measured based on the interpretation of a speech and language pathologist or parent. Results: Our analysis included 10 studies with an average patient age of 4.10 years, and average cohort size of 22.17 patients. Overall, frenectomy for tongue-tie was associated with an improvement in speech articulation (0.78; 95% CI: 0.64-0.87; P <.01). Increasing patient age was found to be negatively correlated with post-frenectomy speech outcomes (P =.01). However, this relationship disappeared in the adjusted model. Conclusion: Overall, we conclude that frenectomy is a suitable treatment to correct speech issues in select patients with tongue-tie if caught early in childhood. Despite the limited investigations around speech outcomes post-frenectomy, these results are informative to providers treating tongue-tie. [ABSTRACT FROM AUTHOR]

Background: The buccal frenum is connective tissue that adheres the mucosa of the cheek to the alveolar process. When restricted, this condition is commonly known as a buccal‐ or cheek‐tie. Restrictive buccal frena are often treated during tongue‐ and lip‐tie procedures, yet widely accepted classification, diagnostic and treatment guidelines are lacking. Objective: Provide a scoping review on the evaluation and management of buccal‐ties, including diagnosis, classification, symptoms and treatment, by surveying healthcare providers with experience evaluating and managing oral restrictions. Methods: Literature review and IRB‐approved survey to assess practice patterns among healthcare providers identified from online directories of tongue‐tie release providers and associated allied health professionals. Results: A multidisciplinary group of 466 providers responded. About 87% indicated that they assess buccal restrictions. Evaluation methods included finger sweep (89.1%), visual inspection (76.4%), tissue blanching (66.5%) and functional assessment (53.4%). Around 94% of providers reported that objective and subjective findings are both needed for diagnosis and that an estimated 5%–10% of infants may be affected. About 70% of providers release buccal‐ties (if needed) simultaneously with tongue‐ties, and 76.8% recommend post‐operative stretches as necessary for optimal healing. Respondents indicated a need for further research, evidence‐based assessments, a classification system and treatment protocols. Conclusion: Evaluating a buccal frenum to diagnose a symptomatic buccal‐tie relies upon visual inspection, palpation and assessment of oral function. Survey data and clinical experience are summarized to review classification systems, diagnostic/evaluation criteria and treatment recommendations as a foundational cornerstone for future works to build upon. [ABSTRACT FROM AUTHOR]

Background: Breastfeeding behaviors and experiences exist on a continuum. What differentiates normal from dysfunctional is defined by frequency and severity. No current validated tool addresses the subjective experience of dyads with a predictive score that can be followed over time. Research Aim: To create and validate a self-report tool to assess breastfeeding and evaluate its ability to predict risk of breastfeeding dysfunction. Methods: This study used a cross-sectional design to determine the validity of a novel instrument to assess breastfeeding dysfunction. We gave the initial questionnaire to 2085 breastfeeding dyads. We assessed content validity by comparison with other tools. We used exploratory factor analysis with varimax rotation for concept identification and Cronbach's alpha for internal consistency. We employed logistic regression to assess the tool's ability to differentiate between normal breastfeeding and breastfeeding dysfunction. Results: Factor analysis mapped 17 questions to four concepts to create a score (FLIP; flow, latch, injury [to the nipple], and post-feed behavior). Internal consistency and reliability of the scores in these concepts were acceptable (Cronbach's alpha ≥ 0.087 for all measures). A logistic regression model that controlled for infant age, with a breastfeeding dysfunction risk classification threshold of 60%, yielded a correct classification of 88.7%, with 93.1% sensitivity, 64.6% specificity, and a 6.5% false positive rate. Conclusions: The FLIP score was determined to be a valid and reliable instrument for quantifying the severity of breastfeeding dysfunction in children under 1 year old. Further studies will assess its usefulness in the management of breastfeeding dysfunction. [ABSTRACT FROM AUTHOR]

Background: Forceful milk ejection reflex in mothers and tongue-tie in infants often cause breastfeeding difficulties. Our purpose was to observe the breastfeeding behavior of tongue-tied neonates, in the presence of forceful milk ejection of their mother versus tongue-tied infants without forceful milk ejection or in the presence of forceful milk ejection in non-tongue-tied infants. Methods: This is an observational, prospective, cohort study. The study was undertaken at the Lactation Institute, in Cluj-Napoca, Romania, between 2012 and 2018. We studied the breastfeeding behavior of neonates attending the Institute. The study includes 80 tongue-tied new-borns of mothers with forceful milk ejection (Group I), compared with the breastfeeding behavior of 40 tongue-tied neonates of mothers with normal let-down (Group II) and 29 neonates without tongue-tie in the presence of forceful let-down (Group III). Descriptive statistics, including numbers and percentages, and SAS software were utilized. Categorical data are presented as counts and percentages and analyzed with chi-square tests, utilizing R and Python software. Statistical significance was set at p-value ≤ 0.001, in some cases at p-value ≤ 0.05 using a chi-square test, sometimes validating the results with Fisher’s Exact Test. Proportional Analysis and Post-Hoc Analysis (pairwise Z-tests for proportions) were also carried out to demonstrate the frequency of cases. Results: From Group I, the majority (92.50%) were breastfed effectively in the first week, significantly different from infants in Group II (20%), where frenotomy was more frequent (92.50%) and performed mainly for suckling difficulties (86.48%). The difficult latch had a higher percentage in infants in Group II (92.50%). “Reflux-like syndrome” (93.10%), breast refusal (24.13%), and, choking (93.10%) were more frequent in infants in Group III. Conclusions: The majority of tongue-tied infants, whose mothers had early forceful milk ejection, were able to effectively breastfeed after birth. In this cohort, frenotomy might not be necessary or could be postponed. The presence of tongue-tie only, without fast milk flow, led to suckling difficulties and the need for frenotomy. Reflux-like syndrome, choking, and breast refusal were more present in infants without tongue-tie but with fast milk flow.

