Influence of Oral Morphology on Speech Production in Subjects Wearing Maxillary Removable Partial Dentures with Major Connectors

Oral health-related quality of life and parental anxiety in chinese children undergoing Dental General Anesthesia: a prospective study

Dental general anesthesia (DGA) is an effective treatment for very young children or those who have severe dental fear and mental or physical disabilities. However, the long-term impacts of DGA on oral health-related quality of life (OHRQoL) and parents' anxiety in China are still questionable. This study aimed to assess the influence of DGA on OHRQoL in Chinese children and their parents' psychological status. A total of 204 children and their parents participated in this study. The ECOHIS was applied to evaluate OHRQoL in children. The parents' anxiety was analyzed using the Chinese version of the Kessler 10 scale. The internal consistency was evaluated with Cronbach's alpha coefficient, and Wilcoxon signed-rank test was used for statistical analyses. The scores of each section of ECOHIS decreased one month after the procedure except for the self-image and social sections (P < 0.05). The scores of the Kessler 10 scale decreased one month after DGA and kept decreasing six months later (P < 0.05). The parents' Kessler 10 scores exhibited a moderately positive correlation with the children's ECOHIS scores (r = 0.480, P < 0.05). After DGA, the OHRQoL of Chinese children and their parents' mental health continued to improve. And they exhibited positive correlation.

Influence of pontic design of anterior fixed dental prosthesis on speech: A clinical case study

BACKGROUND

The pontic design of fixed dental prostheses (FDPs) is strongly associated with the phonetic function, and the phonetic function of anterior FDPs with different pontic designs remains understudied.

AIM

To investigate the immediate and short-term influence of pontic design of anterior FDPs on Chinese speech in a clinical case using objective acoustic analysis.

METHODS

Two FDPs with two types of pontic design (saddle pontic and modified ridge lap pontic) were fabricated for one patient with maxillary anterior teeth missing. The acoustic analysis of patient’s articulation was conducted immediately after wearing the FDPs and 1 wk after wearing these FDPs.

RESULTS

The effect of FDP on Chinese vowels (/a/, /o/, /e/, /i/, /u/, and /ü/) was insignificant, because the recovery of vowel distortion occurred within 1 wk for both FDPs. Three (/f/, /s/, and /sh/) of eight Chinese fricative consonants were found to have obvious distortions, and the /s/ sound distortion last for more than 1 wk for the patient wearing FDP with modified ridge lap pontic design.

CONCLUSION

The influence of anterior FDP on articulation of Chinese vowels is insignificant, while the articulation of Chinese fricative consonants is more susceptible. When fabricating anterior FDPs for patients with speech related professions, saddle pontic design can be an alternative option compared with modified ridge lap pontic design.

Influence of pontic design on speech with an anterior fixed dental prosthesis: A clinical study and finite element analysis

STATEMENT OF PROBLEM

Patients may experience disturbed articulation after treatment with a fixed dental prosthesis. However, studies that assess the relationship between fixed dental prosthesis design and the accuracy of speech sound production are lacking.

PURPOSE

The purpose of this clinical and finite element analysis (FEA) study was to examine the influence of pontic design on speech with anterior fixed dental prostheses.

MATERIAL AND METHODS

First, an articulation test was carried out in which a partially edentulous participant was required to pronounce 4 Chinese words containing the voiceless fricative/s/while wearing fixed dental prostheses with 2 types of pontic designs. The oral morphology was obtained by cone beam computed tomography (CBCT) scanning while the participant, wearing the 2 fixed dental prosthesis designs, was pronouncing the voiceless fricative/s/sound. The geometry of the oral cavity was then reconstructed by an image processing software program. Finally, a finite element model for sound wave propagation inside the oral cavity was developed within the framework of the finite element analysis software program. By using this model, the sound pressure level of the 2 types of pontic design was characterized and quantified under different fundamental frequencies (F₀). The data were analyzed with 1-way ANOVA (α=.05).

RESULTS

The experimental articulation test reported that the pontic design of fixed dental prostheses affected the speech production of the/s/sound (P<.001). The numerical study reported that the sound pressure level values were different under various fundamental frequencies. In addition, the pontic design of fixed dental prostheses affected the sound pressure level values, and the differences varied significantly from 420 to 1300 Hz (P<.05); however, the differences were not significant between 120 and 420 Hz (P>.05). Moreover, further comparisons of low F₀ (120 to 500 Hz), medium F₀ (520 to 900 Hz), and high F₀ (920 to 1300 Hz) reported that the differences in the medium F₀ area were most obvious (P<.001 for maximum sound pressure level value and P=.001 for sound pressure level value at Point Q).

CONCLUSIONS

Both the fixed dental prosthesis pontic design and the fundamental frequency could affect the sound field distribution.

Influence of the Covering Area of Major Connectors of Mandibular Dentures on the Accuracy of Speech Production: A Pilot Study

BACKGROUND/OBJECTIVES

Speech impairment during the initial phase of removable partial denture (RPD) treatment can prevent patient adaptation to RPDs. This quasi-experimental study aimed to investigate the influence of the covering area of major connectors located in the mandibular anterior region on the accuracy of speech production.

METHODS

Fifteen adults (12 men and 3 women aged 26-40 years) with healthy dentition were recruited. Four target syllables were used for the assessments: [ʃi], [ʧi], [çi], and [ki]. There were four speaking conditions: without a connector (control), wearing lingual bar (5 mm width), wearing lingual plates (12 mm width), and wearing connectors covering the occlusal surface of lower dentition (16 mm width; CO). The accuracy of speech production was evaluated by mean appearance ratio of correct labels (MARC) and incorrect labels (MARIC) of the phonetic segments which were calculated with a speech evaluation system (VoiceAnalyzer).

RESULTS

The MARC in the 3 target syllables [ʃi], [ʧi], and [ki] significantly decreased with CO. For the target syllable [ʃi], the MARICs of [ʧi], [ʤi], and [çi] with CO were significantly lower than that in the control. For the target syllable [ʧi], the MARIC of [ki] with CO was significantly higher than that in the control. For the target syllable [çi], the MARIC of [gi] with CO was significantly higher than that in the control.

CONCLUSION

RPDs with major connectors covering the lower dentition could disturb speech production during the initial phase of RPD treatment. Prosthodontic treatment with such RPD designs requires further consideration regarding the information given to patients before starting the treatment.

A Palatal Speech Bulb—A Case Study

Palatal defects of the oral cavity can be either congenital or acquired following trauma or surgical excision of malignant disease. Palatal defects can greatly affect function and subsequent quality of life. Rehabilitation using a removable obturator can be a preferable treatment option as it allows regular review post-surgery. This case study reports on the design and construction of a removable “speech bulb” obturator. A 50-year-old female patient presented complaining of nasal regurgitation and looseness of her current palatal obturator. She had previously undergone wide surgical excision of her soft palate under general anaesthesia due to adenoid cystic carcinoma. Treatment consisted of the provision of a new removable obturator, paying careful attention to the design of the “speech bulb” itself. The design of the “speech bulb” is crucial to optimise function, and the method of prosthesis fabrication is fully described. This case highlights the impact of obturator fit on a patient’s quality of life and will be of benefit to clinicians from many disciplines including dentists, oral and maxillofacial surgeons, Ear, Nose & Throat (ENT) surgeons and speech and language therapists.