Perioral Structures Research Articles

Tongues Tied by Orofacial Myofunctional Therapy about Tongue Tie: A Narrative Review.

The respective review articles aim is to provide an overview as well as describes and enlists different orofacial myofunctional therapy exercises as a modality for tongue tie secondary to surgery.Tongue tie is the basically a connection that joints base of tongue to the floor of mouth. This leads to difficulties various difficulties such as altered speech, oral habits, maligned teeth and many more. During formative years, most children successfully treated of tongue tie by releasing it, but problems start after its correction. That it may can reappear or may lead to same difficulties as prior. Parents and clinicians are only concerned about speech and aesthetics after release of tongue tie. But OMT plays important role ore and post-surgical procedure. OMT help in proper tongue posture along with reducing the probability of tissue reattachment after surgery by exercises. This therapy positively influenced functions by reducing deleterious habits. A review of relevant literature is predicated on articles found using free text terms, mesh terms, and some basic tongue tie as well as tongue tie release pamphlets that were published in English up until the year 2023 in the electronic databases PubMed, EBSCO, Scopus, Google Scholar, and Web of Science. With the aid of mesh keywords, the initial search yielded 38-40 articles; 20-35 were chosen depending on the requirements. Also we searched for orofacial myofunctional exercises or exercises recommended after tongue tie release. Various exercises enlisted in our article that will guide a individual before and after tongue tie release which will give positive outcomes such as proper tongue posture, speech, swallow, regained aesthetics and self-esteem. Tongue plays an important role in development of perioral structures as well as in the swallow to good speech articulation and dental occlusion. So, as pediatric dentist its important know that after release of tongue tie what to do and how to maintain. This review article is focused on the various orofacial myofunctional therapy techniques employed for tongue tie but not a single one to describe them. Our pertaining review act as a guide for clinicians as well as individuals to manage tongue tie after its release. Shah SS, Agarwal PV, Rathi N, et al. Tongues Tied by Orofacial Myofunctional Therapy about Tongue Tie: A Narrative Review. Int J Clin Pediatr Dent 2024;17(1):109-113.

Potential Side Effects of Comprehensive Fixed Orthodontic Treatment: A Narrative Review

Orthodontics is a specialty derived from dental sciences that starts by diagnosing, preventing, intercepting, modifying growth, and treating all dentofacial discrepancies. Medical interventions can cause harm besides their benefits. This review is done to evaluate the most common potential risks that can be caused by orthodontic treatment and detect the most common factor in the treatment that may lead to this hazard. The review was conducted based on PRISMA-S guidelines for literature search strategy for systematic reviews. Despite all the beneficial effects of orthodontic treatment, it also has negative effects on oral and peri-oral structures and social well-being. It is also important to obtain informed consent from patients before the initiation of any orthodontic procedure, especially in cases with a history of trauma or known adverse reactions.

Potential Side Effects of Comprehensive Fixed Orthodontic Treatment: A Narrative Review

Orthodontics is a specialty derived from dental sciences that starts by diagnosing, preventing, intercepting, modifying growth, and treating all dentofacial discrepancies. Medical interventions can cause harm besides their benefits. This review is done to evaluate the most common potential risks that can be caused by orthodontic treatment and detect the most common factor in the treatment that may lead to this hazard. The review was conducted based on PRISMA-S guidelines for literature search strategy for systematic reviews. Despite all the beneficial effects of orthodontic treatment, it also has negative effects on oral and peri-oral structures and social well-being. It is also important to obtain informed consent from patients before the initiation of any orthodontic procedure, especially in cases with a history of trauma or known adverse reactions.

The Average Facial Expressions: A Range of Motion Analysis for Different Sex and Age Groups.

Three-dimensional photographs were taken from healthy subjects in rest, maximum closed smile, and pouting. Displacement for both exercises of perioral landmarks was analyzed with MATLAB as absolute displacement and as the ratio of mouth width. Additionally, displacement in three planes was analyzed for each landmark. Averages were calculated for both genders in four age groups: 4-8, 8-12, 12-16, and >16 years. In total, 328 subjects were included. Oral landmarks predominantly moved forward and backward for both exercises. Nasal landmarks predominantly moved vertically. Growing up, oral landmark displacement decreased for smiling, whereas nasal landmark displacement increased. For pouting, oral landmark displacement increased while growing up, whereas nasal landmark displacement decreased. The present study creates reference values for movement of perioral structures for different sex and age groups, for two facial expressions. These data are of great value for the assessment of mimic function and give insight into the development of facial animation over time.