Copyright of Arquivos de Ciências da Saúde da UNIPAR is the property of Associacao Paranaense de Ensino e Cultura and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The purpose of this article is to (1) define the diagnostic characteristics of ankyloglossia, (2) identify potential problems associated with ankyloglossia, and (3) discuss treatment options, when treatment is appropriate. This article is based on a review of the literature, including recent systematic reviews, and the author's experience as a cleft and orofacial specialist. Ankyloglossia is a common congenital condition characterized by an anterior attachment of the lingual frenulum on the tongue. This causes difficulty elevating and/or protruding the tongue tip. As such, ankyloglossia has been thought to affect neonatal feeding, speech, and other functions. Although systematic reviews have concluded that most infants with ankyloglossia can be fed normally, a small percentage of affected infants will show improved efficiency of feeding post-frenotomy. They also concluded that frenotomy may relieve nipple pain in the breastfeeding mothers of affected infants. Regarding speech, the systematic reviews concluded that there is no evidence that ankyloglossia causes speech disorders. This may be because simple compensations will result in normal acoustics of the sounds. Therefore, frenotomy should be recommended sparingly for newborn infants, and it should rarely, if ever, be recommended for speech disorders. [ABSTRACT FROM AUTHOR]

Background: Despite limited clinical consensus regarding surgery for tethered oral tissues ("tongue-tie") for resolving breastfeeding-related issues, the procedure has been increasing in the United States. Greater understanding of maternal experiences with obtaining surgical release may help to improve breastfeeding outcomes. Research Aim: To explore experiences of breastfeeding mothers with infants having undergone "tongue-tie" surgery. Method: This online, cross-sectional, observational survey occurred between August and September 2020. Eligibility included being ≥ 18 years of age and previously or currently breastfeeding an infant with ≥ 1 tissue surgically released. Of 463 screens, 318 mothers were eligible and 115 consented. The final sample was 90. Results: The sample was predominantly white (n = 86; 95%), non-Hispanic (n = 84; 93%), married/cohabitating (n = 85; 94%), and currently providing their own milk (n = 81; 89%). Difficult latch was the primary reason for seeking help. Participants reported lingual (n = 84; 93%), labial (n = 79; 88%), and buccal (n = 16; 17%) tissue-release, with 80% (n = 73) reporting > 1 released. For each tissue released, > 80% (n = 72) of participants felt "very confident" in their ability to correctly identify it and 97% (n = 87) felt "very involved" and "strongly agreed" with surgical release. International Board Certified Lactation Consultants® were the most frequently identified source of information (n = 45; 50%) and referrals (n = 38; 42%), while pediatric dentists most frequently performed interventions (n = 60; 67%). Conclusions: Participants reported being confident, involved, and in agreement with surgical release and lactation support professionals were frequent information and referral sources. [ABSTRACT FROM AUTHOR]

Copyright of Polish Otorhinolaryngological Review / Polski Przegląd Otorynolaryngologiczny (Index Copernicus) is the property of Index Copernicus International and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Pädiatrie & Pädologie is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Ankyloglossia is a congenital anomaly that occurs due to the presence of a short, thick lingual frenum that limits the tongue movement causing difficulty in speech and may pose a problem in maintenance of the periodontal health in the mandibular anterior region on the lingual aspect, thus affecting the health of the periodontium. The present case report described the case of an 18-year-old female who faced difficulty in pronouncing certain letters and presented with a diastema between the mandibular central incisors. She was diagnosed with Kotlow’s Class II ankyloglossia, and frenectomy of the lingual frenum was advised. The choice of method for the frenectomy was laser, so that only minimal bleeding occurred in an area that otherwise presents with profuse bleeding and reduces the patient morbidity. Posttreatment, good healing was seen, and the desired movement of the tongue was achieved. [ABSTRACT FROM AUTHOR]

Copyright of Revue d'Orthopédie Dento-Faciale is the property of Parresia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Aim: To evaluate breastfeeding symptoms associated with ankyloglossia/tongue‐tie. Methods: Databases included PubMed, Embase, CINAHL, PsycINFO, Web of Science, and Google Scholar. Eligible studies reported baseline breastfeeding symptoms/severity from tongue‐tied infants. Two reviewers independently screened studies, extracted data, and assessed quality. Low‐quality studies were excluded. Main outcomes were weighted mean severity scores for dyads with ankyloglossia relative to reference values for successful breastfeeding. Meta‐analyses used inverse‐variance‐weighted random‐effects models. Results: Of 1328 screened studies, 39 were included (5730 infants with ankyloglossia). The mean LATCH score for patients with untreated ankyloglossia, 7.1 (95% CI: 6.7–7.4), was significantly below the good‐breastfeeding threshold. The mean Infant Breastfeeding Assessment Tool score, 10.0 (8.2–11.7), was not significantly below the good‐breastfeeding threshold. The mean Infant‐Gastroesophageal Reflux Questionnaire‐Revised score, 18.2 (10.5–26.0), was consistent with gastroesophageal reflux disease. The mean Breastfeeding Self‐Efficacy Scale‐Short Form score, 43.7 (39.3–48.1), indicated significant risk of cessation of exclusive breastfeeding within 1–3 months. Mean nipple pain was 4.9 (4.1–5.7) on a 0–10 scale, greater than typical scores for breastfeeding mothers without nipple damage. Total prevalence of breastfeeding difficulties was 49.3% (95% CI: 47.3–51.4%). Early, undesired weaning occurred in 20.3% (18.5–22.2%) of cases before intervention. Conclusion: Ankyloglossia is adversely associated with breastfeeding success and maternal well‐being. [ABSTRACT FROM AUTHOR]

