ABSTRACT
Introdução:A anquiloglossia é caracterizada pela alteração do frênulo lingual resultando na restrição dos movimentos da língua. A avaliação do frênulo lingual em neonatos é importante para diagnosticar precocemente essa alteração. Objetivo:Traçar perfil de serviços que realizam avaliação do frênulo lingual em neonatos nos hospitais e maternidades públicas do estado do Rio Grande do Norte. Metodologia:Trata-se de um estudo observacional, descritivo e transversal, com abordagem quantitativa. Foram incluídos na pesquisa as maternidades públicas e filantrópicas do estadoque realizam procedimentos obstétricos e assistência materno-infantil. As informações acerca da avaliação do frênulo lingual em neonatos e caracterização desses serviços foram coletadas por meio de um questionário eletrônico. Os dados foram armazenados em planilhas no Excel e analisados através do programa estatístico SPSS versão 23.0, em queforam conduzidas análises das variáveis investigadas.Resultados:Participaram do estudo 23 hospitais e maternidades públicas do estado, econstatou-se que apenas 7 (30,44%) ofertam a avaliação do frênulo lingual em neonatos no próprio estabelecimento, enquantoas demais encaminham para outros serviços. O exame foi implantado nas maternidades entre os anos de 2014 e 2018. A quantidade de profissionais que realizam esta avaliação variou entre 1 e 9 por instituição, e os profissionais envolvidos foram os fonoaudiólogos e cirurgiões-dentistas. A prevalência da anquiloglossia variou de 3,7% a 14,5%. A maioria das maternidades realizam a frenotomia e o profissional que executa é o médico ou cirurgião-dentista.Conclusões:Constatou-se uma baixa oferta da avaliação do frênulo lingual em neonatos no próprio estabelecimento de nascimento. Além disso, essa oferta ainda não acontece de forma universal, principalmente no interior do estado (AU).
Introduction:Ankyloglossia is characterized by alterations in the lingual frenulum resulting in restricted tongue movements. Assessing the lingual frenulum in newborns is important for early diagnosis of this disorder. Objective:Describe the profile of health servicesthat assess the lingual frenulum of newborns in public and maternity hospitals of Rio Grande do Norte state. Methodology:This is a cross-sectional descriptive study using a quantitative approach. Included in the research were public and philanthropic maternity hospitals in statethat perform obstetric procedures and provide maternal and child care. The information about lingual frenulum assessment in newborns and characterization of these health services was collected via an electronic questionnaire. The data were stored in Excel spreadsheets and analyzed using the SPSS version 23.0 program, where analyses of the variables investigated were carried out. Results:A total of 23 public and maternity hospitalsparticipated, only 7 of which (30.44%) assessed the lingual frenulum of newborns on site, while the others referred them to other medical facilities. The examination was implemented in maternity hospitals between 2014 and 2018. The number of professionals who performed this assessment varied between 1 and 9 per institution, and included speech therapists, and dentists. The prevalence of ankyloglossia ranged from 3.7 to 14.5%. Most of the maternity hospitals performed frenotomy, where the procedure was conducted by a doctor or dentist. Conclusions:On-site lingual frenulum assessment of newborns was low in the institutions, and does not occur universally, mainly in the rural areas of the state (AU).
Introducción: La anquiloglosia se caracteriza por la alteración del frenillo lingual que resulta en la restricción de los movimientos de la lengua. La evaluación del frenillo lingual en neonatos es importante para un diagnóstico precoz de este trastorno.Objetivo: Delinear un perfil de servicios que realizanevaluación del frenillo lingual en neonatos en hospitales públicos y maternidades del estado de Rio Grande do Norte.Metodología: Se trata de un estudio observacional y transversal con enfoque cuantitativo. Se incluyeron en la investigación las maternidades públicas y filantrópicas del estadoque realizan procedimientos obstétricos y de atención materno-infantil. La información sobre la evaluación del frenillo lingual en neonatos y la caracterización de estos servicios fui recogido por medio de un cuestionario electrónico. Los datos fueron almacenados en hojas Excel y analizados utilizando el programa estadístico SPSSversión 23.0, donde se realizaron análisis de las variables investigadas. Resultados: Un total de 23 hospitales públicos y maternidades participaron del estudio, en el que se constató que solo 7 (30,44%) evalúan el frenillo lingual en neonatos en establecimiento propio, mientras los demás refieren a otros servicios. El examen se implementó en las maternidades entre 2014 y 2018. El número de profesionales que realizan esta evaluación varió entre 1 y 9 por institución, y los profesionales involucrados fueron terapeutas del habla y odontólogos. La prevalencia de anquiloglosia varió entre 3,7 y 14,5 %. La mayoría de las maternidades realizan la frenotomía y el profesional que la realiza es el médico u odontólogo. Conclusiones: Hubo una baja oferta de avaluación del frenillo lingual en neonatos en el propio establecimiento. Además, esta oferta aún no es universal, especialmente en el interior del estado (AU).
