Angle Orthod. 2021 Nov 1;91(6):711-717. doi: 10.2319/110620-917.1.
To evaluate effects of orthodontic treatment with aligners and conventional fixed appliances on production of speech.
This was a parallel, randomized clinical trial. Patients with Angle Class I malocclusion, moderate crowding, and no speech impairment were randomly allocated to two groups: patients with orthodontic aligners (OAs; n = 20; mean age = 23.60 ± 5.65 years) and those with conventional fixed appliances (n = 20; mean age = 20.56 ± 4.51 years) and treated at the University of North Parana's clinic in Londrina, Brazil. Evaluation of speech production was performed semiobjectively by a speech therapist (myofunctional orofacial examination) and subjectively (self-assessment) at five time points: baseline, immediately after insertion of appliances, and subsequently at 3, 30, and 180 days after insertion. For intergroup comparison, independent t, χ2, Fisher exact, and Mann-Whitney tests were used; for intragroup comparison, the Friedman test was applied (α = 5%).
In the semiobjective evaluation, patients with OAs exhibited a change in production of speech production, compared with patients with fixed appliances, immediately and 3 days after insertion of appliances (P < .001). Thirty days after insertion, the groups were similar (P = .487), an outcome that was unchanged at 180 days. However, in the self-assessments, patients in both groups reported significant speech difficulties immediately and 3 days after insertion of appliances, but such impairment was no longer perceived at 30 days or 180 days.
Although the speech therapist identified changes in speech production at the start of treatment in the OA group only, patient self-assessments demonstrated that orthodontic treatment, regardless of the type of appliance used, interfered with their perception of speech.
评估使用矫正器和传统固定矫治器治疗对语音产生的影响。
这是一项平行、随机临床试验。将患有安氏 I 类错颌、中度拥挤且无语音障碍的患者随机分为两组:使用正畸直丝弓矫治器(OAs;n=20;平均年龄=23.60±5.65 岁)和传统固定矫治器(n=20;平均年龄=20.56±4.51 岁)的患者,并在巴西隆德里纳的北巴西南大学诊所进行治疗。语音生产的评估由语音治疗师(肌功能口面检查)进行半客观评估和主观评估(自我评估),共五个时间点:基线、矫治器插入后即刻,以及随后的 3、30 和 180 天。组间比较采用独立 t 检验、卡方检验、Fisher 确切检验和 Mann-Whitney 检验;组内比较采用 Friedman 检验(α=5%)。
在半客观评估中,与使用固定矫治器的患者相比,使用 OAs 的患者在插入矫治器后即刻和 3 天出现语音生产变化(P<0.001)。插入矫治器 30 天后,两组相似(P=0.487),180 天后结果不变。然而,在自我评估中,两组患者均在插入矫治器后即刻和 3 天报告存在明显的语音困难,但在 30 天或 180 天不再感知到这种障碍。
尽管治疗开始时语音治疗师仅在 OAs 组中发现了语音生产的变化,但患者的自我评估表明,无论使用哪种矫治器,正畸治疗都会干扰他们对语音的感知。