Background: Release of tongue-tie in the newborn has been performed on a more regular basis at the Centenary Hospital for Women and Children (CHWC) in Canberra, Australia since 2006 and clear clinical pathways and guidelines have been established. Since that time, there has been an increase in the numbers referred for tongue-tie assessment. In 2018, the tongue-tie assessment and treatment forms were modified to capture more data during the breastfeeding and tongue-tie assessment. Aims: To review the mother/baby pairs who were assessed for tongue-tie release at the CHWC in 2014 and 2018. Methods: Tongue-tie assessment and treatment forms for babies referred for tongue-tie release from 1 January 2014 to 30 June 2014 and 1 January 2018 to 30 June 2018 were reviewed. Data collected included gestational age, birth weight, gender, day of release, tongue-tie type and additionally, data from 2018 included presenting breastfeeding problems, frenulum attachment to the inferior alveolar ridge (IAR) and immediate breastfeeding outcomes. Results: In 2014, 115 mother/baby pairs were assessed for tongue-tie release, and this increased by 25% to 143 mother/ baby pairs in 2018 over the same 6-month period. In 2014, 109/115(95%) tongue-tie releases were performed and in 2018 there was a non-significant 1% decrease, with 135/143(94%) releases. There was also a shift in the tongue-tie type presenting in 2018, with more 25% (Type 4) attachments (17/113[15%] vs 41/143[28.7%] p=0.01 respectively) and fewer 100% (Type 1) attachments (18/113[15.9%] vs 11/143[7.7%] p=0.039 respectively). Regarding the IAR, all the 75- 100% tongue-ties attached to the IAR, together with a significant proportion of the 25 to 50% tongue-ties. Conclusion: While there was an increase in referrals between 2014 and 2018, there was no evidence of a significant increase in number of tongue-tie releases between the two periods. This may reflect the importance of a thorough assessment of breastfeeding, breastfeeding problems and tongue function. [ABSTRACT FROM AUTHOR]

Copyright of Pädiatrie & Pädologie is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background Tongue-tie can be diagnosed in 3–11% of babies, with some studies reporting almost universal breastfeeding difficulties, and others reporting very few feeding difficulties that relate to the tongue-tie itself, instead noting that incorrect positioning and attachment are the primary reasons behind the observed breastfeeding difficulties and not the tongue-tie itself. The only existing trials of frenotomy are small and underpowered and/or include only very short-term or subjective outcomes. Objective To investigate whether frenotomy is clinically and cost-effective to promote continuation of breastfeeding at 3 months in infants with breastfeeding difficulties diagnosed with tongue-tie. Design A multicentre, unblinded, randomised, parallel group controlled trial. Setting Twelve infant feeding services in the UK. Participants Infants aged up to 10 weeks referred to an infant feeding service (by a parent, midwife or other breastfeeding support service) with breastfeeding difficulties and judged to have tongue-tie. Interventions Infants were randomly allocated to frenotomy with standard breastfeeding support or standard breastfeeding support without frenotomy. Main outcome measures Primary outcome was any breastmilk feeding at 3 months according to maternal self-report. Secondary outcomes included mother’s pain, exclusive breastmilk feeding, exclusive direct breastfeeding, frenotomy, adverse events, maternal anxiety and depression, maternal and infant NHS health-care resource use, cost-effectiveness, and any breastmilk feeding at 6 months of age. Results Between March 2019 and November 2020, 169 infants were randomised, 80 to the frenotomy with breastfeeding support arm and 89 to the breastfeeding support arm from a planned sample size of 870 infants. The trial was stopped in the context of the COVID-19 pandemic due to withdrawal of breastfeeding support services, slow recruitment and crossover between arms. In the frenotomy with breastfeeding support arm 74/80 infants (93%) received their allocated intervention, compared to 23/89 (26%) in the breastfeeding support arm. Primary outcome data were available for 163/169 infants (96%). There was no evidence of a difference between the arms in the rate of breastmilk feeding at 3 months, which was high in both groups (67/76, 88% vs. 75/87, 86%; adjusted risk ratio 1.02, 95% confidence interval 0.90 to 1.16). Adverse events were reported for three infants after surgery [bleeding (n = 1), salivary duct damage (n = 1), accidental cut to the tongue and salivary duct damage (n = 1)]. Cost-effectiveness could not be determined with the information available. Limitations The statistical power of the analysis was extremely limited due to not achieving the target sample size and the high proportion of infants in the breastfeeding support arm who underwent frenotomy. Conclusions This trial does not provide sufficient information to assess whether frenotomy in addition to breastfeeding support improves breastfeeding rates in infants diagnosed with tongue-tie. Future work There is a clear lack of equipoise in the UK concerning the use of frenotomy, however, the effectiveness and cost-effectiveness of the procedure still need to be established. Other study designs will need to be considered to address this objective. Trial registration This trial is registered as ISRCTN 10268851. Funding This project was funded by the National Institute for Health and Care Research (NIHR) Health Technology Assessment Programme (project number 16/143/01) and will be published in full in Health Technology Assessment; Vol. 27, No. 11. See the NIHR Journals Library website for further project information. The funder had no role in study design or data collection, analysis and interpretation. The views expressed are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health and Social Care. Plain language summary Many mothers and babies experience difficulties in establishing breastfeeding. In some babies it is thought that their difficulties may be linked to a condition called tongue-tie, in which a piece of skin tightly joins the middle part of the underside of the tongue to the base of the baby’s mouth. This can be treated by an operation to divide the tight part/skin in the middle of the underneath of the tongue. We planned to carry out a trial of 870 babies to find out whether an operation together with breastfeeding support helps more mothers and babies with tongue-tie to continue breastfeeding until the baby is 3 months old compared to breastfeeding support on its own and whether the costs were different between the two groups of mothers and babies. We were only able to recruit 169 babies as the trial was stopped because of slow recruitment, changes to services in the COVID-19 pandemic and a high proportion of the babies in the breastfeeding support group going on to have an operation. There were no differences in the rate of breastfeeding at 3 months between the babies in the group who had an operation straightaway and those in the group that had breastfeeding support alone, or had an operation later. More than four in every five babies in both groups were still breastmilk feeding at 3 months. Three babies who had an operation, around 1 in 50 babies, had a complication of the operation (bleeding, scarring or a cut to the tube that makes saliva). Because of the small size of the study, we cannot say whether an operation to divide a tongue-tie along with breastfeeding support helps babies with tongue-tie and breastfeeding difficulties or has different costs. We will need to try different types of research to answer the question. Scientific summary Background Breastfeeding difficulties have been associated with many factors, from a societal to an individual level. Tongue-tie can be diagnosed in 3–11% of babies, with the variation in reported prevalence thought to relate to the use of different diagnostic or severity criteria. Up to half of babies with tongue-tie are reported to have breastfeeding difficulties, but the reported proportion is highly variable. Some studies report almost universal difficulties, and others report very few feeding difficulties that relate to the tongue-tie itself, instead noting that incorrect positioning and attachment are the primary reasons behind the observed breastfeeding difficulties and not the tongue-tie itself. In a UK survey, it was noted that management of tongue-tie in infants with breastfeeding difficulties was therefore highly variable across the country. This is coupled with highly variable provision of breastfeeding support, which can range from minimal to expert and intensive, and using a variety of different models including peer supporter, midwife and health visitor. A Cochrane review identified five prior randomised controlled trials (RCTs) of frenotomy including a total of only 302 infants. The trials are small and underpowered and/or include only very short-term or subjective outcomes, suggesting further robust evidence is needed. Hence there is considerable controversy regarding, not only the diagnosis and clinical significance, but also the management of tongue-tie. Current National Institute for Health and Care Excellence (NICE) guidance allows for the procedure, based on lack of safety concerns, but notes very limited evidence of efficacy. There is therefore a clear need for an assessment of the clinical- and cost-effectiveness of frenotomy for babies diagnosed with tongue-tie in the form of an adequately powered, pragmatic RCT, taking into account the diagnostic controversy and variation in practice. Objective To investigate whether frenotomy is clinically- and cost-effective to promote continuation of breastfeeding at 3 months in infants with breastfeeding difficulties diagnosed with tongue-tie. Methods Study design The FROSTTIE trial was a multicentre, RCT conducted in 12 infant feeding services in England. Participants Inclusion criteria Any infant aged

