Background: Obstructive sleep apnea syndrome (OSAS) and impaired nasal breathing are common in children and are frequently linked to maxillary constriction. Rapid maxillary expansion (RME) is an orthopedic treatment used to increase upper airway dimensions and improve respiratory function. It has been hypothesized that RME could contribute to improvements in behavior and cognition, possibly through enhanced sleep and respiratory function. It also promotes the shift from oral to nasal breathing, supporting craniofacial development and neuromuscular stability, and it is increasingly recognized as a multidisciplinary intervention that can improve pediatric health outcomes. With increasing evidence supporting its efficacy, RME should be considered not only for its orthodontic benefits but also as a multidisciplinary treatment option within pediatric care protocols. This underscores the importance of integrated care among orthodontists, ENT specialists, and pediatricians. Aim: To systematically assess the impact of RME on nasal respiratory parameters and sleep-disordered breathing, particularly OSAS, in pediatric patients. Methods: Following PRISMA guidelines, a systematic review was conducted using 12 clinical studies evaluating anatomical and functional respiratory changes after RME in children with mouth breathing or OSAS. Parameters included airway volume (CBCT, cephalometry), nasal resistance (rhinomanometry), and polysomnography (PSG) data. Results: RME consistently resulted in significant increases in nasal cavity volume and upper airway dimensions. Multiple studies reported reductions in the apnea–hypopnea index (AHI), improved oxygen saturation, and better subjective sleep quality. Longitudinal studies confirmed the stability of these benefits. However, variability in study protocols limited meta-analytical comparison. Conclusions: RME is effective in enhancing nasal breathing and mitigating OSAS symptoms in children. While results are promising, further high-quality randomized controlled trials are needed to validate these findings and guide standardized treatment protocols.

Background: Irreversible pulpitis is commonly associated with reduced success of inferior alveolar nerve block (IANB) during root canal treatment, often leading to inadequate intraoperative pain control. Inflammatory mediators can decrease local anesthetic effectiveness and alter nerve response. Preoperative administration of anti-inflammatory drugs has been proposed as a strategy to improve anesthetic success. This review evaluates whether preoperative anti-inflammatory medication enhances the efficacy of IANB in patients with irreversible pulpitis. Methods: Thirteen articles published between 2014 and 2024 were included in the qualitative analysis following a screening of titles, abstracts, and full texts. The quality of the studies was assessed using the ROBINS tool. Results: Premedication with non-steroidal anti-inflammatory drugs or corticosteroids significantly improves the success of IANB in patients with symptomatic irreversible pulpitis. Success rates in treated groups generally range between 55% and 73%, compared to less than 40% in control groups. Ibuprofen, ketorolac, and dexamethasone were among the most effective agents. Discussion: Premedication with non-steroidal anti-inflammatory drugs or corticosteroids, especially ibuprofen and dexamethasone, improves the efficacy of IANB in symptomatic irreversible pulpitis, enhancing anesthetic success and reducing intraoperative pain.

Background: Ankyloglossia is a congenital condition characterized by restricted tongue mobility, which may influence oral functions such as speech, swallowing, and oral motor coordination. This systematic review aimed to evaluate oral functional outcomes following surgical and/or myofunctional interventions in individuals with lingual hypomobility. A secondary aim was to assess variability and consistency of functional improvements across different therapeutic approaches. Methods: This systematic review was conducted in accordance with PRISMA guidelines. PubMed, Scopus, and Web of Science were searched between 15 June 2025 and 10 August 2025. Eligible clinical studies (randomized controlled trials, cohort studies, and case series/reports) evaluated lingual frenotomy, frenulectomy, or frenuloplasty, alone or combined with orofacial myofunctional therapy, and reported oral functional outcomes, including tongue mobility, oral posture, swallowing-related tasks, neuromuscular measures, and patient-reported function. Risk of bias was assessed using validated tools (ROBINS-I and RoB 2). Due to heterogeneity in study design and outcome measures, a narrative synthesis was performed. Results: Ten studies involving more than 1,300 participants across pediatric, adolescent, and adult populations were included. The evidence comprised randomized controlled trials, observational studies, and case series. Surgical intervention alone was primarily associated with immediate anatomical and mobility-related improvements. In contrast, combined surgical and myofunctional approaches were more consistently associated with improvements in functional outcomes, including tongue mobility, resting posture, and swallowing-related functions. However, the consistency of these improvements varied across age groups, intervention protocols, and outcome assessment methods. Risk of bias was variable and frequently influenced by heterogeneous diagnostic criteria, nonstandardized interventions, and nonuniform outcome measures. Discussion: Combined surgical and myofunctional interventions appear to be associated with improvements in oral functional outcomes compared with stand-alone approaches. However, due to substantial methodological heterogeneity and limited high-quality evidence, these findings should be interpreted with caution and are primarily applicable to the specific functional domains evaluated.