Subject(s)
Humans , Male , Female , Infant, Newborn , Health Profile , Infant, Newborn , Ankyloglossia/surgery , Hospitals, Maternity , Lingual Frenum/surgery , Brazil/epidemiology , Cross-Sectional Studies/methods , Surveys and Questionnaires/statistics & numerical data , Observational Studies as Topic/methods , Health Services ResearchABSTRACT
Objetivo: o objetivo do presente estudo foi realizar uma revisão narrativa de literatura sobre a anquiloglossia em bebês, apresentando os critérios para diagnóstico, implicações na amamentação e formas de tratamentos. Fontes dos dados: foram realizadas, em abril de 2022, buscas nas bases de dados PubMed e Scielo, considerando artigos publicados entre os anos 1990 e 2022. Foram utilizadas como palavras-chave: frenectomy; babies; ankyloglossia; breastfeeding. A seleção dos trabalhos foi realizada através da leitura dos títulos e dos resumos. Após a aplicação dos critérios de inclusão e exclusão, 27 artigos foram selecionados, sendo eles pesquisas originais, relatos de caso e revisões de literatura. Livros textos nacionais também foram utilizados. Síntese dos dados: apesar de não existir um teste para diagnóstico considerado padrão-ouro, a triagem neonatal para investigação de anquiloglossia é uma obrigatoriedade nas maternidades de todo o país. Os testes para diagnóstico mais utilizados no Brasil são "Teste da Linguinha" e de Bristol. Não foram encontradas evidências científicas que relacionem a frenotomia e/ou frenectomia à melhora da amamentação. A abordagem multidisciplinar abrangendo dentistas, fonoaudiólogos, pediatras, consultores de amamentação, otorrinolaringologistas, cirurgiões e outros profissionais capacitados, deve ser considerada para delinear a melhor conduta clínica. Dentre as técnicas cirúrgicas, a frenotomia em bebês mostra-se como sendo a mais segura por apresentar menos riscos de complicações transoperatórios e pós-cirúrgica. Conclusão: faz-se necessário a realização de estudos controlados e com baixo viés metodológico sobre diagnóstico, tratamento e impactos da anquiloglossia na amamentação para padronizar e nortear a conduta clínica da equipe multidisciplinar responsável pelo binômio mãe-bebê no período puerperal.
Objective: the aim was to conduct a narrative literature review on ankyloglossia in infants, presenting the criteria for diagnosis, implications on breastfeeding, and treatment options. Sources of data: a search was conducted in PubMed and Scielo databases, considering articles published between 1990 and 2022 in April 2022. The key words used were: frenectomy; babies; ankyloglossia; breastfeeding. The selection of the papers was made through the title and by reading the abstracts. After applying the inclusion and exclusion criteria, 27 articles were selected, which were original research, case reports and literature reviews. National textbooks were also used. Synthesis of data: there is no test for diagnosis considered gold standard, neonatal screening for ankyloglossia investigation is a mandatory in maternity hospitals all over the country. The most used diagnostic tests in Brazil are the "Martinelli Test" and the "Bristol test". No scientific evidence was found relating frenotomy and/or frenectomy to improve breastfeeding. A multidisciplinary approach including dentists, speech therapists, pediatricians, breastfeeding consultants, otorhinolaryngologists, surgeons, and other trained professionals must be considered to outline the best clinical management. Among the surgical techniques, frenotomy in infants is the safest because it presents fewer risks of transoperative and post-surgical complications. Conclusion: it is necessary to carry out controlled studies with low methodological bias on diagnosis, treatment, and the impact of ankyloglossia on breastfeeding, to standardize and guide the clinical management of the multidisciplinary team responsible for the mother-baby binomial during the puerperal period.
Subject(s)
Infant , Ankyloglossia/diagnosis , Patient Care Team , Breast Feeding , Lingual Frenum/surgeryABSTRACT
Introduction: The World Health Organization (WHO) establishes that breast-feeding must be promoted, supported, and protected due to its benefits in maternal and child health and for the economic, environmental, family and community benefits it produces. Case Report: Ankyloglossia in the newborn can cause early cessation of breastfeeding. A clinical case of a 2-month-old baby, referred to the surgical team of the Dental Service of the Pereira Rossell Hospital Center, with difficulties in breastfeeding due to ankyloglossia is presented. Diagnosis and laser surgical treatment was performed. In the immediate postoperative period, there was an improvement, achieving breastfeeding without the aid of devices, and a progressive improvement during the month following the intervention occurred. Conclusion: Early diagnosis and timely intervention collaborate in the maintenance of lactation and in the progressive improvement of the process.