The most common symptom attributed to ankyloglossia is difficulty breast feeding due to poor latch, inefficient milk extraction and/or maternal nipple pain. During the past two decades, despite a declining birth rate, there has been a dramatic increase in the number of infants diagnosed with and treated for ankyloglossia in the United States, Canada and Australia. Despite a dramatic increase in the diagnosis and treatment of ankyloglossia in these countries, there remains no universally agreed upon definition of ankyloglossia and none of the published scoring systems have been rigorously validated. However ankyloglossia is defined, the majority of infants with ankyloglossia are asymptomatic. Perhaps, infants with ankyloglossia have a greater incidence of difficulty breast feeding. Lingual frenulotomy may decrease maternal pain and at least transiently improve the quality of breast feeding in some infants however no published studies take into account the fact that sucking and feeding are soothing to infants and the observed improvements immediately following frenulotomy may be a response to the pain associated with the procedure rather than a result of the procedure itself. While there are almost certainly some infants in whom tongue-tie interferes with breast-feeding, there is currently no good evidence lingual frenulotomy leads to longer duration of breast-feeding. Frenulotomy appears to be a generally safe procedure however there are reports of serious complications. Finally, there are no studies of long-term outcomes following frenulotomy during infancy and given traditional thinking that the lingual frenulum is a cord of connective tissue tethering the tongue to the floor of the mouth may be incorrect and the frenulum contains motor and sensory branches of the lingual nerve, the procedure may be less benign than previously thought.

Ankyloglossia (tongue-tie) is a condition of the oral cavity in which an abnormally short lingual frenulum affects the tongue's mobility. Literature on the correlation between ankyloglossia and obstructive sleep apnea (OSA) is scarce. The main objective of this study was to report our preliminary experience in adult OSA patients before and after ankyloglossia treatment, using drug-induced sleep endoscopy (DISE) to evaluate the upper airway modifications resulting after treatment, and to present a systematic review of the impact of ankyloglossia and its treatment on OSA adults. We found that, after frenotomy, regarding the DISE findings, and according to the VOTE classification, two of the three patients showed an improvement in tongue level, from 2A-P (complete anteroposterior collapse) to 1ap (partial anteroposterior collapse). The third patient showed no changes in his UA after frenotomy, neither worsening nor showing improvement. Thus, the results of this study suggest that frenotomy in OSA patients with ankyloglossia could reduce tongue collapse, probably by allowing the tongue to take into the physiological position in the oral cavity. These patients should undergo speech therapy and oropharyngeal exercises prior to any surgical procedure, in order to avoid glossoptosis and to improve the quality of life and sleep apnea results. [ABSTRACT FROM AUTHOR]

The lingual frenulum is a submucosal component significantly involved in the mobility of the tongue. In the case of short lingual frenulum, different surgical approaches have been proposed. Atmospheric plasma is a thermal technique of vaporization or sublimation of the superficial tissues, without going deep, and the resulting fine carbonized layer avoids bleeding. The aim of the present investigation was to evaluate the effectiveness of atmospheric plasma (voltaic arc dermabrasion) for the frenectomy of a short lingual frenulum. A total of 30 patients with an age range between 6–11 years old and a class III/IV Kotlow's ankyloglossia classification were included in the study. The Kotlow's free-tongue, maximal interincisal mouth opening (MIO, mm) and interincisal mouth opening with tongue tip to maxillary incisive papillae at roof of mouth (MOTTIP, mm) were calculated at the baseline, immediately postoperatively (T0), at one week (T1), one month (T2) and two months (T3). A significant increase of Kotlow's measurements, MOTTIP and MIO were detected when comparing the baseline and the T0 (p < 0.05). No significant difference was detected between the T0, T1 and T2 (p > 0.05). The atmospheric plasma demonstrated a very minimal invasive approach for frenectomy, without important or fibrotic complications and with very low recurrence rates. [ABSTRACT FROM AUTHOR]

Brief Background Tongue-tie or ankyloglossia is a rare congenital anomaly. It is a short, thick, and fibrosed lingual frenulum which causes restriction in function of the tongue and also in speech. For its management laser has some advantages over other techniques like less operative time, haemostasis, less postoperative complications. Results Uneventful healing was observed in 7 days as laser is less invasive, resulting in better healing. Summary and Conlusions Tongue being highly vascular and mobile structure, laser-assisted lingual frenectomy is the simplest, safest and less traumatic of all the treatment modalities available. [ABSTRACT FROM AUTHOR]