Addisonian Hyperpigmentation as Oral Manifestation in Primary Adrenal Insufficiency – A Case Report

Primary adrenal insufficiency is an endocrine disorder which is characterized by aldosterone and cortisol deficiency due to destruction of the adrenal cortex. The purpose of this case report is to present a rare case of 10-year-old child patient who reported with a chief complaint of pain in the upper left back tooth region of the jaw since a week and was diagnosed as Addison disease with hyperpigmentation of dorsal surface of the tongue, perioral structures and skin folds, nails and overall skin of the body. Oral manifestations along with endocrine issues play a crucial role in diagnosis & treatment planning of this disease. Dental infection can be a cause of adrenal crisis in patients with long term adrenal insufficiency, so paediatric dentists should be aware and a multidisciplinary approach is mandatory to ensure adequate medical and dental treatment in children. Limited number of case reports in literature suggest that adrenal crisis is a rare emergency condition in dentistry, and diagnosis is mandatory to rule out any condition before a dental surgical procedure

Effect of an early oral stimulation program on oral feeding in preterm neonates

ObjectiveTo evaluate the effect of prefeeding oral stimulation program on feeding performance, weight gain, and length of hospital stay of preterm infants in neonatal ICUs.BackgroundPrevious research has declared that poor oral-motor developments in premature infants are common. So, most of the preterm infants require individualized therapy. Early intervention of oral-motor management on feeding pattern improves the outcome.Patients and methodsTo reach the goal of this research, a case–control study was conducted. A total of 50 preterm infants were divided into two groups: (a) interventional group (25 preterm infants), which received prefeeding oral stimulation program by stimulation of the oral and perioral structures for 5 min for 10 days and was started immediately after delivery, and (b) control group (25 preterm infants), which did not receive stimulation. Postmenstrual age, total intake volume, body weight, the transition time from initiation of oral feeding to full oral feeding, and feeding efficiency were calculated.ResultsWe found that the mean oral feeding duration was significantly lower among intervention group compared with control group (P = 0.04). The percentage of weight change was significantly higher among intervention group compared with control group (P = 0.03).ConclusionOur study reveals that early sensory oral-motor stimulation with nonnutritive sucking in preterm infants may be effective to expedite oral feeding and hospital discharge. A touch therapy program may confer a statistically significant weight gain for premature babies at much shorter intervals, which leads to a shorter hospital stay.

Van der Woude Syndrome: A Case Report

Among the many disturbances of development and growth that involve the oral and perioral structures, cleft lip and palate is perhaps the commonest. Dental literature is replete with syndromes associated with cleft lip and palate, one of which is Van der Woude syndrome. The characteristics of Van der Woude syndrome is the association of cleft lip and/or palate with distinctive lower lip pits. A case of Van der Woude syndrome in an 11-year-old boy and his sister is presented.

Transantral approach for surgical removal of impacted maxillary second premolar located in trifurcation of molar roots: a case report

AbstractImpaction of teeth is a well‐documented phenomenon, and multiple cases have been reported in various sites in the oral and perioral structures. However, to our best knowledge, no single case has been reported of an impacted premolar with its crown lying in trifurcation of the roots of the neighbouring molar and its root projecting into the maxillary sinus. This unique case was managed by a transantral surgical extraction. This article aims to describe, by means of case report and review of the literature, the characteristics and occurrence of ectopic retention of the maxillary premolars. Different diagnostic procedures and surgical approaches for the removal of such impacted teeth are discussed. This case report and review emphasise the importance of using the cone‐beam computed tomography in the diagnosis and planning of management strategy for impacted teeth in close proximity to the roots of the surrounding teeth and other structures.

Results of Total Maxillary Edentulism Rehabilitation Protocol with Implant-Supported Prostheses in the Pterygomaxillary-Pyramidal Region as Posterior Anchorage Loci.

To present functional and esthetic success of a well-defined protocol for rehabilitation with implant-supported complete-arch prostheses in the treatment of patients with maxillary edentulism. Medical records of patients treated from 1990 to September 2014 were reviewed. This clinic history should include clinical, anatomicalfunctional, and esthetic data for at least the first 5 years of follow-up. Two hundred eighty-two implants were inserted into the pterygomaxillary-pyramidal region in 141 edentulous patients using cylindrical osteotomes to form bone sites and thereby minimize the use of drills in bone preparation. Also, 580 implants were inserted in the premaxilla using lyophilized bone of bovine origin as a graft material and platelet-rich plasma for repairing small bone defects around implants and as a volume-generating material to support perioral structures. Of the 282 implants placed in the pterygomaxillary-pyramidal region, 272 survived (96.1% survival rate). The 10 failures occurred after being subjected to functional load. Of the 580 implants placed in the premaxilla, 19 implants failed; thus, the survival rate was 96.7%. Moreover, from the results obtained in the study sample, it was observed that the retention and stability obtained with the implant-supported prosthesis helps improve the ability to speak, swallow, and chew, which improves patient comfort and satisfaction. The rehabilitation of total maxillary edentulism with an implant-supported complete-arch prosthesis achieves a high level of functional and esthetic success, which is reflected directly in oral health and patient satisfaction.