Introducción: La Organización Mundial de la Salud (OMS) establece que la lactancia materna debe ser promovida, apoyada y protegida por sus beneficios demostrados en la salud materno-infantil y por las ventajas económicas, ambientales, familiares y comunitarias que produce.Reporte de Caso: La anquiloglosia en el recién nacido puede provocar el abandono temprano de la lactancia. Se presenta un caso clínico de un bebe de 2 meses, derivado al equipo quirúrgico del Servicio Odontológico del Centro Hospitalario Pereira Rossell, por dificultades en el amamantamiento a causa de anquiloglosia. Se realizó el diagnóstico y tratamiento quirúrgico con láser. En el postoperatorio inmediato se registró una mejoría en el amamantamiento, logrando la lactancia sin intermediario y una mejoría progresiva en la praxis durante el mes siguiente a la intervención.Conclusión: El diagnóstico precoz y la intervención oportuna colaboran en el mantenimiento de la lactancia y en la mejora progresiva de la praxis.
Subject(s)
Humans , Male , Infant , Ankyloglossia/surgery , Lingual Frenum/surgery , Breast Feeding , Laser Therapy , LasersABSTRACT
El frenillo lingual corto, o anquiloglosia, puede generar problemas durante la lactancia con repercusión en el desarrollo del lactante, daño en el pezón de la madre y abandono precoz de la lactancia. Actualmente no existe homogeneidad en los criterios diagnósticos, lo que ocasiona tanto sobrediagnóstico como infradiagnóstico de esta alteración, con las consecuencias clínicas que ello conlleva. La dificultad en el abordaje radica en saber cuándo se trata de variantes anatómicas normales o de un frenillo lingual sin repercusión funcional, y cuándo los problemas de lactancia, que clásicamente se le atribuyen se deben realmente al frenillo. Alrededor del 50 % de los niños con frenillo lingual corto no presenta problemas de lactancia o estos se resuelven con apoyo y asesoramiento. En el resto de casos se puede recurrir a tratamiento quirúrgico. En este artículo se ha realizado una actualización de la clasificación y tratamiento de la anquiloglosia que permitirá a los profesionales un manejo adecuado de estos pacientes
Short frenulum, or ankyloglossia, may lead to breastfeeding problems, with an impact on infant development, nipple damage, and early abandonment of breastfeeding. There are currently no homogeneous diagnostic criteria, thus leading to both overdiagnosis and underdiagnosis and associated clinical consequences. The challenge to approach this condition lies in establishing whether it is a normal anatomical variation or a lingual frenulum without a functional impact and when breastfeeding difficulties which are typically attributed to it are actually caused by the frenulum. Approximately 50 % of ankyloglossia cases do not result in breastfeeding problems or these can be resolved with support and advice. Surgery may be proposed for the rest of the cases. This article offers an update on the classification and treatment of ankyloglossia, which will help health care providers to provide an adequate management to these patients
Subject(s)
Humans , Infant , Ankyloglossia/diagnosis , Ankyloglossia/therapy , Lingual Frenum/surgery , Breast Feeding , Health Personnel , Nipples/injuriesABSTRACT
Objetivo: Relatar dois casos clínicos de alteração de frênulo lingual em gemelares, com 10 anos de idade, ambas do sexo feminino, avaliadas nos aspectos anatômicos e funcionais da língua antes e 15 dias após a frenectomia. Relato de casos: Inicialmente, o odontopediatra realizou a anamnese com a mãe. Em seguida, as participantes foram submetidas à avaliação clínica odontológica e, posteriormente, foi realizada a avaliação fonoaudiológica do frênulo lingual. A avaliação fonoaudiológica foi realizada por meio do Protocolo de Avaliação do Frênulo da Língua, que foi aplicado antes e 15 dias após a frenectomia. As duas participantes apresentaram melhor desempenho em provas anatômicas após o procedimento cirúrgico. Entretanto, algumas alterações, principalmente ao elevar a língua, continuaram sendo observadas em uma das pacientes 15 dias após a frenectomia. Ademais, as duas participantes passaram a executar a maioria dos movimentos de língua com maior precisão. No que se refere à fala, somente a participante que apresentava um maior número de alterações fonéticas anteriores, permaneceu com algumas alterações na fala decorridos 15 dias da cirurgia. Discussão: Algumas dificuldades envolvendo mobilidade da língua e alterações na fala podem persistir após a realização da cirurgia, indicando a necessidade de intervenção fonoaudiológica específica. Conclusão: Ambos os casos apresentaram melhora no desempenho tanto nas provas anatômicas quanto funcionais após a frenectomia.
Aim: to report two clinical cases of alteration of the lingual frenulum in twins, aged 10 years, both female, evaluated in the anatomical and functional aspects of the tongue before and 15 days after the frenectomy. Case reports: Initially, the paediatric dentistry performed the anamnesis with the mother. Then, the participants were submitted to a dental clinical evaluation and, sub-sequently, the speech language pathologist evaluation of the lingual frenulum was performed. The speech language pathologist assessment was performed using the Tongue Frenulum Evaluation Protocol, which was applied before and 15 days after the frenectomy. Both participants performed better in anatomical tests after the surgical procedure. However, some changes, especially when elevating the tongue, continued to be observed in one of the patients 15 days after the frenectomy. In addition, the two participants started to perform most of the tongue movements with greater precision. About speech, only the participant who had a greater number of previous phonetic changes, remained with some speech disorders after 15 days of surgery. Discussion: Some di-fficulties involving mobility of the tongue and changes in speech may persist after surgery, indicating the need for specific speech therapy intervention. Conclusion:Both cases showed improvement in performance both in anatomical and functional tests after frenectomy
Subject(s)
Humans , Female , Child , Speech Disorders/rehabilitation , Lingual Frenum/surgery , AnkyloglossiaABSTRACT
ABSTRACT 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.