It is necessary to treat neonatal pain because it may have short- and long-term adverse effects. Frenotomy is a painful procedure where sucking, a common strategy to relieve pain, cannot be used because the technique is performed on the tongue. In a previous randomized clinical trial, we demonstrated that inhaled lavender essential oil (LEO) reduced the signs of pain during neonatal frenotomy. We aimed to find out whether inhaled vanilla essential oil (VEO) is more effective in reducing pain during frenotomy than LEO. Randomized clinical trial with neonates who underwent a frenotomy for type 3 tongue-ties between May and October 2021. Pain was assessed using pre and post-procedure heart rate (HR) and oxygen saturation (SatO2), crying time, and NIPS score. Neonates were randomized into "experimental" and "control" group. In both groups, we performed swaddling, administered oral sucrose, and let the newborn suck for 2 min. We placed a gauze pad with one drop of LEO (control group) or of VEO (experimental group) under the neonate's nose for 2 min prior to and during the frenotomy. We enrolled 142 neonates (71 per group). Both groups showed similar NIPS scores (2.02 vs 2.38) and crying times (15.3 vs 18.7 s). We observed no differences in HR increase or in SatO2 decrease between both groups. We observed no side effects in either of the groups.Conclusions: We observed no appreciable difference between LEO and VEO; therefore, we cannot conclude which of them was more effective in treating pain in neonates who underwent a frenotomy.Trial Registration:  This clinical trial is registered with www.Clinicaltrials: gov with NCT04867824.What Is Known: • Pain management is one of the most important goals of neonatal care as it can have long-term neurodevelopmental effects. • Lavender essential oil can help relieve pain due to its sedative, antispasmodic, and anticolic properties.What Is New: • Lavender and vanilla essential oils are safe, beneficial, easy to use, and cheap in relieving pain in neonates who undergo a frenotomy for type 3 tongue-ties. [ABSTRACT FROM AUTHOR]

Objectives: Frenotomy is performed in breast fed infants who experience difficulty in latching after failed conservative management for ankyloglossia or tongue-tie. Though parents sometimes enquire about massage after frenotomy, neither published evidence nor clinical consensus supports this. The aim of our study was to assess if there was significant difference in breast feeding or recurrence rate between those infants who had post frenotomy massage and those who did not. Methods: A retrospective study was conducted in a tertiary Children's hospital from January 2018 to December 2018. The tongue-tie service consisted of five pediatric surgical consultants, three of whom routinely advice post frenotomy massage. As a result, we had two groups to compare -massage and non-massage group. Total sample size (n = 599) consisted of those who were advised massage (n = 282) and those who were not advised massage (n = 317). Results: Overall recurrence rate was 4/599 (0.66%) and this did not achieve statistical significance between the two groups. Breast feeding rates were also similar in both the groups. However, it is interesting to note that only 43.5% of those advised massage adhered to the massage regimen. Conclusions: Improvement in breast feeding and recurrence after frenotomy were similar between massage and non-massage groups. This confirms the lack of any additional benefit of post frenotomy massage. This study assists clinicians with decision making not to advise massage as it is unlikely to benefit infants with tongue-tie. [ABSTRACT FROM AUTHOR]

[1] Background: Congenital superficial ranulas (CSR) are very uncommon entities in neonates, corresponding to 0.74% in contrast to lingual frenulum alterations ranging from 2.8 to 10.7%. Both anomalies should be appropriately diagnosed and treated [2]. Methods: This paper introduces the case of an 8-week infant with CSR and short lingual frenulum, successfully managed by surgical marsupialization during a frenotomy procedure. After the comprehensive oral examination, we have identified the primary cause of feeding issues. Ranula was diagnosed by classic clinical presentation, ultrasound, and presence of typical mucous during the surgical management [3]. Results: The healing was uneventful, and we did not observe recurrence during the 6-month follow-up. Post-surgery, the infant could breastfeed easily [4]. Conclusion: CSR in case of concomitant ankyloglossia should be identified and surgically treated by marsupialization in the first 6 months before transitioning to solid food.

Background: Neonatal pain may affect long-term neurodevelopment and must be treated. Frenotomy is a painful procedure wherein a common strategy to relieve pain (sucking) cannot be used because the technique is performed on the tongue. Lavender essential oil (LEO) has sedative and antispasmodic properties and has been successfully used to treat pain during heel puncture and vaccination. Our aim was to demonstrate if the use of inhaled LEO is effective in reducing pain during frenotomy in healthy, full-term neonates. Methods: We conducted a randomized clinical trial in neonates who underwent a frenotomy between August 2020 and April 2021. We assessed pain using pre and post-procedure heart rate and oxygen saturation, crying time and Neonatal Infant Pain Scale (NIPS) score. Patients with type 3 tongue tie were randomized into the "experimental group" and "control group". In both groups, we performed swaddling, administered oral sucrose, and let the newborn suck for two minutes. In the experimental group, we also placed a gauze pad with one drop of LEO under the neonate's nose for two minutes prior to and during the frenotomy. Results: We enrolled 142 patients (71 per group). The experimental group showed significantly lower NIPS scores (1.88 vs 2.92) and cried almost half the amount of time (14.8 vs. 24.6 seconds, P = 0.006). Comparing with the control group, we observed no side effects in either of the groups. Conclusions: We observed a significant decrease in crying time and lower NIPS scores in the neonates who received inhaled LEO and underwent a frenotomy for type 3 tongue-ties. Thus, we recommend using inhaled LEO during neonatal frenotomies. [ABSTRACT FROM AUTHOR]

While recent decades have seen a rapid rise in cases of infant tongue-tie and in surgery to correct it, a controversy is now raging over the condition. Opinion is especially divided over so-called posterior tongue-tie, a variant which is detected based on the "feel" of the sub-lingual space. Drawing on ethnographic research with clinicians in England, we clarify the professional and personal commitments involved in the controversy. Our analysis is informed by Douglas' theory of cultural representations (grid-group theory), in which ideas of what is natural and unnatural constitute central metaphors. [ABSTRACT FROM AUTHOR]