The Use of Lip Bumper in Lip Sucking Treatment

<p><strong><em>Background: </em></strong><em>Oral habits include habit which are continuously done and has the potential to cause defects on teeth and perioral tissues.Lip sucking or biting habits are often found simultaneously or as a substitution of finger sucking. This habit may affect the labial and perioral structures. The habit may take </em><em>several</em><em> forms. Two extreme types are mild wetting</em><em> of</em><em> the lips with the tongue and pulling the lips into the mouth between the teeth. The lip bumper is a functional device that is used successfully to intercept developing dental and occlusal problems by allowing a proper development of the arch length and width for eruption of the permanent teeth.</em><strong><em>Purpos</em></strong><strong><em>e:</em></strong><em> This study aimed to re-validate the effectiveness of lip bumper application and habitual therapy in treating the bad habit of lip sucking. <strong>Case Report:</strong> The mother of a 9-year-old girl reported an upper front teeth protrusion and frequent occurrence of mouth ulcer. Further examination revealed that the patient had a habit of lip sucking. </em><strong><em>Case Management</em></strong><strong><em>:</em></strong><em> Removable Lip Bumper is used to control lip habits such as lip sucking and to improve mentalis muscle hyperactivity. Such habit was treated with the use of a removable lip bumper and habitual therapy conducted by both parents. Constants reminder and encouragement from the parent to wear the lip bumper is one of the key success factors in this treatment. <strong>Conclusion: </strong>Five months after the initial application of a lip bumper and habitual therapy, the patient overcame the habit of lip sucking.</em></p><p><strong><em>Keywords</em></strong><strong><em>:</em></strong><em> lip bumper, lip sucking, myofunctional therapy</em></p><p><strong><em>Correspondence</em></strong><strong><em>:</em></strong><em> YulieEmildaAkwan, </em><em>Department of Pediatric Dentistry</em><em>, Faculty of Dentistry, Hang TuahUniversity, Arif Rahman Hakim 150, Surabaya, Phone 031-5945864, Email: <span style="text-decoration: underline;">yulieemilda@yahoo.com.</span></em></p>

Wind Instrumentalist Embouchure and the Applied Forces on the Perioral Structures

Introduction:The wind instrumentalist embouchure is probably one of the most demanding tasks that occurs during their musical performance. It is important to quantify the forces that are applied during the wind instrumentalist embouchure on the perioral structures.Objective:Quantify the force on the perioral structures involved during the embouchure mechanism of wind instrumentalists.Methods:Piezoresistive sensors of FlexiForceTMwere placed on the mouthpiece of 28 different wind instrumentalists, in order to obtain the applied forces transmitted to the upper lip or the lower lip. The application of the sensors were done according to the particular characteristics of the different types of wind instruments, single reed, double reed or metal. Each participant performed three times three different notes at different pitches: high, medium and low. The average medium and maximum pressure was obtained from the nine essays. The sensors were connected to a data acquisition board from National Instruments and the results displayed in LabVIEW 2011.Results:Measurement values were obtained for the different groups of wind instruments. In an ascending order, the pressures registered where for the bassoon (6g-31g), the oboe (17g-125g), the saxophone (39g-120g), the clarinet (54g-106g), the trumpet, (63g-172g), the bisel flute (73g-245g), the French horn (56g-305g), the transversal flute (220g-305g) and the trombone (201g-325g).Conclusion:Metal instrumentalists seem to apply greater forces than woodwind musicians when performing the embouchure mechanism, being in this specific case the trombone the instrument from the metal group to exert more force, while on the contrary, the bassoon registered the lower values.

