Comparison of ChatGPT knowledge against 2020 consensus statement on ankyloglossia in children.

OBJECTIVE: This paper evaluates ChatGPT's accuracy and consistency in providing information on ankyloglossia, a congenital oral condition. Assessing alignment with expert consensus, the study explores potential implications for patients relying on AI for medical information. METHODS: Statements from the 2020 clinical consensus statement on ankyloglossia were presented to ChatGPT, and its responses were scored using a 9-point Likert scale. The study analyzed the mean and standard deviation of ChatGPT scores for each statement. Statistical analysis was conducted using Excel. RESULTS: Among the 63 statements assessed, 67 % of ChatGPT responses closely aligned with expert consensus mean scores. However, 17 % (11/63) were statements in which the ChatGPT mean response was different from the CCS mean by 2.0 or greater, raising concerns about ChatGPT's potential influence in disseminating uncertain or debated medical information. Variations in mean scores highlighted discrepancies, with some statements showing significant deviations from expert opinions. CONCLUSION: While ChatGPT mirrored medical viewpoints on ankyloglossia, alignment with non-consensus statements raises caution in relying on it for medical advice. Future research should refine AI models, address inaccuracies, and explore diverse user queries for safe integration into medical decision-making. Despite potential benefits, ongoing examination of ChatGPT's power and limitations is crucial, considering its impact on health equity and information access.

Stunted girl: A heartbreaking case report of underdiagnosed and untreated posterior ankyloglossia.

INTRODUCTION: Plastic surgeons can help to eliminate stunting by surgically treating children born with congenital craniofacial anomalies such as tongue-tie, or ankyloglossia. Releasing ankyloglossia can help to support breastfeeding and the later development of orofacial anatomy and physiology. Failure to do so can lead to growth and development difficulties in children. We report a heartbreaking case of a stunted 8 year-old female with underdiagnosed and untreated ankyloglossia. PRESENTATION OF CASE: The patient was consulted with a short stature, speech disorder, and swallowing disorder. History taking and physical examination led to a diagnosis of type 4 (posterior) ankyloglossia. The Hazelbaker Assessment Tool for Lingual Frenulum Function mandated a frenotomy. Under general anesthesia, frenotomy was performed surgically, and significant tongue mobility was gained. DISCUSSION: This case alerted both surgeon and pediatrician that collaboration is a must to intervene in such a specific congenital anomalies. Posterior (type 4) ankyloglossia may cause difficulties in tongue mobility which can lead to difficulties in breastfeeding and swallowing, speech disorders, and malocclusion. Posterior ankyloglossia is not only the most severe form of ankyloglossia, but also the most difficult to diagnose. CONCLUSION: In the absence of social and environmental factors, posterior (type 4) ankyloglossia was the single most responsible factor in this growth and development delay in the girl. Timely diagnosis and treatment could have prevented such a stunted condition.

Alternative Therapies for Ankyloglossia-Associated Breastfeeding Challenges: A Systematic Review.

Background: Ankyloglossia (AG) diagnoses are increasingly common, and management is not standardized. Nonsurgical alternative therapies are frequently recommended in conjunction with or instead of frenotomy, with uncertain evidence. Objective: To evaluate the efficacy of nonsurgical alternative therapies (chiropractic care, myofunctional therapy, and osteopathy) in improving breastfeeding for infants diagnosed with AG. Methods: PubMed, Embase, CINAHL, Scopus, Web of Science, Clinicaltrials.gov, and Google Scholar were searched (September-October 2023). Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. A librarian-designed search included the terms "Ankyloglossia," "Non-surgical," "myofunctional therapy," "chiropractic," "osteopathy," and related therapies, with no date restrictions. English language studies of infants <24 months with AG and alternative therapy were included. Risk-of-bias evaluation used Newcastle-Ottawa Scale (NOS). Results: Of 1,304 identified articles, four studies (2016-2022) met inclusion criteria (two cross-sectional, one case report, and one case series). All studies reported frenotomy in combination with alternative therapy yielded favorable outcomes for maternal pain, weight gain, feeding duration, and maintenance of latch. The risk of bias was moderate for two studies, low for the case series, and not calculated for the case report, which has an inherent high risk of bias. All studies lacked control or comparator groups preventing definitive conclusions about the role of alternative therapies in AG. Conclusion: Although some studies suggest the potential benefits of combining alternative therapies with surgery for AG-related breastfeeding issues, the lack of control groups renders the evidence inconclusive. Nonsurgical approaches alone currently lack sufficient evidence. As these alternative therapies gain popularity, rigorous research is crucial to determine their cost-effectiveness and role in managing AG.