RESUMO Objetivo: avaliar a influência da frenotomia sobre a amamentação de recém-nascidos com diagnóstico de anquiloglossia. Método: trata-se de um estudo de intervenção realizado com 50 recém-nascidos com diagnóstico de anquiloglossia. Foi realizado em três etapas: diagnóstico, intervenção e reavaliação. Na fase diagnóstica, foram aplicados o Protocolo de Avaliação do Frênulo da Língua com Escores para Bebês para o diagnóstico de anquiloglossia e um questionário de avaliação dos sintomas e coordenação de sucção, deglutição e respiração durante a amamentação. Na intervenção, foi realizada a frenotomia e, na reavaliação, foram reaplicados o protocolo de diagnóstico e o questionário para comparação dos efeitos pós-cirúrgicos. Resultados: dos 50 bebês participantes do estudo, 35 (70%) eram do gênero masculino e 15 (30%) do gênero feminino. Foram relatados 68% dos casos de anquiloglossia na família, sendo primo (a) o grau de parentesco na maioria desses casos (38%). Houve redução estatisticamente significativa na média de pontuação no protocolo de 8,38 (7-12 pontos) para 0,86 (0-5 pontos), na etapa de reavaliação, assim como melhora estatisticamente significante em todas as variáveis relacionadas aos sintomas da amamentação. Conclusão: a intervenção cirúrgica, denominada frenotomia, possibilitou a melhora dos sintomas negativos da amamentação em neonatos com diagnóstico de anquiloglossia.
Subject(s)
Humans , Male , Female , Infant, Newborn , Infant , Ankyloglossia/surgery , Breast Feeding , Surveys and Questionnaires , Treatment Outcome , Lingual Frenum/surgeryABSTRACT
ABSTRACT Purpose Verify the position of lips and tongue at rest in newborns with and without ankyloglossia. Methods Cross-sectional study, carried out with 130 newborns in University Hospital. Data collection was performed by the researcher and speech-language pathologists from the Hospital. Information on gestational age, sex, weight, height and days of life was collected. The position of the lips and tongue at rest was evaluated through visual inspection with the newborns asleep. After the newborns were awakened, Neonatal Screening of the validated Protocol for the evaluation of the lingual frenulum for infants was performed to detect the alteration of the lingual frenulum. The data obtained were described and submitted to statistical analysis using the Chi-Square test to verify the association between the position of the lips with the tongue and to compare the position of the lips and tongue with and without ankyloglossia. The Mann-Whitney test was used to verify the behavior of the variables the differed between newborns with and without ankyloglossia. The significance level of 5% was adopted. Results When comparing the data, a significant difference was found between: weight and height with and without ankyloglossia; position of lips and tongue. An association between the position of the tongue and lips with and without ankyloglossia was also found. Conclusion Newborns without alteration of the lingual frenulum have a tendency to remain with their lips closed and their tongue elevated during rest and newborns with ankyloglossia have a tendency to keep their lips parted and their tongue low during rest.
RESUMO Objetivo Verificar a posição de lábios e língua no repouso em recém-nascidos com e sem anquiloglossia. Método Estudo transversal, realizado com 130 recém-nascidos em um Hospital Universitário. A coleta de dados foi realizada pela pesquisadora e por fonoaudiólogas do Hospital. Foi coletado informações sobre idade gestacional, sexo, peso, altura, dias de vida dos recém-nascidos. Foi avaliada a posição dos lábios e língua no repouso, com os recém-nascidos adormecidos, por inspeção visual. Após os recém-nascidos serem despertos, foi realizada Triagem Neonatal do Protocolo validado de avaliação do frênulo da língua em bebês, para detecção da alteração do frênulo lingual. Os dados obtidos foram descritos e submetidos à análise estatística através do teste Qui-Quadrado, para verificar a associação entre posição dos lábios com a língua e para comparar posição de lábios e língua com e sem anquiloglossia. O teste de Mann-Whitney foi utilizado para verificar o comportamento das variáveis que diferiam entre recém-nascidos com e sem anquiloglossia. Foi adotado o nível de significância de 5%. Resultados Houve diferença significativa entre: peso e altura com e sem anquiloglossia; entre posição de lábios e língua. Encontrou-se também associação entre posição de língua e de lábios com e sem anquiloglossia. Conclusão Os recém-nascidos sem alteração de frênulo lingual têm a tendência de permanecerem com os lábios fechados e a língua elevada durante o repouso, e recém-nascidos com anquiloglossia, têm a tendência de manterem os lábios entreabertos e a língua baixa durante o repouso.
