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Oliver S, Keyser MMB, Jhingree S, Bocklage C, Lathrop H, Giduz N, Moss K, Blakey G, White R, Turvey T, Mielke J, Zajac D, Jacox LA. Impacts of anterior-posterior jaw disproportions on speech of dentofacial disharmony patients. Eur J Orthod 2023; 45:1-10. [PMID: 36308520 PMCID: PMC9912703 DOI: 10.1093/ejo/cjac057] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND/OBJECTIVES Articulation problems impact communication, development, and quality of life, and are diagnosed in 73-87% of patients with Class II Dentofacial Disharmony (DFD). We evaluated whether differences exist in stop (/t/ or/k/), fricative (/s/ or/ʃ/), and affricate (/tʃ/) consonant sounds of Class II DFD subjects, and whether extent of malocclusion correlates with severity of speech distortion. We hypothesized that Class II patients display milder distortions than Class III and anterior open bite (AOB), as Class II patients can posture into a Class I occlusion. MATERIALS/METHODS Audio and orthodontic records were collected from DFD patients (N = 53-Class II, 102-Class III, 72-Controls) who were pursuing orthodontics and orthognathic surgery. A speech pathologist perceptually scored speech. Acoustic differences in recordings were measured using Spectral Moment Analysis. RESULTS When Class II subjects were compared to controls, significant differences were found for the centroid frequency (M1) of the /s/ sound and the spectral spread (M2) of /t/, /tʃ/, and /s/ sounds, with pairwise significance for controls relative to Class II AOB and all Class II subjects. Class II AOB subjects had higher M1 and M2 values than patients with Class II closed bites and Class I controls for most sounds. When comparing across anterior-posterior (AP) groups, differences exist between controls, Class II and III DFD subjects for M1 of /t/, /tʃ/, and/ʃ/ and M2 for /t/, /tʃ/, /s/, and /ʃ/ sounds. Using linear regression, correlations between Class II and III severity and spectral measures were found for /t/ and /tʃ/ sounds. CONCLUSIONS/IMPLICATIONS Class II and III patients have a higher prevalence of qualitative distortions and spectral changes in consonants compared to controls, but Class II spectral shifts are smaller and affect fewer sounds than in Class III and AOB cohorts. Linear correlations between AP discrepancy and spectral change suggest causation and that treatment may improve articulation problems.
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Affiliation(s)
- Steven Oliver
- Division of Craniofacial and Surgical Care, Orthodontics Group, Adams School of Dentistry, University of North Carolina, Chapel Hill, NC, USA
| | - Mary Morgan Bitler Keyser
- Division of Craniofacial and Surgical Care, Orthodontics Group, Adams School of Dentistry, University of North Carolina, Chapel Hill, NC, USA
| | - Samantha Jhingree
- Division of Craniofacial and Surgical Care, Orthodontics Group, Adams School of Dentistry, University of North Carolina, Chapel Hill, NC, USA
| | - Clare Bocklage
- Division of Craniofacial and Surgical Care, Orthodontics Group, Adams School of Dentistry, University of North Carolina, Chapel Hill, NC, USA
| | - Hillary Lathrop
- Division of Craniofacial and Surgical Care, Orthodontics Group, Adams School of Dentistry, University of North Carolina, Chapel Hill, NC, USA
| | - Natalie Giduz
- Division of Craniofacial and Surgical Care, Orthodontics Group, Adams School of Dentistry, University of North Carolina, Chapel Hill, NC, USA
| | - Kevin Moss
- Division of Oral and Craniofacial Health Sciences, Adams School of Dentistry, University of North Carolina, Chapel Hill, NC, USA
| | - George Blakey
- Division of Craniofacial and Surgical Care, Oral Surgery Group, Adams School of Dentistry, University of North Carolina, Chapel Hill, NC, USA
| | - Raymond White
- Division of Craniofacial and Surgical Care, Oral Surgery Group, Adams School of Dentistry, University of North Carolina, Chapel Hill, NC, USA
| | - Timothy Turvey
- Division of Craniofacial and Surgical Care, Oral Surgery Group, Adams School of Dentistry, University of North Carolina, Chapel Hill, NC, USA
| | - Jeff Mielke
- North Carolina State University, English Department, Tompkins Hall, Raleigh, NC, USA
| | - David Zajac
- Division of Craniofacial and Surgical Care, Speech Pathology Group, Adams School of Dentistry, University of North Carolina, Chapel Hill, NC, USA
| | - Laura Anne Jacox
- Division of Craniofacial and Surgical Care, Orthodontics Group, Adams School of Dentistry, University of North Carolina, Chapel Hill, NC, USA