Relationship of ankyloglossia and obstructive sleep apnea: systematic review and meta-analysis.

PURPOSE: Recent studies have highlighted the potential role of a short lingual frenulum as a risk factor for pediatric obstructive sleep apnea syndrome. A shortened frenulum may contribute to abnormal orofacial development, leading to increased upper airway resistance and susceptibility to upper airway collapsibility during sleep. Recognizing early indicators, such as a short lingual frenulum, is crucial for prompt intervention. This systematic review aims to evaluate the association between a short lingual frenulum and the risk of obstructive sleep apnea syndrome in children. METHODS: This systematic review adheres to PRISMA criteria for a quantitative analysis. A comprehensive search was conducted on five databases until January 2024 to identify relevant studies. The selected articles underwent rigorous analysis, considering study design, sample characteristics, lingual frenulum characterization, sleep assessment methods, and key findings. RESULTS: A total of 239 references were initially identified. Finally, six studies were included in the qualitative synthesis, with four studies eligible for the quantitative synthesis. The Newcastle-Ottawa scale was employed to assess study quality. Meta-analysis, supported by a moderate evidence profile according to the GRADE scale, revealed statistically significant differences, with odds ratios of 3.051 (confidence interval: 1.939 to 4.801) for a short frenulum and 12.304 (confidence interval: 6.141 to 24.653) for a high-arched palate. CONCLUSION: This systematic review and meta-analysis provide evidence supporting the association between ankyloglossia and obstructive sleep apnea in children. Nevertheless, it is crucial to consider additional factors such as tongue mobility and the presence of a high-arched palate in further evaluations.

Lingual Frenotomy in Pediatric Ankyloglossia: A Diode Laser Approach in Two Case Reports.

Ankyloglossia can be related to a number of complications, such as breastfeeding difficulties or alterations in craniofacial development. Treatment can involve surgery to correct the altered lingual frenulum and can be performed by various techniques. The purpose of this paper is to present two case reports of ankyloglossia in pediatric patients of different ages, the diagnostic criteria, and the treatment decision rationale, which led to a lingual frenotomy performed with a diode laser.

Oral Structural Dysphagia in Children.

Oral causes of dysphagia in infancy may involve the lips, the tongue, or the palate. Whereas ankyloglossia is commonly diagnosed in infants with dysphagia, assessment of the need for surgical intervention may be less straightforward. Tongue size (macroglossia) may be associated with dysphagia as it may cause limitation of movement of the food or milk bolus by the lips or cheeks. Congenital conditions such as cleft lip and palate, micrognathia, or craniofacial microsomia may also be associated with dysphagia. Diagnosis and treatment of these conditions can be improved with the engagement of lactation and feeding experts as well as multidisciplinary craniofacial teams.

Speech Outcomes of Frenectomy for Tongue-Tie Release: A Systematic Review and Meta-Analysis.

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.

Use of At-Breast Supplementers to Facilitate Feeding Solely at the Breast for Infants with Retrognathia: Two Case Studies.

Objective: Infants with significant retrognathia often have difficulty forming a latch adequate to establish exclusive breastfeeding. This article describes the use of at-breast supplementers (ABSs) to facilitate extended breastfeeding relationships, even when supplementation is necessary for growth. Methods: Two cases are described where infants with severe retrognathia initially struggled with weight gain necessitating supplementation but were able to ultimately exclusively feed at-breast with the use of ABSs. Results: While the two cases differed in the form of supplemental milk used and duration of ABS use, both dyads breastfed for beyond 2 years. Conclusions: Feeding solely at the breast and subsequent extended breastfeeding may be possible even for infants who require supplementation, including those with anatomical or functional challenges such as retrognathia. The ABS is a relatively simple system that may be beneficial for difficulties such as poor latch and low milk supply. More awareness and education is needed so that clinicians consider supporting dyads with this approach.

Ankyloglossia in Children, a Cause of Obstructive Sleep Apnoea: Case Report of Paediatric Ankyloglossia and Sleep Apnoea: DISE Resolves the Mystery.