Effects of spatiotemporal manipulation of audiovisual speech on the perception of prosodic structure

Work in audiovisual speech processing (AVSP) has established that the availability of visual speech signals can influence auditory perception by improving the intelligibility of speech in noise (Sumby and Pollack, 1954). However, exactly which aspects of visible signals are most responsible for this enhancement remains an open question, although convergent evidence along several lines suggests that visible information may reflect a common articulatory-acoustic temporal signature, and that the multi-modal availability of this temporal signature is at the root of this effect. We evaluated this hypothesis in a perceptual study using simple talking face animations whose motion is driven by a signal derived from the collective motion of perioral structures of an actual talker. We applied spatial and temporal manipulations to the structure of this driving signal using a biologically plausible model that preserves the smoothness of the manipulated trajectory, and tested whether these kinematic manipulations influenced the perception of linguistic prominence, an important component of the timing and rhythm (prosody) of speech. The data suggest that perceivers are sensitive to these manipulations, and that the cross-correlation between the acoustic amplitude envelope and the manipulated visible signal was a strong predictor of the perception of prominence.

Oral Sensorimotor Intervention Enhances Breastfeeding Establishment in Preterm Infants.

To assess the efficacy of an oral sensorimotor intervention on breastfeeding establishment and maintenance in preterm infants. Thirty-one preterm infants born ≤34 weeks gestation were randomized into an experimental or control group. The experimental group received a 15-minute program consisting of stroking the peri-oral structures for the first 5 minutes, tongue exercises for the next 5 minutes, followed by non-nutritive sucking for the final 5 minutes. The control group received a sham intervention for the same duration. The interventions were administered once daily for 10 days. The outcomes included: time to attainment of full oral feeding, breastfeeding acquisition (i.e., ≥50% of direct breastfeeding at hospital discharge), breastfeeding skill assessment using the Preterm Infant Breastfeeding Behavior Scale (PIBBS), length of hospitalization, and breastfeeding maintenance at 3 and 6 months posthospitalization. Full oral feeding was attained earlier in the experimental group compared with the control (10.7 ± 2.1 vs. 19.3 ± 3.6 days, p < 0.01). This was associated with a greater number of infants in the intervention group acquiring breastfeeding at hospital discharge compared with the controls (n = 11 vs. 5, p = 0.049). There was no statistical difference in PIBBS score, length of hospitalization, and breastfeeding rates at 3 and 6 months posthospitalization between the two groups (all tests, p > 0.32). An oral sensorimotor intervention accelerated the achievement of full oral feeding and enhanced direct breastfeeding rates at hospital discharge only. Provision of an oral sensorimotor intervention is a safe and low-cost intervention that may increase breastfeeding rates in a highly vulnerable population.

Factitious cheilitis: A rare case report

Self-injurious behavior (SIB) can be defined as the destruction or damage of body tissue without suicidal intent. Oral and perioral structures can be traumatized by SIB which involves biting of lips, cheek, lateral surface of the tongue, or buccal mucosa. Depending on its frequency and severity, SIB can lead to various degrees of self-injury. We hereby present a case of patient having lip lesion with positive history of lip chewing.

Odontogenic Tumors: A Review of 675 Cases in Eastern Libya.

Aims:The aim of this study was to determine the relative frequency of odontogenic tumors (OTs) in an Eastern Libyan population based on the 2005 World Health Organization (WHO) classification, and also to compare the actual data with previous studies.Materials and Methods:We retrieved and analyzed 85 OTs from a total of 675 tumors and tumor-like lesions of the oral and perioral structures, for gender, age, tumor site, and frequency. The diagnosis was based on the most recent WHO (2005) classification of OTs.Results:OTs constituted 12.6% of all oral/jaw tumors and tumor-like lesions. Ameloblastoma (28.2%) was the most common type, followed by keratocystic odontogenic tumor (25.2%) and odontoma (19.9%). The male: female ratio was 1.2:1, and maxilla: mandible ratio 1:2. The mean age of occurrence of tumors was 29 years with a peak incidence between 10 and 40 years.Conclusions:OTs are relatively common lesion in this Libyan Population, but the incidence of tumors is neither similar to Caucasians nor Sub-Saharan population.

Central Connectivity of Transient Receptor Potential Melastatin 8-Expressing Axons in the Brain Stem and Spinal Dorsal Horn

