Prospective Evaluation of Cervical Mobility and Postural Adaptations Following Functional Lingual Frenuloplasty: A Multidisciplinary Pilot Protocol

Background
Restricted tongue mobility has been associated with oro-myofunctional dysfunctions affecting breathing, swallowing, speech, and craniofacial development. More recently, interdisciplinary clinical observations have suggested possible interactions between tongue mobility, cervical muscle compensation, fascial dynamics, and global postural organization. However, objective and standardized prospective data regarding postural adaptations following functional lingual frenuloplasty remain limited, and to our knowledge no prospective protocol has yet combined validated immersive motion analysis, balance assessment, and surface electromyography to objectively quantify these adaptations.

Objective
To develop and evaluate the feasibility of a standardized multidisciplinary protocol assessing objectively measurable cervical mobility and postural adaptations before and after functional lingual frenuloplasty using validated assessment tools.

Methodology
This pilot prospective study includes patients presenting with symptomatic restrictive tongue mobility associated with oro-myofunctional dysfunctions. Patients undergo multidisciplinary evaluation involving dentistry, posturology, occlusodontics, and myofunctional therapy.

Assessments are performed at four time points:
1 month pre-operatively,
1 day pre-operatively,
1 day post-operatively (after anesthetic resolution),
and 1 month post-operatively.

The intervention consists of functional lingual frenuloplasty associated with standardized pre- and post-operative myofunctional rehabilitation. Primary outcomes include objective cervical range-of-motion measurements obtained using the validated PhysioVR system, postural balance analysis using the validated BalanceVR platform, and surface electromyographic (EMG) assessment of selected cervical and/or masticatory muscle groups.
Measured parameters include cervical rotation, flexion-extension amplitudes, center-of-pressure displacement, postural stability indices, and neuromuscular activation patterns during standardized functional tasks. EMG recordings are performed at baseline and at 1 month post-operatively in order to evaluate potential neuromuscular adaptations following treatment. To improve methodological consistency, predefined exclusion criteria include recent cervical trauma, active orthodontic treatment, severe cervical pathology, recent manual therapy, neurological disorders, and medications potentially affecting muscular tone or neuromuscular regulation. The study design primarily relies on intra-subject comparison to reduce interindividual variability and improve interpretation of functional changes over time.

Implications
The objective of this protocol is not to establish direct causality between ankyloglossia and postural disorders, but rather to investigate reproducible functional associations and objectively measurable neuromuscular adaptations observed clinically.
 

This pilot protocol may contribute to the development of future standardized methodologies exploring the relationships between tongue mobility, cervical dynamics, breathing function, and global neuromuscular organization through reproducible and quantifiable measurements that, to our knowledge, have not previously been prospectively studied in this combined framework.