Tongue mobility is an obstructive sleep apnoea (OSA) marker and myofunctional therapy (MFT) target. For this reason, all paediatric patients with sleep-disordered breathing should require a combined functional assessment from an ear, nose, and throat (ENT) specialist and a phonoaudiologist to confirm or rule out the presence of ankyloglossia. To our knowledge, this is the first case of a 13-year-old girl diagnosed with severe OSA and a significant decrease of 94% in her apnoea index (AI), requiring frenotomy with an immediate postoperative change in the tongue position. A drug-induced sleep endoscopy (DISE) was performed before and immediately postfrenotomy, and the anatomical changes provoked by this surgery during sleep were confirmed for the first time.

Frenotomy Provides Improved Direct Laryngoscopy Exposure in Select Adult Patients With Ankyloglossia.

Objective: To analyze the effects of lingual frenotomy on adults with restrictive ankyloglossia and difficult direct laryngoscopy exposure. Methods: A case series study was conducted. Restriction of tongue protrusion due to ankyloglossia was identified in 2 patients who had a history of suboptimal true vocal fold (TVF) exposure on direct laryngoscopy for phonomicrosurgery. Inadequate exposure of the vocal folds was achieved on direct laryngoscopy attempts with manual tongue protrusion. Mandibular tori were not present in these patients. An intraoperative lingual frenotomy was performed in both patients. Results: After frenotomy and with manual tongue protrusion, direct laryngoscopy exposure was substantially improved allowing for considerably more visualization of the anterior TVFs. Conclusion: Lingual frenulum procedures with manual tongue protrusion should be considered in select adult patients with restrictive ankyloglossia affecting optimal direct laryngoscopy exposure.

Ankyloglossia and Breastfeeding Duration: A Multicenter Birth Cohort Study.

Background and Objective: The prevalence of ankyloglossia and its impact on breastfeeding practices may be overestimated, leading to surgical overtreatment in newborns. The study was conducted to estimate the prevalence of ankyloglossia in the first year of life and investigate the association with exclusive and total breastfeeding duration in different regions of Brazil. Materials and Methods: This multicenter prospective cohort study involved the recruitment of mother-infant pairs soon after childbirth in public hospitals in three state capitals in Brazil. Interviews were held with the mothers after birth, at 6 and 12 months to collect sociodemographic variables and data on exclusive and total breastfeeding duration. At 12 months of age, the children were submitted to a dental examination for classification of the lingual frenulum using the Bristol Tongue Assessment Tool. Data analysis involved Poisson regression with robust variance, with the calculation of unadjusted and adjusted relative risk (RR). Results: The final sample was composed of 293 children. The prevalence of defined and suspected ankyloglossia was 1% and 4.8%, respectively, totaling 5.8% (confidence interval [95% CI]: 3.1-8.5). No significant difference was found in the prevalence of exclusive and total breastfeeding at 1, 4, and 6 months between children with defined/suspected ankyloglossia and those without ankyloglossia. The multivariable analysis showed that the probability of the child achieving 6 months of breastfeeding did not differ between groups (RR = 0.98; 95% CI: 0.79-1.23; p = 0.907). Conclusion: The prevalence of defined ankyloglossia was very low and defined/suspected ankyloglossia was not associated with exclusive or total breastfeeding duration. Clinical Trial Registration: Registered with clinicaltrials.gov (n° NCT03841123).

Is Public Interest Associated with Real-World Management of Ankyloglossia?

OBJECTIVES: Assess the relationship between public interest in ankyloglossia as determined by internet search volume and real-world medical claims data. STUDY DESIGN: Retrospective Cohort Study. SETTING: This retrospective cohort study was conducted using claims data from the Merative™ Marketscan® Research Databases. The internet search data was collected from Google Trends. METHODS: Annual Google Trends data were compiled using search terms associated with "ankyloglossia" and "frenotomy" for the years 2011 to 2021. We obtained incidence of ankyloglossia diagnoses and frenotomy procedures in children under 12 months from Marketscan relative to all infants enrolled. We compared associations between search and incidence data among US states and over time. RESULTS: Google search correlated with ankyloglossia incidence (r = 0.4104, P = .0031) and with frenotomy incidence (r = 0.4062, P = .0034) per state. Ankyloglossia diagnoses increased with Google search index (coefficient = 0.336, 95% confidence interval [CI] 0.284, 0.388) and year (coefficient = 0.028, 95% CI 0.025, 0.031). Similarly, frenotomy procedures increased with Google search index (coefficient = 0.371, 95% CI 0.313, 0.429) and year (coefficient = 0.027, 95% CI 0.024, 0.030). CONCLUSIONS: Associations between online ankyloglossia search trends and both diagnosis and treatment rates, persist across US regions and timeframes. Internet search trends are pivotal in shaping pediatric health care decisions, driving clinical consensus, and disseminating evidence-based information.