Ankyloglossia is an abnormal congenital condition of the tongue characterized by abnormal attachment of lingual frenum or shorter lingual frenulum. Although various conventional surgical modalities and lasers for frenectomy has been described in literature, only few articles have been reported in the existing literature regarding the diode laser of 808 nm wavelength for frenectomy procedure in pediatric patient. Hence, the current article describes the clinical case report of successful and effective treatment of ankyloglossia using soft-tissue diode laser of 808 nm wavelength with minimally invasive dentistry approach in a 10-year-old male pediatric patient. In addition, the tongue-tie was clinically evaluated using the Hazelbaker Assessment Tool for Lingual Frenulum Function. Diode lasers can be used as a safe alternative surgical tool for managing tongue-tie with minimally invasive dentistry approach and also for alleviating the dental anxiety in pediatric patients. [ABSTRACT FROM AUTHOR]

Ankyloglossia, commonly known as tongue-tie, is the most common disorder of tongue morphology characterized by aberrant attachment of the lingual frenum. This study aimed to provide a comprehensive literature review and evaluate the effectiveness of various laser wavelengths in the surgical treatment of patients with ankyloglossia. An electronic screening of PubMed and the Cochrane Central Register of Controlled Trials (CENTRAL) databases was conducted on 8 November 2021. The following search terms were used to review the available data on the subject of interest: (ankyloglossia OR tongue tie OR short lingual frenulum OR lingual frenectomy OR lingual frenulectomy OR lingual frenotomy OR lingual frenulotomy) AND laser. The use of lasers in ankyloglossia treatment resulted in shorter procedure time, reduced indications for general anesthesia, reduced administration of postoperative analgesics, fewer sutures or none needed, reduced postoperative bleeding, and improved healing. Despite many advantages, this method has its clinical limitations: it requires the use of expensive equipment; well-trained personnel familiar with lasers; and personal protective equipment for the patient, caregiver, operator, and assistant. The laser procedure does not eliminate the need for myofunctional exercises and work with a speech therapist. [ABSTRACT FROM AUTHOR]

Introduction: Tongue-tie is a congenital condition of a thickened, tightened or shortened frenulum. This condition may cause breastfeeding difficulties to both mother and infant, such as ineffective suckling and painful nipple. In older children, it can cause speech difficulties. Although many studies have investigated the problems associated with tongue-tie and its treatments, there are limited studies on the mother's experiences of tongue-tie and post frenotomy. This study aimed to explore the mother's experiences of tongue-tie associated problems, frenotomy and the outcome. Methods: In-depth interviews were conducted in a one-on-one setting with fifteen mothers whose infant and children underwent frenotomy. Data were collected, transcripted, translated and analysed according to themes. Results: The analysis revealed a common story of stressful challenges and difficulties of breastfeeding. The mothers described that tongue-tie caused poor latching, nipple pain and bleeding, prolong feeding and lack of sleep. Their infant had poor weight gain, sleeping problems, insufficient milk transfer, fatigue and constant crying. For the older children, mothers complained of restricted tongue movement, difficulty in licking ice cream and speech problems. All of them agreed that the frenotomy procedure was easy, simple and less invasive and the outcome was positive. Furthermore, mothers continued breastfeeding without any difficulties and complications. Conclusion: Mothers in this study had difficulties with breastfeeding. However, all of the reported symptoms improved after frenotomy. They considered frenotomy was a simple and safe procedure that was highly recommended for symptomatic tongue-tie. [ABSTRACT FROM AUTHOR]

Aim: Ankyloglossia is a common congenital malformation characterized by a short, thick, or tight tongue frenulum, and its effect on speech articulation remains controversial. This study aimed to evaluate (a) the association between ankyloglossia and speech disorders, and (b) the effectiveness of surgical interventions on the articulation of patients with ankyloglossia. Material and Methods: A comprehensive search of PubMed was conducted. Randomized control trials (RCTs), cohort studies, case‐control studies, and case series with more than five cases were included. Result: Of the 16 included studies, except for one cross‐sectional study, all studies were small in sample size. The evidence quality was generally low, with an average of 3.88 in a 7‐point system. Three studies investigated the occurrence of speech disorders in the ankyloglossia population and obtained different results. Fifteen studies assessed the effectiveness of surgery, among which eight self‐control studies observed significant postoperative improvement, whereas three of four cohort studies with untreated controls reported no significant differences. Three RCTs compared surgical techniques and one pointed out the advantage of frenuloplasty over frenulotomy. Conclusion: There was no clear connection between ankyloglossia and speech disorders. More widely accepted uniform grading systems and well‐designed clinical studies are needed. [ABSTRACT FROM AUTHOR]

Tongue is an important oral structure that affects speech, position of teeth, periodontal tissue, nutrition, swallowing, nursing, and certain social activities. Tongue-tie or ankyloglossia is a developmental anomaly of the tongue, characterized by an abnormally short, thick lingual frenulum resulting in limited tongue movement. Diagnosis must include functional assessment of tongue mobility, in addition to the physical appearance of the frenulum. Tongue mobility and appearance associated with the insertion, as well as the attachment and the shortness of the lingual frenulum should be evaluated. Ankyloglossia management should be considered at any age considering the risk-benefit evaluation and because of the highest vascularization and mobility of the tongue. Lingual frenuloplasty for the management of ankyloglossia in children is being discussed in the form of case series.

