This randomized, double-blind and controlled clinical trial investigates how a diode laser lingual frenectomy can improve obstructive sleep apnea syndrome (OSAS) in pediatric patients. Background: Several authors have shown that a short lingual frenulum causes a reduction in incoming air flow and the relationship between OSAS and a short lingual frenulum. Methods: Thirty-two pediatric patients were equally randomly divided into a Study Group (SG) and a Control Group (CG). On each SG patient a polysomnography 1 (PSG1) and a lingual frenectomy were performed using a diode laser via Doctor Smile Wiser technology, power 7 W. After three months, a new polysomnography (PSG2) was performed to evaluate the lingual frenectomy efficacy in pediatric patients. The pain was assessed by a numerical rating scale (NRS) before and after surgery. The CG followed the same protocol without a lingual frenectomy but myofunctional and speech therapy were conducted to qualitatively and quantitatively improve the lingual functionality. In the SG, eight subjects (50%) had severe OSAS and eight had moderate (50%) while in the CG, three subjects had severe OSAS (18.8%) and thirteen had moderate (81.2%). Results: In the SG, 93.8% were classified as mild OSAS and 6.2% as moderate. In contrast, in the CG, 18.75% were classified as mild OSAS, 62.5% as moderate and 18.75% as severe. Conclusion: The study demonstrates how a lingual laser frenectomy can improve OSAS in pediatric patients.

Background: The purpose of this study is to verify parents’ knowledge of child nutrition and their awareness of the interaction between unhealthy sugars in their child’s diet and caries formation. Methods: a questionnaire was proposed using Instagram to analyze type of breastfeeding; type of weaning and diet; home oral hygiene maneuvers; bad habits (use of pacifiers, bottles, and sugary substances); knowledge on the usefulness of fluoride; and first dental visit. A total of 200 parents from different regions of Italy with children aged 2 months to 6 years were contacted. Results showed that 66% parents preferred breastfeeding, while the remaining 34% chose artificial breastfeeding. Fifty percent (100 babies) started weaning at six months, 20% (40 babies) at the fifth month, 13.5% (27 babies) at the fourth month, and only 11.5% (23 babies) in a range from the seventh to ninth month of life. Oral hygiene practices were performed only by 25% of parents before eruption of the first tooth. After eruption of the first tooth, there is greater attention to home oral hygiene practices: 59% of parents carry out and teach their children daily home oral hygiene maneuvers. Conclusions: it is possible to raise awareness among parents and caregivers on the importance of food education.

Background: Ankyloglossia is an anatomical alteration of the frenulum length, volume, compactness, and insertion. It can lead to alterations in the ability to swallow and chewing, and dysfunctional coordination amongst cranio-facial muscles; these alterations are often responsible for respiratory alterations, skeletal malocclusions and dyslalia or the delay of speech. The aim of this study is to estimate the efficacy of lingual frenulectomy with diode-laser technology through a qualitative and quantitative evaluation. Methods: One hundred and twenty-five pediatric patients were recruited: 100 with a lingual pathological frenulum were randomly divided into four operating groups; the other 25 with a borderline pathological frenulum were recruited as a control group. Each patient was included in a follow-up program (T0-T1-T2-T3-T4) for a quantitative and qualitative evaluation: the first through an accurate measurement of Kotlow’s free tongue measurement (≥16), Mouth Opening with Tongue Tip to incisive papilla (MOTTIP), Maximal Intercisal Mouth Opening (MIO) and Protrusion; and the second using the Assessment Tool for Lingual Frenulum Function (ATLFF), Bristol Tongue Assessment Tool (BTAT), and grade of tongue functionality. Results: The increase of the aforementioned quantitative parameters was circa 10 mm, and all patients reacquired full functionality of the tongue. Conclusions: Diode-laser technology is efficient and innovative in the treatment of pathological lingual frenulums.

Objectives: Given the widespread adoption of CBCT in clinical and research activity, it seems reasonable to critically evaluate the evidence produced on the investigations over the relationship between upper airway morphology and skeletal malocclusions patterns. Methods: The analysis method and inclusion criteria were pre-specified and documented in a protocol to minimize the risk of post hoc selective bias. A methodological quality grading system was used to identify the most valuable studies. Results: The nine selected articles, published between 2009 and 2020, involved subjects recruited from existing databases. The average methodological quality grading assessment score was 18.6 (range: minimum 16, maximum 23). Methodological quality scores ranged from 36.1% to 63.8% of the maximum possible score, with an average quality score of 51.1%. No high-quality studies were found in the sample. Conclusions: This systematic review revealed that no high-quality studies have compared upper airway morphology with skeletal patterns using cone-beam computed tomography. The heterogeneity of the results did not confirm strong evidence of a direct correlation between skeletal patterns and upper airway morphology. This appears to be due to a lack of consistency in CBCT protocols.

Background: The orthodontic management of pediatric patients with rare diseases, such as Ectodermal Dysplasia (ED) and Osteogenesis Imperfecta (OI), requires complex protocols due to dental anomalies in both the number and structure of teeth. These conditions necessitate a departure from traditional orthodontic approaches, as skeletal anchoring is often required because of these anomalies. Case Presentation: A patient with ED, characterized by hypodontia and malformed teeth, presented with insufficient natural teeth for anchorage. This challenge was addressed using a Maxillary Skeletal Expander (MSE) with miniscrews. Cone-beam computed tomography (CBCT) and cephalometric radiographs were used to assess bone density, which guided the creation of a customized hybrid device. A second patient with OI, a condition causing fragile bones, had malformed teeth and a high risk of fractures. Skeletal anchoring with MSE and miniscrews was chosen to avoid damaging brittle bones. The fragile nature of the patient’s bones required careful planning and close monitoring throughout the treatment process. Both patients were treated at the UOC of Pediatric Dentistry, Sapienza University of Rome, using MSE with miniscrews. Pre- and post-treatment imaging (CBCT and cephalometric radiographs) were used to evaluate bone quality and monitor progress. Skeletal anchoring successfully addressed the unique challenges in both cases, achieving outcomes comparable to those in unaffected patients. Discsussions: despite limited bone volume, MSE successfully achieved maxillary arch expansion and improved occlusion. Post-treatment radiographs showed successful maxillary expansion and alignment without complications. Conclusions: This case series highlighted the effectiveness of MSE with miniscrews in treating patients with rare diseases. It advances orthodontic management by offering reliable solutions for complex cases involving dental anomalies and compromised bone structures.

Article: Evaluation of nasal airway resistance in a cohort of children with primary snoring and maxillary deficiency - Minerva Dental and Oral Science 2022 Nov 07 - Minerva Medica - Journals