New Validated Tool to Diagnose Breastfeeding Dysfunction.

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.

The buccal frenum: Trends in diagnosis and indications for treatment of buccal-ties among 466 healthcare professionals.

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.

Ankyloglossia and malocclusion: A systematic review and meta-analysis.

BACKGROUND: Ankyloglossia is a congenital alteration that affects the tongue's mobility, influencing craniofacial development; however, its association with malocclusion is still unclear. This systematic review and meta-analysis investigated the association between ankyloglossia and malocclusion in patients. TYPES OF STUDIES REVIEWED: The authors conducted a systematic review and meta-analysis of observational studies that investigated the association between malocclusion and the presence of ankyloglossia in any age group, used any assessment tool to diagnose ankyloglossia, and considered all types of malocclusion. The authors conducted searches in 8 electronic databases through July 1, 2022. They used Joanna Briggs Institute appraisal tools to assess the methodological quality and the Grading of Recommendations, Assessment, Development and Evaluations approach to assess the certainty of the evidence. RESULTS: Eleven studies (5 cross-sectional, 6 case-control) included 2,904 patients and over 13 occlusal alterations. The certainty of the evidence ranged from low through very low. Patients with Angle Class III malocclusion had similar or more inserted lingual frenula than patients with Class I malocclusion (standard mean difference, 0.37; 95% CI, -0.50 to 1.25) and Class II malocclusion (standard mean difference, 0.55; 95% CI, -0.52 to 1.63). Patients with Class III malocclusion had clinically significant increased mouth opening reduction compared with patients with Class I malocclusion (mean difference, 6.67; 95% CI, 4.01 to 9.33) and Class II malocclusion (mean difference, 5.04; 95% CI, 2.35 to 7.72) patients. PRACTICAL IMPLICATIONS: There is uncertain evidence that ankyloglossia may be associated with the development of occlusal alterations. Ankyloglossia did not influence the Angle classification. Clinicians should closely follow children with ankyloglossia to evaluate whether this condition interferes with the occlusion. Future research should prospectively follow up on the long-term association between ankyloglossia and malocclusion. The protocol was registered a priori in the PROSPERO database (CRD42021248034). No amendments were deemed necessary after the registration of the protocol. Some subgroup analyses planned a priori were not possible, such as the severity of ankyloglossia, sex, and age, due to the lack of studies reporting data for these subgroups.

Relationship between Ankyloglossia and Breastfeeding: A Bibliometric Review

ABSTRACT Objective: To assess global trends in the publication of studies investigating the association between ankyloglossia and breastfeeding. Material and Methods: An electronic search was performed in the Scopus database without restrictions. Observational studies and clinical trials were included. Bibliometric indices such as publication year, authors, co-authors, journals, field of knowledge, countries, and the most cited keywords were analyzed using the VOSviewer program. Results: The search retrieved 350 studies, and 68 were selected. The first article was published in 2000 in the United States. The United States presented the highest number of publications (n=21), followed by Brazil (n=9) and the United Kingdom (n=9). An increase in publications on this theme was observed in 2013; 2021 was the year with the highest number of publications (n=14). The most common word was "frenulum". The authors with the highest number of publications were Botze and Dollbert from Israel (n=3), Ghaheri, and Mace from the United States (n=3). Among the journals, "Breastfeeding Medicine" presented the highest number of publications (n=7), followed by the "International Journal of Pediatric Otorhinolaryngology" (n=6), "CODAS" (n=5), "Journal of Human Lactation" (n=4) and "Pediatrics" (n=3); the latter published the top-cited studies, with 412 citations. Conclusion: There has been an increase in recent articles evaluating the correlation between ankyloglossia and breastfeeding, indicating the growing interest of researchers in this field.