Purpose: To evaluate the effectiveness of lingual frenectomy, as a standalone treatment or in association with myofunctional therapy, on the general and functional aspects of six- to 12-year-old children with anomalies in the lingual frenulum. Methods: This randomized controlled clinical trial involved 40 children diagnosed with altered lingual frenulum. Children who received a frenectomy were evaluated 15 and 30 days after the procedure. After 15 days, the children were randomized into two groups: a group that received isotonic tongue exercises (Study Group [SG]) and a group that did not receive isotonic tongue exercises (Control Group [CG]). The outcome evaluator was blinded to group assignment. Statistical tests were used to compare between and within groups (P<0.05). Results: There were 20 children in each group. SG children improved significantly when compared to CG subjects regarding tongue mobility (P=0.016), maximum mouth opening (MMO; P=0.024), and MMO with the tip of the tongue touching the incisive papilla (P=0.026). Conclusion: Frenectomy associated with myofunctional therapy benefitted tongue mobility. [ABSTRACT FROM AUTHOR]

It is widely accepted that neonatal tongue-tie can contribute to breastfeeding problems including maternal nipple pain and trauma. However, lack of consensus continues regarding the diagnosis and management of tongue-tie, reflecting the ongoing knowledge gaps and lack of evidence. This case report describes the experience of a breastfeeding mother whose first child was diagnosed with tongue-tie. [ABSTRACT FROM AUTHOR]

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.

The lingual frenulum is a submucosal component significantly involved in the mobility of the tongue. In the case of short lingual frenulum, different surgical approaches have been proposed. Atmospheric plasma is a thermal technique of vaporization or sublimation of the superficial tissues, without going deep, and the resulting fine carbonized layer avoids bleeding. The aim of the present investigation was to evaluate the effectiveness of atmospheric plasma (voltaic arc dermabrasion) for the frenectomy of a short lingual frenulum. A total of 30 patients with an age range between 6–11 years old and a class III/IV Kotlow’s ankyloglossia classification were included in the study. The Kotlow’s free-tongue, maximal interincisal mouth opening (MIO, mm) and interincisal mouth opening with tongue tip to maxillary incisive papillae at roof of mouth (MOTTIP, mm) were calculated at the baseline, immediately postoperatively (T0), at one week (T1), one month (T2) and two months (T3). A significant increase of Kotlow’s measurements, MOTTIP and MIO were detected when comparing the baseline and the T0 (p < 0.05). No significant difference was detected between the T0, T1 and T2 (p > 0.05). The atmospheric plasma demonstrated a very minimal invasive approach for frenectomy, without important or fibrotic complications and with very low recurrence rates.

Background: Surgical intervention for tongue-tie, or ankyloglossia performed by paediatric dentists can alleviate symptoms and improve functional abilities in infants and children. Despite widespread practice, there are currently no established clinical guidelines or consistent approaches for pre- and post-operative care of children., Aim: The aim of this study was to explore approaches to pre- and post-operative care for children with ankyloglossia having frenum surgery., Design: A scoping review of peer-reviewed articles in four electronic databases was conducted. Intervention studies that reported on pre- or post-operative regimens for infants, children and adolescents (0 to 18 years) with a diagnosis of tongue-tie or ankyloglossia, who had surgical intervention such as frenotomy or frenectomy, were included and quality assessments performed., Results: Twenty-three studies were identified, with seven studies incorporating both pre- and post-operative care, and 16 studies focussing solely on post-operative care. Tongue exercises were commonly prescribed, and only three studies examined the relationship between post-operative care and recovery outcomes. Considerable variability existed in study design, prescribed care and outcome measures., Conclusion: There was substantial variability in pre- and post-operative care protocols, including dosage, frequency and duration of exercises and other care regimens for infants and children having frenum surgery. Further research is needed to determine the most effective course of pre- and post-operative care for children undergoing frenum surgery., (© 2024 The Author(s). International Journal of Paediatric Dentistry published by BSPD, IAPD and John Wiley & Sons Ltd.)

Ankyloglossia, which is a congenital condition also referred to as tongue-tie, is described as a small lingual frenum that restricts tongue movement and its function. The main purpose of the frenum is to restrict the movement of the cheek, lip muscles, and tongue throughout the development of fetuses and maintain equilibrium between the developing bones, lip musculature, and tongue. The constriction of the buccal musculature counteracts the outward pressure that the tongue applies to the teeth. Arch width maintenance requires a state of equilibrium between these two muscle groups. Therefore, altering tongue position might additionally have an impact on a mandible's position. A 20-year-old female patient presented to the Periodontics Department with moderate ankyloglossia (Kotlow Class II). For the correction of the tongue-tie, conventional surgery with sutures was scheduled under local anesthesia. One week, one month, and three months follow-up, the patient demonstrated good healing. There was an improvement in speech clarity and tongue movements., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Sawai et al.)

Ankyloglossia (tongue-tie) is a condition of the oral cavity in which an abnormally short lingual frenulum affects the tongue’s mobility. Literature on the correlation between ankyloglossia and obstructive sleep apnea (OSA) is scarce. The main objective of this study was to report our preliminary experience in adult OSA patients before and after ankyloglossia treatment, using drug-induced sleep endoscopy (DISE) to evaluate the upper airway modifications resulting after treatment, and to present a systematic review of the impact of ankyloglossia and its treatment on OSA adults. We found that, after frenotomy, regarding the DISE findings, and according to the VOTE classification, two of the three patients showed an improvement in tongue level, from 2A-P (complete anteroposterior collapse) to 1ap (partial anteroposterior collapse). The third patient showed no changes in his UA after frenotomy, neither worsening nor showing improvement. Thus, the results of this study suggest that frenotomy in OSA patients with ankyloglossia could reduce tongue collapse, probably by allowing the tongue to take into the physiological position in the oral cavity. These patients should undergo speech therapy and oropharyngeal exercises prior to any surgical procedure, in order to avoid glossoptosis and to improve the quality of life and sleep apnea results.

Tongue-tie is a continuation of the lingual frenum that is attached to the tip of the tongue. It is a congenital oral anomaly that could restrict tongue movements, caused by a lingual frenum a membrane that originates from the floor of the mouth to the bottom of the tongue that is too thick and short, which limits the natural ability of the tongue to move and function. The tongue is an auxiliary organ that facilitates speaking, mastication, and deglutition. This condition may result in several difficulties including chewing, breastfeeding, speech, and pronunciation of particular words, as well as possessing social and mechanical consequences. Ankyloglossia can be seen in young age groups. The use of lasers has increased in dentistry in recent years. However, in oral and maxillofacial surgery, the use of lasers has been largely restricted to soft tissues, and less focus is placed on the use of hard tissues. Carbon dioxide (CO 2 ) lasers, erbium-doped yttrium aluminum garnet (Er: YAG) lasers, and Er, the erbium, chromium: yttrium: scandium gallium-garnet (Cr: YSGG) lasers are among the several types of lasers that have been utilized in dentistry for correction of soft tissues as well as for hard tissues., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Rakhunde et al.)