Subject(s)
Humans , Female , Infant, Newborn , Infant , Ankyloglossia , Tongue , Breast Feeding , Cross-Sectional Studies , Lingual Frenum/surgery , LipABSTRACT
Abstract Objective: To compare intra- and post-operative consequences associated with Z-frenuloplasty and laser therapy for both upper labial and lingual frenulectomies. Material and Methods: Clinical data of 120 consecutive patients with a mean age of 11 years and 2 months (age range from 9 years and 1 month to 14 years and 3 months) with hypertrophic labial and lingual frenula were assembled. Of the 70 labial frenula, 35 were removed through Z-frenuloplasty (Group 1) and 35 with laser (Group 2); of 50 lingual frenula, instead, 25 were extracted through Z-frenuloplasty (Group 1A) and 25 with laser (Group 2A). The cutting device was Laser Diode Handy 10 in continuous mode. Finally, the time of the surgery, pain and swelling were measured 24-48 hours after the removal. VAS scale was used. Results: The time of the surgery, VAS score after the removal and the swelling were lesser in Group 2 and 2A. Conclusion: Both Z-frenuloplasty and Laser therapy are valid instruments to remove frenula. Moreover, laser offers more advantages like less use of anesthesia, no bleeding in the operating phase, no need for suturing, a faster tissue healing and minor limitations in speech and nutrition.
Subject(s)
Humans , Male , Female , Child , Adolescent , Minor Surgical Procedures , Surgery, Oral , Labial Frenum/surgery , Lingual Frenum/surgery , Child , Laser Therapy , Italy/epidemiologyABSTRACT
Objetivo: relatar uma série de casos clínicos de frenotomia lingual em bebês diagnosticados com anquilo-glossia pelo Teste da Linguinha. Relato de casos: cinco bebês, de 0 a 2 anos de idade, foram diagnosticados nas Unidade Básicas de Saúde e na Santa Casa de Misericórdia de Sobral, Ceará, com anquiloglossia mode-rada a severa. As mães relataram dificuldades de amamentação e engasgos das crianças. Os pacientes foram submetidos a procedimentos cirúrgicos de frenotomia lingual, que foram realizados na Universidade Federal do Ceará (UFC), Campus Sobral, no Grupo de Estudos em Odontopediatria (GEOP) do curso de graduação em Odontologia. As cirurgias foram realizadas com os pacientes conscientes e sob estabilização protetora. Foi administrada apenas anestesia tópica nos pacientes menores de 1 ano e anestesia infiltrativa naqueles com faixa etária maior que 1 ano. Em seguida, foi executado um pequeno corte na porção mediana do freio lingual e, quando necessário, realizada divulsão dos tecidos adjacentes. Ao final, foi feita a limpeza do local da cirurgia com a confirmação visual da efetiva liberação da língua. Por fim, as crianças receberam atestado e as mães, recomendações pós-cirúrgicas. Além disso, as crianças foram encaminhadas para consulta com o fonoaudiólogo e foram marcadas três consultas de retorno para o acompanhamento dos casos. Considera-ções finais: a frenotomia lingual mostrou-se uma técnica cirúrgica conservadora, eficaz e segura. Os bebês apresentaram excelentes resultados pós-operatórios e encontram-se em acompanhamento multiprofissional. (AU)
Objective: to report a series of clinical cases of lin-gual frenectomy in babies diagnosed with ankylo-glossia through the tongue test. Case Reports: five babies aged 0 to 2 years were diagnosed with moderate to severe ankyloglossia in Basic Health Units and in Santa Casa de Misericórdia do So-bral, Ceará, Brazil. The mothers of the children reported difficulties in breastfeeding and gagging. The patients were submitted to surgical procedu-res of lingual frenectomy, which were performed at the Federal University of Ceará (UFC), Cam-pus Sobral, in the Group of Studies in Pediatric Dentistry of the undergraduate dental course. The surgeries were performed with conscious patients under protective stabilization. Only topical anesthesia was administered in patients younger than 1 year and infiltrative anesthesia was used for those older than 1 year. Thereafter, a small cut was per-formed on the median portion of the lingual fre-nulum and, if necessary, divulsion of the adjacent tissues was performed. At the end, the surgical site was cleaned and the effective release of the tongue was confirmed visually. Finally, the chil-dren received medical certification and the mo-thers received postoperative recommendations. In addition, the children were referred to visits with a speech therapist and three follow-up ap-pointments were scheduled. Final considerations: lingual frenectomy proved to be a conservative, effective, and safe surgical technique. The babies presented excellent postoperative results and they are under multi-professional follow-up. (AU)
Subject(s)
Humans , Male , Female , Infant, Newborn , Infant , Child, Preschool , Ankyloglossia/surgery , Ankyloglossia/diagnosis , Lingual Frenum/surgery , Brazil , Treatment Outcome , Lingual Frenum/pathologyABSTRACT