Frenectomia lingual com laser de diodo de alta potência: relato de caso / Lingual frenectomy with high-power diode laser: a case report / Frenectomía lingual con láser de diodo de alta potencia: informe de un caso

Introdução: A laserterapia de alta potência tem estabelecido proporções satisfatórias na odontologia e se tornando a primeira opção de conduta cirúrgica para procedimentos, trazendo qualidade de vida aos pacientes e praticidade aos Cirurgiões. Objetivo: Relatar caso clínico de frenectomia lingual com uso do laser de diodo de alta potência ressaltando os benefícios da conduta. Relato de caso: Paciente sexo feminino, leucoderma, sem alterações sistêmicas, chega à Clínica Escola de Odontologia da Universidade Federal de Campina Grande, com queixa principal de alterações na sua fonologia. No exame intraoral observou-se dificuldade de movimentação lingual e em formato de coração devido a inserção fibrosa do freio, sendo observado a Anquiloglossia. Após explicações da alteração, do tratamento, e assinatura do Termo de Consentimento, foi iniciado a cirurgia: antissepsia, anestesia com vasoconstrictor, e em modo contínuo utilizou-se o laser de diodo de alta potência (TW Surgical- MMO®) configurado em 2W de potência, fibra 600µm, no comprimento de onda infravermelho, de modo que as fibras fossem separadas uniformemente e promovesse mobilidade imediata da língua, por fim realizou-se uma sutura em ponto simples com fio reabsorvível. Para o pós-operatório foi prescrito Dipirona em caso de dor, e estabelecido o acompanhamento. No retorno de 7 dias observou-se cicatrização normal e não ingestão do medicamento, em 30 dias foi visto a completa cicatrização e mobilidade sem desconforto, além de relato da paciente de melhoria na condição de relacionamentos sociais, autoestima e deglutição. Conclusão: O resultado apresentado neste artigo ratifica a benefício da escolha do laser em comparação ao convencional, demonstrando que não há sangramento no trans e pós cirúrgico, além de favorecer o processo de reparação tecidual, da redução do tempo cirúrgico, aumento do conforto, e diminuição de uso de medicamento, desta forma associando o laser cirúrgico a melhoria da qualidade de vida.

Introduction: High-power laser therapy has established satisfactory proportions in dentistry and has become the first choice for surgical procedures, bringing quality of life to patients and convenience to surgeons. Objective: To report a clinical case of lingual frenectomy using high-power diode laser, highlighting the benefits of this approach. Case report: A female patient, leucoderma, without systemic alterations, arrived at the Dental School Clinic of the Federal University of Campina Grande with the main complaint of alterations in her phonology. In the intraoral examination, difficulty in lingual movement and a heart-shaped tongue due to fibrous insertion of the frenum were observed, indicating Ankyloglossia. After explanations of the condition, treatment, and signing of the Informed Consent Form, the surgery was initiated: antisepsis, anesthesia with vasoconstrictor, and continuous mode using a high-power diode laser configured at 2W of power, 600µm fiber, at an infrared wavelength, with the aim of uniformly separating the fibers and promoting immediate tongue mobility. Finally, a simple suture was performed using absorbable thread. For the postoperative period, Dipyrone was prescribed for pain relief, and follow-up was established. At the 7-day follow-up, normal healing was observed, and the patient did not require the medication. At 30 days, complete healing and discomfort-free mobility were observed, along with the patient's testimony of improvement in social relationships, self-esteem, and swallowing. Conclusion: The results presented in this article confirm the benefits of choosing laser therapy over conventional methods, demonstrating the absence of bleeding during and after surgery, promoting tissue repair, reducing surgical time, increasing comfort, and decreasing the use of medication. Therefore, the use of surgical laser is associated with an improvement in quality of life.