Background: Ankyloglossia or tongue-tie is a congenital oral anomaly with short, tight, and thick lingual frenulum. It may be asymptomatic or can cause movement limitations of the tongue, speech and articulation difficulties, breastfeeding difficulties in neonates, as well as periodontal and malocclusion problems. The etiopathogenesis of ankyloglossia is unknown; it can occur either as a sole anomaly in the vast majority or in association with other craniofacial anomalies. Objectives: The aims of this paper were (1) to provide a comprehensive review on the criteria for clinical assessment and diagnosis, etiology and inheritance, and the therapeutic options of ankyloglossia; and (2) to demonstrate the treatment of ankyloglossia by means of frenuloplasty in three cases. Review: The available evidence from the literature indicates that among neonates, children, and adults the prevalence of ankyloglossia is low and in some cases remains undiagnosed. The early clinical assessment, diagnosis, and treatment are beneficial for the patients and their mothers. Conclusions: Frenuloplasty is a safe, quick, effective, and economical method and for this reason the parents should not hesitate towards frenulum release. More clinical studies are needed to confirm the benefits of the surgical interventions and to compare the results with those obtained using nonsurgical therapy or with untreated cases. [ABSTRACT FROM AUTHOR]

Tongue is an important oral structure that affects speech, position of teeth, periodontal tissue, nutrition, swallowing, nursing, and certain social activities. Tongue-tie or ankyloglossia is a developmental anomaly of the tongue, characterized by an abnormally short, thick lingual frenulum resulting in limited tongue movement. Diagnosis must include functional assessment of tongue mobility, in addition to the physical appearance of the frenulum. Tongue mobility and appearance associated with the insertion, as well as the attachment and the shortness of the lingual frenulum should be evaluated. Ankyloglossia management should be considered at any age considering the risk-benefit evaluation and because of the highest vascularization and mobility of the tongue. Lingual frenuloplasty for the management of ankyloglossia in children is being discussed in the form of case series. [ABSTRACT FROM AUTHOR]

Maximum tongue strength, mean swallow pressures, and tongue endurance were measured in 324 children ages 6–12 years. The purpose of this study was to measure saliva swallow pressures in absolute terms (i.e., kilopascals) and as a percentage of maximum tongue strength to determine functional reserve in across ages in children and to examine factors that may influence tongue strength and swallow pressures including age, tongue endurance, and tongue-tie. The study results showed that maximum tongue strength and swallow pressures increased with age, while tongue endurance did not. Swallow pressures averaged 44% of maximum tongue strength across ages, indicating that children typically have a functional reserve of 56%. Tongue strength and swallow pressures were not decreased in the 20 children with tongue-tie. A sample clinical case is discussed. [ABSTRACT FROM AUTHOR]

Background and Objectives: Ankyloglossia is a functional term describing limitations of motor activity of the tongue due to the embryological malformation of the lingual frenulum. The lingual frenulum has a complex, three-dimensional structure, it is not only a mucosal fold, which connects the ventral surface of the tongue and the floor of the mouth. Such knowledge forced us to develop more advanced techniques for tongue release in ankyloglossia. The aim of this study is to describe a novel, precise surgical technique for tongue release. Materials and Methods: Miofrenuloplasty was performed in six patients with impaired tongue movements due to anatomical limitations. All of them were prepared for surgery and evaluated after the procedure by a speech therapist. Results: The healing process was uneventful in all patients. We did not observe any major complications. Tongue mobility and neck muscle tension improved significantly in all cases. In one case, the speech improvement was minor. Conclusions: Miofrenuloplasty is an advanced, but effective and highly predictable procedure for full functional tongue release in cases caused by MFGG complex. It should be done by experienced surgeon. [ABSTRACT FROM AUTHOR]

Ankyloglossia or tongue-tie is the result of a short, tight, lingual frenulum causing difficulty in speech articulation due to limitation in tongue movement. In this article, we have reported a 22-year-old male with tongue-tie who complained of difficulty in speech following which he underwent frenectomy procedure under local anesthesia without any complications. Finally, he was given speech therapy sessions. [ABSTRACT FROM AUTHOR]

Background: A functional definition of ankyloglossia has been based on assessment of tongue mobility using the tongue range of motion ratio (TRMR) with the tongue tip extended towards the incisive papilla (TIP). Whereas this measurement has been helpful in assessing for variations in the mobility of the anterior one‐third of the tongue (tongue tip and apex), it may be insufficient to adequately assess the mobility of the posterior two‐thirds body of the tongue. A commonly used modification is to assess TRMR while the tongue is held in suction against the roof of the mouth in lingual‐palatal suction (LPS). Objective: This study aims to explore the utility and normative values of TRMR‐LPS as an adjunct to functional assessment of tongue mobility using TRMR‐TIP. Study Design: Cross‐sectional cohort study of 611 subjects (ages: 3‐83 years) from the general population. Methods: Measurements of tongue mobility using TRMR were performed with TIP and LPS functional movements. Objective TRMR measurements were compared with subjective self‐assessment of resting tongue position, ease or difficulty elevating the tongue tip to the palate, and ease or difficulty elevating the tongue body to the palate. Results: There was a statistically significant association between the objective measures of TRMR‐TIP and TRMR‐LPS and subjective reports of tongue mobility. LPS measurements were much more highly correlated with differences in elevating the posterior body of the tongue as compared to TIP measurements (R2 0.31 vs 0.05, P <.0001). Conclusions: This study validates the TRMR‐LPS as a useful functional metric for assessment of posterior tongue mobility. [ABSTRACT FROM AUTHOR]