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.
Eur J Orthod. 2023 Feb 10;45(1):1-10. doi: 10.1093/ejo/cjac057.
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.
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.
背景/目的：构音问题影响交流、发育和生活质量，73%-87%的 II 类牙颌面畸形（DFD）患者存在构音问题。我们评估 II 类 DFD 患者的塞音（/t/或/k/）、擦音（/s/或/ʃ/）和塞擦音（/tʃ/）辅音是否存在差异，以及错颌畸形的严重程度是否与语音失真的严重程度相关。我们假设 II 类患者的语音扭曲程度比 III 类和前牙开颌（AOB）患者轻，因为 II 类患者可以维持 I 类牙颌。
材料/方法：从接受正畸和正颌手术的 DFD 患者（N=53-II 类，102-III 类，72-对照组）中收集音频和正畸记录。语音病理学家对语音进行感知评分。使用谱矩分析测量记录中的声学差异。
与对照组相比，当比较 II 类受试者时，/s/声音的质心频率（M1）和/t/、/tʃ/和/s/声音的谱展宽（M2）存在显著差异，对照组相对于 II 类 AOB 和所有 II 类受试者的差异具有统计学意义。II 类 AOB 受试者的大多数声音的 M1 和 M2 值均高于 II 类闭合性错颌和 I 类对照组。当比较前-后（AP）组时，对照组、II 类和 III 类 DFD 患者的/t/、/tʃ/和/ʃ/的 M1 和/t/、/tʃ/、/s/和/ʃ/的 M2 存在差异。使用线性回归，发现 II 类和 III 类严重程度与/t/和/tʃ/声音的谱测量值之间存在相关性。
结论/意义：与对照组相比，II 类和 III 类患者的辅音存在更高的定性扭曲和频谱变化发生率，但 II 类的频谱变化较小，影响的声音少于 III 类和 AOB 队列。AP 差异与光谱变化之间的线性相关性表明病因，治疗可能改善发音问题。