Introducción: La terapia láser de alta potencia se ha establecido en proporciones satisfactorias en odontología y se ha convertido en la primera elección para procedimientos quirúrgicos, aportando calidad de vida a los pacientes y practicidad a los cirujanos. Objetivo: Relatar un caso clínico de frenectomía lingual con láser de diodo de alta potencia, destacando los beneficios de este procedimiento. Relato del caso: Paciente del sexo femenino, leucoderma, sin alteraciones sistémicas, llegó a la Clínica de la Facultad de Odontología de la Universidad Federal de Campina Grande con la queja principal de alteraciones en su fonología. El examen intraoral reveló dificultad en el movimiento lingual y lengua en forma de corazón debido a la inserción fibrosa del freno, observándose anquiloglosia. Tras explicar la alteración, el tratamiento y firmar el consentimiento, se inició la cirugía: antisepsia, anestesia con vasoconstrictor y uso continuado de un láser de diodo de alta potencia (TW Surgical- MMO®) configurado a 2W de potencia, fibra de 600µm, a longitud de onda infrarroja, para que las fibras se separaran uniformemente y favorecieran la movilidad inmediata de la lengua, y finalmente una sutura de punto único con hilo reabsorbible. En el postoperatorio, se prescribió dipirona en caso de dolor y se estableció un seguimiento. En el seguimiento a los 7 días, se observó una cicatrización normal y no se tomó medicación. A los 30 días, se observó una cicatrización completa y movilidad sin molestias, así como el informe del paciente de una mejora de las relaciones sociales, la autoestima y la deglución. Conclusión: Los resultados presentados en este artículo confirman el beneficio de la elección del láser frente a la cirugía convencional, demostrando que no hay sangrado durante ni después de la cirugía, además de favorecer el proceso de reparación tisular, reducir el tiempo quirúrgico, aumentar el confort y reducir el uso de medicación, asociando así el láser quirúrgico a una mejor calidad de vida.

The development of a specialist tongue tie assessment clinic for neonates.

OBJECTIVES: Ankyloglossia or tongue tie is a condition where the lingual frenulum restricts tongue movement, negatively impacting breastfeeding. An increasing number of infants diagnosed with ankyloglossia may lead to unnecessary procedures. To limit the overtreatment of this problem, we established a specialist clinic to provide the best available evidence-based care to the mother-infant dyad. METHODS: We discuss the development of a specialist tongue tie assessment clinic in our unit. RESULTS: From January to October 2023, there were 162 visits to the clinic by 157 patients. During this time, there were 96 frenotomies performed. CONCLUSIONS: The mother-infant dyad is a vulnerable patient group. Establishing a specialist tongue tie assessment clinic with otolaryngology and lactation expertise provides the best available evidence-based care.

Dysfunctional suction dynamics in newborns with ankyloglossia / Dinâmica de sucção disfuncional em recém-nascidos com anquiloglossia

ABSTRACT Purpose Compare infant suction in babies with and without ankyloglossia using a microprocessor-controlled pressure sensor coupled to a pacifier. Methods Fifty-five infants from 0 to 2 months of age underwent clinical examination for ankyloglossia, after which they were offered a silicone pacifier connected to the pressure acquisition device and suction activity was recorded. Thus, we extracted the frequency of sucks within a burst, the average suck duration, the burst duration, the number of sucks per burst, the maximum amplitude of sucks per burst and the inter-burst interval. Results The key difference in newborns with ankyloglossia in relation to control was that they perform longer bursts of suction activity. Conclusion The longer burst durations are likely a compensatory strategy and may underlie the pain reported by mothers during breastfeeding. We therefore propose a method for objectively quantifying some parameters of infant suction capacity and demonstrate its use in assisting the evaluation of ankyloglossia.

RESUMO Objetivo Comparar a sucção infantil em bebês com e sem anquiloglossia usando um sensor de pressão controlado por microprocessador acoplado a uma chupeta. Método Cinquenta e cinco lactentes de 0 a 2 meses de idade foram submetidos ao exame clínico de anquiloglossia, em seguida foi oferecido uma chupeta de silicone conectada ao dispositivo de aquisição de pressão e a atividade de sucção foi registrada. Assim, obtivemos dados sobre a frequência de sucções dentro de um período de sucções, a duração média da sucção, a duração da rajada, o número de sucções por rajada, a amplitude máxima das sucções por rajada e o intervalo entre rajadas. O teste t não pareado foi utilizado para comparações entre os grupos. Resultados A principal diferença dos recém-nascidos com anquiloglossia em relação aos do grupo controle é que eles realizam rajadas mais longas durante a atividade de sucção. Conclusão A duração mais longa das rajadas é provavelmente uma estratégia compensatória e pode estar por trás da dor relatada pelas mães durante a amamentação. Portanto, propomos um método para quantificar objetivamente alguns parâmetros da sucção infantil e demonstramos seu uso para auxiliar na avaliação da anquiloglossia.