Le frein de la langue est un repli muqueux qui relie le plancher de la bouche à la langue et qui empêche son recul. Il permet également de limiter les mouvements de celle-ci. Sa brièveté et ou son hypertrophie peuvent entraver la mobilité et par conséquent empêcher l'exécution correcte des nombreuses fonctions qui lui sont dévolues. Les pathologies du frein de la langue sont décelées pour la plupart, en bas âge, grâce à la vigilance des sages-femmes, des pédiatres et souvent des mères. L'objectif de la présente étude était de déterminer les motifs de consultation liés à cette pathologie et d'évaluer les résultats après le traitement. Patients et méthodes. Il s'agit d'une étude descriptive avec un rapport d'une série de cas observés sur une période de cinq ans (décembre 2008-Janvier 2013), dans le service d'odontostomatologie de l'hôpital national Ignace Deen de Conakry. Elle avait permis de recenser 51 patients. La mise en évidence clinique du frein pathologique a été le principal critère de sélection. Résultats Les patients avaient des âges compris entre 2 semaines et 50 ans et 70,58 % avaient des âges inferieurs à 1 an. Le principal motif de consultation était la difficulté à l'allaitement ainsi que la douleur mammaire lors de la succion. Le traitement chirurgical (freinectomie) a été réalisé chez tous les patients soit 100%. La correction du motif de la consultation a été favorable chez 60% de l'effectif. Conclusion. Les pathologies des freins de la langue sont une réalité pour dans notre pratique quotidienne. Les difficultés à l'allaitement, alertent souvent les parents. La freinectomie est le traitement de choix permettant la rémission des symptômes. La découverte précoce permet d'éviter la souffrance du nourrisson et de sa mère
Subject(s)
Guinea , Lingual Frenum/diagnosis , Lingual Frenum/surgery , Speech-Language PathologyABSTRACT
La aplicación del LÁSER (light amplification of stimulation emision of radiation) en las áreas de la medicina y la odontología viene demostrando una constante evolución, brindándonos alternativas a los tratamientos convencionales. Los láseres quirúrgicos de tejidos blandos muestran grandes ventajas comparados a los procedimientos habituales de corte, ya sea con bisturí frío o electrobisturí. La mínima necesidad de anestesia, la analgesia intra y postoperatoria, la coagulación inmediata, la cicatrización por segunda, el efecto bactericida, la ausencia de puntos de sutura, el confort postoperatorio, son algunas de las ventajas que hacen que la cirugía con láser sea una opción indiscutible que está ganando terreno entre los profesionales de la salud (AU)
Subject(s)
Humans , Female , Child , Electrosurgery/methods , Extraoral Traction Appliances , Lasers , Lingual Frenum/surgery , Malocclusion, Angle Class III/therapy , Patient Care Team , Argentina , Schools, Dental , Speech Therapy , Wound Healing , Palatal Expansion Technique , Treatment Outcome , Orthodontic Appliances, FunctionalABSTRACT
Abstract Given the growing trend towards medical indications for continuous use of anticoagulants, the number of patients on these medications continues to rise. The management of patients on oral anticoagulants requiring oral surgical procedures has aroused much controversy. Changes in an anticoagulation regimen are associated with an increased risk of thromboembolism. However, it seems logical and advantageous for the patients' health if surgery could be performed without any change to the anticoagulation therapy. In dentistry, high-power lasers have been poorly explored in this field. The hemostatic properties of high-power lasers could be helpful during oral soft tissue surgeries in anticoagulated patients. The aim of this study was to compare bleeding time in anticoagulated rats after lingual frenectomy performed with a scalpel or diode laser with bleeding time in healthy animals. Twenty-four male Wistar rats were assigned to four groups (n = 6): (CS) Control-Scalpel Surgery; (AS) Anticoagulated-Scalpel Surgery; (CL) Control-Laser (diode laser 810 nm/1.5 W) Surgery; and (AL) Anticoagulated-Laser Surgery (diode laser 810 nm/1.5 W). Warfarin administration was used to induce anticoagulation. Blood was blotted every 30 seconds with filter paper until bleeding stopped to verify bleeding time. Two blinded researchers performed the surgeries and collected the bleeding time data. Diode laser surgery led to complete hemostasis in rats during and after lingual frenectomy. Zero bleeding was assessed during surgeries and after diode laser surgeries in anticoagulated rats. Laser-induced hemostasis offered an alternative solution to the controversial issue of intraoperative and postoperative bleeding control in patients on anticoagulation therapy.
Subject(s)
Animals , Male , Blood Coagulation/radiation effects , Laser Coagulation/methods , Postoperative Hemorrhage/prevention & control , Lasers, Semiconductor/therapeutic use , Lingual Frenum/surgery , Thromboembolism , Warfarin/therapeutic use , Bleeding Time , Double-Blind Method , Reproducibility of Results , Risk Factors , Treatment Outcome , Rats, Wistar , Anticoagulants/therapeutic useSubject(s)
Humans , Adolescent , Child , Dental Care for Children/standards , Tooth Extraction/methods , Tooth Diseases/surgery , Oral Surgical Procedures/methods , Tooth Ankylosis/surgery , Surgery, Oral/methods , Decompression, Surgical/methods , Tooth, Impacted/surgery , Tooth, Unerupted/surgery , Tooth, Supernumerary/surgery , Lingual Frenum/surgery , Mucocele/surgery , Odontoma/surgery , Dentigerous Cyst/surgeryABSTRACT
This paper reports a series of clinical cases of ankyloglossia in children, which were approached by different techniques: frenotomy and frenectomy with the use of one hemostat, two hemostats, a groove director or laser. Information on the indications, contraindications, advantages and disadvantages of the techniques was also presented. Children diagnosed with ankyloglossia were subjected to different surgical procedures. The choice of the techniques was based on the age of the patient, length of the frenulum and availability of the instruments and equipment. All the techniques presented are successful for the treatment of ankyloglossia and require a skilled professional. Laser may be considered a simple and safe alternative for children while reducing the amount of local anesthetics needed, the bleeding and the chances of infection, swelling and discomfort.