- Division of Oral and Craniofacial Health Sciences, Adams School of Dentistry, University of North Carolina, Chapel Hill, NC, USA
- UNC Adams School of Dentistry, 385 S Columbia St, Chapel Hill, NC 27599, USA
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Chen B, Li LX, Zhou LL. Dental management of a patient with Moebius syndrome: A case report. World J Clin Cases 2021; 9:7269-7278. [PMID: 34540988 PMCID: PMC8409181 DOI: 10.12998/wjcc.v9.i24.7269] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 06/16/2021] [Accepted: 07/05/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Moebius syndrome (MBS) is a nonprogressive and rare congenital neuromuscular disorder involving the facial nerve and abductor nerve; it mainly manifests as facial paralysis and eye strabismus paralytic symptoms. Tissues in the oral cavity are also compromised, characterized by microstomia, micrognathia, tongue malformation, cleft lip, high arched palate or cleft palate, bifid uvula, and dental malocclusion. Therefore, dentistry plays a fundamental and crucial role in caring for these individuals. However, there is limited available data on MBS treatment, particularly regarding dental management.
CASE SUMMARY This case report presents dental treatment of a 21-year-old man with MBS and discusses crucial interactions among oral complications of MBS. In this case, the patient was clinically characterized by congenital neuromuscular disorder, occlusal disorders, and tooth and gum problems. It is noteworthy that the patient presented early eruption of deciduous teeth 2 mo after birth, which has not been reported in other MBS cases and suggests a potentially new clinical manifestation of this syndrome. It is important to note that MBS cannot be cured, and oral manifestations of this syndrome can be managed by a multidisciplinary health care team that helps the patient maintain oral hygiene and dental health. After a series of oral treatments, no obvious poor oral hygiene, swollen gums, or abnormal imaging results were observed after 2 years of follow-up.
CONCLUSION This case addressed the oral clinical manifestations of MBS and difficulties experienced during dental management, and suggested early tooth eruption as a potentially new clinical manifestation of this syndrome. Knowledge of the loop-mediated association among oral complications of this syndrome is essential to perfecting treatments.
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Affiliation(s)
- Ben Chen
- Department of Oral Medicine, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310009, Zhejiang Province, China
| | - Ling-Xia Li
- Department of Generality, Hospital of Stomatology, Zhejiang Chinese Medical University, Hangzhou 310000, Zhejiang Province, China
| | - Li-Li Zhou
- Department of Oral Medicine, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310009, Zhejiang Province, China
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de Boer G, Bressmann T. Application of linear discriminant analysis to the nasometric assessment of resonance disorders: a pilot study. Cleft Palate Craniofac J 2018; 52:173-82. [PMID: 25714268 DOI: 10.1597/13-109] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Objective : Nasalance scores have traditionally been used to assess hypernasality. However, resonance disorders are often complex, and hypernasality and nasal obstruction may co-occur in patients with cleft palate. In this study, normal speakers simulated different resonance disorders, and linear discriminant analysis was used to create a tentative diagnostic formula based on nasalance scores for nonnasal and nasal speech stimuli. Materials and Methods : Eleven female participants were recorded with the Nasometer 6450 while reading nonnasal and nasal speech stimuli. Nasalance measurements were taken of their normal resonance and their simulations of hyponasal, hypernasal, and mixed resonance. Results : A repeated-measures analysis of variance revealed a resonance condition-stimuli interaction effect (P < .001). A linear discriminant analysis of the participants' nasalance scores led to formulas correctly classifying 64.4% of the resonance conditions. When the hyponasal and mixed resonance conditions with obstruction of the less patent nostril were removed from the analysis, the resultant formulas correctly classified 88.6% of the resonance conditions. Conclusion : The simulations produced distinctive nasalance scores, enabling the creation of formulas that predicted resonance condition above chance level. The preliminary results demonstrate the potential of this approach for the diagnosis of resonance disorders.
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