The Study Of The Effects On Speech Performance And Experience In Patients With Customized Lingual Appliances And Removable Orthodontic Aligners

Objective: To compare the effects of objective pronunciation function,aesthetic effect and subjective feelings in patients with customized lingual fixed appliances and removable orthodontic aligners.Patients and Methods: 60 samples in our hospital were selected from 2016 to 2018.Experimental groups included 20 patients with customized lingual fixed appliances and 20 patients with removable orthodontic aligners.Control group included 20 patients with labial fixed appliances.Patients’ voice recordings of Dysarthria Rating Scale and questionnaire survey of subjective feelings were performed before(T0),within 24 hours later(T1),a week after(T2),a month after(T3)and three month after(T4)the start of therapy.Dysarthria Rating Scale included 211 Chinese characters.Ten reviewers scored every Chinese characters of all voice recordings and two repeated evaluations were conducted.The total score of 211 Chinese characters per patient at every time point was calculated.The mean value of two repeated evaluations was calculated as objective pronunciation score.Patients filled out questionnaires at T0、T1、T2、T3 and T4.The questionnaire survey included eight questions.Five-point system was used to score according to the degree of influence.Score of objective pronunciation and subjective feelings in T1、T2、T3、T4 minus score in T0.Scores of differences in every time point of three groups were compared.The changes of objective pronunciation scores between the younger and older groups,male and female groups compared.The trend chart of objective pronunciation and subjective perception score changing with time were drawed.Result:1.The rate of objective articulation clarity decline in lingual group was 3.6%、2.1%、0.7% at T1、T2、T3,which was significantly greater than that in aligner group and labial group.There was no difference in change of objective articulation between aligner group and labial group.There was no difference in articulation among the three groups at T4.2.There was no difference in objective articulation between the younger and older groups,male and female groups at T1,T2,T3 and T4.3.The subjective articulation clarity change in lingual group was significantly greater than that in aligner group and labial group at T1 and T2(P < 0.05).There was no difference in articulation among the three groups at T3 and T4.The tooth pain in aligner group was significantly greater than that in the lingual group and the labial group at T1(P < 0.05),but at T2,T3 and T4,there was no difference among the three groups.The eating and social contact difficulty in lingual group and the labial group was significantly greater than that in the aligner group at T1(P < 0.05),but at T2,T3 and T4,there was no difference among the three groups.The aesthetic effect in labial group was significantly greater than that in the lingual group and the aligner group at T1,T2,T3 and T4(P < 0.05).4.There was no difference in soft tissue discomfort,psychological and ulcer formation among the three groups at T1,T2,T3 and T4(P > 0.05).Conclusion:1.The three kinds of appliances all have slight effect on pronunciation.The effect of lingual appliances on pronunciation was more obvious than that of aligners and labial appliances,but the patients adapted well at three months after the start of therapy.2.Tooth pain is obvious in the initial stage of aligners appliance wearing,but it has little effect on eating and social interaction.The aesthetic effect of lingual and aligners appliances is better than that of labial appliances.3.In terms of soft tissue discomfort,psychological and ulcer formation,there was no difference among the three appliances.