Subject(s)
Humans , Male , Female , Child, Preschool , Child , Lingual Frenum/surgery , Mouth Abnormalities/surgery , Lasers, Semiconductor/therapeutic use , Tongue Diseases/surgery , Treatment OutcomeABSTRACT
OBJETIVO: Descrever as mudanças ocorridas após a frenectomia com relação à mobilidade e funções da língua. MÉTODOS: Foram avaliados 53 sujeitos, os quais nunca haviam se submetido a fonoterapia ou a cirurgia do frênulo. Um protocolo com escores específicos para avaliação do frênulo lingual foi utilizado para avaliar os sujeitos com evidências de alteração neste aspecto. Foi encontrada alteração em dez sujeitos, que foram encaminhados a um otorrinolaringologista para frenectomia. Após a cirurgia, esses sujeitos foram reavaliados pelo fonoaudiólogo utilizando-se o mesmo protocolo. Fotos e vídeos foram usados para comparação. RESULTADOS: Trinta dias após a cirurgia, os sujeitos apresentaram a forma da ponta da língua modificada, assim como os movimentos melhorados. O fechamento labial e a fala também melhoraram. CONCLUSÃO: A frenectomia é eficiente para melhorar a mobilidade e a postura da língua, assim como suas funções, incluindo a produção da fala.
PURPOSE: To describe the changes after frenectomy concerning mobility and functions of the tongue. METHODS: Participants were 53 subjects who had never undergone speech therapy or lingual frenulum surgery. A specific lingual frenulum protocol with scores was used by speech-language pathologists when there was evidence of frenulum alteration. Ten subjects had abnormal frenulum and were referred to an otolaryngologist for frenectomy. After surgery, the subjects were re-evaluated using the same protocol. Photos and videos were taken for comparison. RESULTS: Thirty days after surgery, the subjects had the shape of the tip of the tongue and its movements improved. Lip closure and speech were also improved. CONCLUSION: Frenectomy is efficient to improve tongue posture, tongue mobility, oral functions, and oral communication.
Subject(s)
Adolescent , Adult , Child , Child, Preschool , Female , Humans , Male , Young Adult , Articulation Disorders/surgery , Lingual Frenum/surgery , Tongue Diseases/surgery , Tongue/physiology , Articulation Disorders/physiopathology , Lingual Frenum/anatomy & histology , Lingual Frenum/physiopathology , Movement , Tongue Diseases/physiopathology , Tongue/anatomy & histologyABSTRACT
Introdução: O freio lingual é uma estrutura anatômica que tem importante participação no ato da sucção, fala e alimentação. Um freio lingual curto e aderido ao soalho bucal dificulta os movimentos da língua, o que pode prejudicar as diversas funções dessa estrutura. Tal alteração é denominada clinicamente pelo termo anquiloglossia. Objetivo e relato de caso: Descrever um caso de anquiloglossia numa criança do sexo feminino, com 2 anos de idade, atendida na clínica de Puericultura do Departamento de Pediatria da Universidade Federal do Paraná. A menina teve o diagnóstico de anquiloglossia do tipo II e foi tratada por frenectomia. Conclusão: O exame rotineiro do freio lingual permite a identificação de anormalidades de sua inserção e possibilita medidas preventivas para as intercorrências no período do aleitamento materno.
Introduction: The lingual frenulum is an anatomic structure that plays an important role in the act of suction, speech and feeding. A short and adhered lingual frenulum obstructs the tongue movement. This can impair the diverse functions of this structure. This alteration is called ankyloglossia. Objective and case report: The aim of this article is to relate a case of ankyloglossia in a female child of two-years old who was examined in the Clinic of Child Care of the Department of Pediatrics, Federal University of Paranß. The child was diagnosed with type II ankyloglossia and treated by frenectomy. Conclusion: The routine examination of the lingual frenulum permits the identification of insertion abnormalities and enables the establishment of preventive measures for complications during the period of breastfeeding.