Transient receptor potential melastatin 8 (TRPM8) ion channels mediate the detection of noxious and innocuous cold and are expressed by primary sensory neurons, but little is known about the processing of the TRPM8-mediated cold information within the trigeminal sensory nuclei (TSN) and the spinal dorsal horn (DH). To address this issue, we characterized TRPM8-positive (+) neurons in the trigeminal ganglion and investigated the distribution of TRPM8+ axons and terminals, and their synaptic organization in the TSN and in the DH using light and electron microscopic immunohistochemistry in transgenic mice expressing a genetically encoded axonal tracer in TRPM8+ neurons. TRPM8 was expressed in a fraction of small myelinated primary afferent fibers (23.7%) and unmyelinated fibers (76.3%), suggesting that TRPM8-mediated cold is conveyed via C and Aδ afferents. TRPM8+ axons were observed in all TSN, but at different densities in the dorsal and ventral areas of the rostral TSN, which dominantly receive sensory afferents from intra- and peri-oral structures and from the face, respectively. While synaptic boutons arising from Aδ and non-peptidergic C afferents usually receive many axoaxonic contacts and form complex synaptic arrangements, TRPM8+ boutons arising from afferents of the same classes of fibers showed a unique synaptic connectivity; simple synapses with one or two dendrites and sparse axoaxonic contacts. These findings suggest that TRPM8-mediated cold is conveyed via a specific subset of C and Aδ afferent neurons and is processed in a unique manner and differently in the TSN and DH.

Il ruolo dell’odontoiatra nella medicina estetica: norme e indicazioni

ObjectivesThe aim of this paper is to evaluate the roles played by dentistry graduates in Aesthetic Medicine interventions involving the face and the lips and to analyze age-related esthetic changes in the perioral structures. Materials and methodsWe briefly review the treatments in which dentists are involved, including the injection of fillers or botulinum toxin, and the professional liability and insurance issues related to these interventions. Results and conclusionsIn the last decade, there have been dramatic increase in both the supply and demand for Aesthetic Medicine interventions involving the face and the lips, but clear laws regulating the roles of dentists in this professional activity are lacking. In response to this situation, the presidency of the Italian Board of Dentists Board expressed its opinion on the lawfulness of such treatment by dentists in June 2010. The authors maintain that individuals holding graduate degrees in dentistry and prosthodontics from Italian universities are competent to perform Aesthetic Medicine treatments within the limits prescribed by the current law.

Orodental manifestations of facial port-wine stains

Patients with facial port-wine stains (PWS) often demonstrate oral manifestations of their disorder; however, the spectrum and prevalence of such findings among a cohort of patients with PWS has not been established. As a result, dermatologists and oral health specialists may be uncertain how to counsel their patients with PWS regarding oral hypervascularity, bony oral changes, and oral hygiene. We sought to identify physical findings and complications involving the teeth, oral cavity, and perioral structures in individuals with facial PWS. This was a cross-sectional study of 30 patients with facial PWS. Descriptive data were collected through anonymous paired surveys completed by patients and their dentists, and analyzed (Fisher exact test) for trends based on physical findings and stage of the PWS. The most common orodental manifestations according to patients were enlargement of the lip (53.3%), stained gums (46.7%), abnormal bite (30%), and spontaneous bleeding of the gums (26.7%). Staining of the gingiva correlated significantly with gingival hyperplasia (P = .006), maxillary hyperplasia (P = .014), and widened interdental spaces (P = .002), and in all cases gingival staining predated these findings. Lip hyperplasia was reported more frequently by patients than by their dentists (50% vs 18.2%, P = .008). Orodental manifestations were more common among patients with darker and thicker PWS. Hemorrhage after dental procedures was rare (4.5%). Modest sample size and difficulty recruiting control subjects are limitations. Facial PWS commonly affect the orodental structures, and intraoral staining may predict future complications.

Impactos oro-faciais associados à utilização de instrumentos musicais

The increasing use of musical instruments since childhood, can lead to clinical conditions for which medical professionals oral health should pay particular attention in order to prevent and minimize consequences of such use. The development of pathology associated with the use of musical instruments can provide temporary or permanent limitations, justifying the importance of including valid form of the condition of the oral structures in the activities of occupational health.Aim of this review paper is intended to address generally, the characteristics of musical instruments that can affect the oral or perioral structures and their clinical manifestations.The authors conducted a literature review using the Medline, Scielo, Embase and SciVers, as well as the manual search in university libraries and in music schools in Portugal, Spain and United Kingdom. Also adopted an active research based on the references used in the various publications found.

The effect of oral habits in the oral cavity of children and its treatment

Oral habits include habit which is continuously done and has the potential to cause defects in teeth and perioral tissues. Some of the oral habits are finger/thumb sucking, lip sucking/biting, nail biting, bruxism, abnormal swallowing and mouth breathing. The etiology of oral habits includes the disharmonious relationship between parents and children, dissatisfaction in oral phase, premature weaning, emotional disturbance, anomaly, and diseases. Oral habits will influence the development of occlusion and perioral structures in children in the growing and development process. The treatment of oral habits can be done with or without appliances. The non-appliance treatment consists of psychological approach, medical approach and myofunctional therapy while the appliance treatment will include the use of orthodontic appliances.