Subject(s)
Child, Preschool , Breast Feeding , Ankyloglossia , Lingual Frenum/abnormalities , Lingual Frenum/surgery , TongueABSTRACT
En la conformación del macizo cráneofacial intervienen factores genéticos, del medio o combinación de ambos. La alteración de uno de ellos puedeproducir modificaciones en el crecimiento, por ejemplo, maloclusión de los maxilares. Parece no haber dudas sobre el rol del factor genético; las autoras hacen referencia a las influencias de los factores del medio, entre ellos el factor lingual, particularmente en el desarrollo de un frenillo lingual corto que ocasiona una anquiloglosia. Se coincide con otros autores en que se trata de un factor etiológico que actúa en el comienzo de la maloclusión y se señala la forma correcta en que la lengua debe ubicarse para que tal patología no ocurra. El tratamiento del niño debe iniciarse precozmente a los 3 años para aprovechar la respueta biológica más dócil a los requerimientos terapéuticos. Finalmente se subraya la importancia de un tratamiento interdisciplinario realizado en un equipo integrado por odontopediatría, cirugía, ortodoncia, fonoaudiología, psicología y musicoterapia, para lograr resultados morfológicos, funcionales y estéticos satisfactorios
Subject(s)
Humans , Male , Female , Child, Preschool , Child , Tongue Diseases/etiology , Tongue Diseases/therapy , Lingual Frenum/abnormalities , Lingual Frenum/surgery , Orthodontic Appliances, Functional , Tongue/physiology , Myofunctional Therapy , Malocclusion/etiology , Patient Care Team , Posture , Speech Therapy , Tongue HabitsABSTRACT
Frenula consist of a mucosal fold in the labial, buccal and occasionally the lingual surface of the alveolar ridge. Their high attachment may cause orthodontic problem eg. [Diastima], prosthodontic problems eg. [Poor retention of denture], periodontic problems [gingival recession and inflammation] and speech problem [tongue tied in ligual frenum]. The removal of frenum could be done by surgical excision using scalpel through different techniques eg. [Vertical, Z plasty and hemostat]. Modern technology now offers an alternative mode of treatment like laser surgery. eight patients [14-75 years old] with freni indicated for excision were referred for laser clinic in police hospital. Laser used was diode with wavelength [810] nm [Oralaser Jet 20 - Germany], energy 1.8 Jul/sec and frequency 10,000 Hz using PPR1 [pulse pause relation] program with fiber tip diameter of 400 micron in contact mode. Laser safety measures were followed. showed dry and bloodless field during operation, no post operative swelling, no pain or discomfort, with normal healing process. as these were first cases to be treated by laser in Sudan, we suggest and stimulate the use of laser for soft tissue surgery because of its time saving, patients comfort and easy manipulation
Subject(s)
Humans , Male , Female , Lingual Frenum/surgery , Laser Therapy , LasersABSTRACT
Se realizó un estudio descriptivo longitudinal y prospectivo sobre la anquiloglosia, que se define como un frenillo corto que restringe los movimientos de la lengua. El universo de nuestro estudio procedió de las escuelas primarias del municipio Melena del Sur, compuesto por niños con edades comprendidas entre 5 y 11 años. En coordinación con la logopeda y el estomatólogo general, se les trató quirúrgicamente en la Clínica Dental "Orlando Corvo" del municipio Melena del Sur, y posteriormente los pacientes fueron remitidos a la logopeda para corregir con ejercicios los problemas de habla. Se realizó una técnica quirúrgica diferente a la propuesta por la literatura, lo que permitió que los pacientes no necesitaran de sutura quirúrgica. De un universo de 829 niños revisados en las edades de 5 a 11 años, en las escuelas primarias del municipio Melena del Sur, 29 presentaron anquiloglosia, para el 3,49 por ciento de incidencia del problema. En los niños que presentaron anquiloglosia, el fonema más afectado fue el /R/. La evolución en la dicción de los niños afectados por anquiloglosia antes y después del tratamiento estomatológico-logopeda, fue satisfactoria en el 99 por ciento de los casos. Se modificó la técnica quirúrgica propuesta por los autores y se hizo más sencilla al realizar el corte más próximo a la cara ventral de la lengua. Se obtuvieron resultados satisfactorios en cuanto al tiempo de curación de la herida(AU)
A descriptive, longitudinal and prospective study on ankyloglossia is conducted. It is defined as a short frenum restricting the movements of the tongue. Children aged 5-11 from the primary schools of Melena del Sur entered this study. They were surgically treated in coordination with the speech specialist and the general stomatologist at "Orlando Corvo" dental clinic, in the municiaplity of Melena del Sur. These patiens were referred later to the speech specialist to correct the speech problems with exercises. As a surgical technique different to the one proposed in literature was used, patients did not need surgical suture. Of the 829 children aged 5-11 that were checked at the primary schools of the municipality of Melena del Sur, 29 presented ankyloglossia, accounting for 3.49 percent of incidence. Among children with ankyloglossia, the most affected phonema was /R/. The evolution of diction in those children affected with ankyloglossia before and after the treatment given by the stomatologist and the speech specialist was satisfactory in 99 percent of the cases. The surgical technique suggested by the authors was modified and it was simpler on cutting closer to the ventral side of the tongue. Satisfactory results were obtained as to the healing time of the wound(AU)