Orthognathic speech pathology: Understanding how jaw disharmonies and their surgical correction influence speech

正颌言语病理学：了解下颌不和谐及其手术矫正如何影响言语

• 批准号: 10456146
• 负责人: Laura Anne Jacox
• 金额: $ 16.7万
• 依托单位: UNIV OF NORTH CAROLINA CHAPEL HILL
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-08-01 至 2026-07-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10456146
• 关键词: Acoustics; Address; Alveolar; Alveolus; American; Anatomy; Anterior; Articulation; Arts; Award; Biology; Bite; Caring; Clinical; Communication; Complement; Consensus; Craniofacial Abnormalities; Data; Dental Schools; Development; Disease; Doctor of Philosophy; Enrollment; Ensure; Esthetics; Evaluation; Evidence based treatment; Face; Foundations; General Population; Generations; Gestures; Grant; Growth; High Prevalence; Impairment; Investigation; Jaw; Knowledge; Language; Lead; Link; Long-Term Effects; Longterm Follow-up; Malocclusion; Mastication; Medicine; Mentors; Movement; Open Bite; Operative Surgical Procedures; Oral Surgical Procedures; Oral cavity; Orthodontic; Orthodontics; Participant; Pathologic; Pathologist; Pathology; Patients; Pattern; Population; Positioning Attribute; Postoperative Period; Posture; Property; Provider; Publishing; Quality of life; Randomized; Randomized Controlled Trials; Recommendation; Records; Research; Schools; Science; Scientist; Severities; Speech; Speech Disorders; Speech Pathology; Speech Sound; Speech Therapy; Syndrome; Technology; Testing; Time; Tongue; Tooth structure; Training; Training Activity; Treatment outcome; base; dentofacial; design; evidence base; evidence based guidelines; experimental study; follow-up; improved; operation; orthognathic; programs; recruit; skills; sound; spelling; standard of care; ultrasound; Acoustics; Address; Alveolar; Alveolus; American; Anatomy; Anterior; Articulation; Arts; Award; Biology; Bite; Caring; Clinical; Communication; Complement; Consensus; Craniofacial Abnormalities; Data; Dental Schools; Development; Disease; Doctor of Philosophy; Enrollment; Ensure; Esthetics; Evaluation; Evidence based treatment; Face; Foundations; General Population; Generations; Gestures; Grant; Growth; High Prevalence; Impairment; Investigation; Jaw; Knowledge; Language; Lead; Link; Long-Term Effects; Longterm Follow-up; Malocclusion; Mastication; Medicine; Mentors; Movement; Open Bite; Operative Surgical Procedures; Oral Surgical Procedures; Oral cavity; Orthodontic; Orthodontics; Participant; Pathologic; Pathologist; Pathology; Patients; Pattern; Population; Positioning Attribute; Postoperative Period; Posture; Property; Provider; Publishing; Quality of life; Randomized; Randomized Controlled Trials; Recommendation; Records; Research; Schools; Science; Scientist; Severities; Speech; Speech Disorders; Speech Pathology; Speech Sound; Speech Therapy; Syndrome; Technology; Testing; Time; Tongue; Tooth structure; Training; Training Activity; Treatment outcome; base; dentofacial; design; evidence base; evidence based guidelines; experimental study; follow-up; improved; operation; orthognathic; programs; recruit; skills; sound; spelling; standard of care; ultrasound

ABSTRACT Scientific Approach: Patients with severe dentofacial disharmonies (DFD; jaw disharmonies) seek orthognathic surgery and orthodontic care to address issues with mastication, esthetics and speech. Preliminary data from thousands of DFD patients generated by our colleagues at UNC-CH indicate speech concerns surpass impaired chewing function as a motivator for surgery. Due to limited studies, we, as providers, are unable to give evidence- based recommendations as to whether our orthodontic and surgical interventions will address speech disorders associated with DFD. Despite limited data, patients undergo invasive jaw surgery in hopes of speech improvement. To address this gap in knowledge, we have gathered surgical records and pre-operative audio recordings of patients with DFD to quantitatively characterize their speech. In this proposal, we present preliminary data identifying anatomical thresholds for significant articulation errors. Based on these data, we hypothesize that speech distortions correlate with severity of anterior-posterior and vertical jaw disharmonies, and that corrective surgery yields long-term improvement in speech. We propose the following aims to address this hypothesis and explore the relationship between correction of jaw disharmonies and speech. Aim 1: To examine the relationship between underbite (Class III) and open bite jaw disharmonies, and speech distortion. Aim 2: To assess short- and long-term effects of corrective orthognathic surgery on speech distortion in patients with underbite and open bite. Training approach: Dr. Jacox is a dual-trained clinician-scientist, who completed dental school in parallel with graduate school at Harvard School of Dental Medicine (HSDM- DMD) and Graduate School of Arts and Sciences (GSAS- PhD). In addition, she is a certified diplomate of the American Board of Orthodontics. Her research program and focus of this application was inspired by a patient seeking treatment `to help her talk normally', whereby an evidence-based treatment option was not clear. The mentoring plan for this K08 award is designed to ensure Dr. Jacox will be a well-rounded and successful independent clinician-scientist following completion of the activities in this proposal. Dr. Jacox has assembled a strong mentoring team to guide her professional development and the establishment of her independent research program. Two co-mentors and four consultants from diverse yet appropriate scientific and professional backgrounds will assist in the completion of the training and scientific activities. Scientific interactions as well as didactic training in speech science and technologies of speech science will add to Dr. Jacox's strong foundation in clinical orthodontics and the biology of dentofacial disharmonies. These growth opportunities will allow for successful completion of the proposed experiments, while the professional development activities will complement the training activities and provide Dr. Jacox with skills necessary to thrive in academics and launch her independent research program.

抽象的 科学方法：严重的牙面不和谐患者（DFD; Jaw Dranarmonies）寻求正性 手术和正畸护理解决咀嚼，美学和言语的问题。初步数据 我们的同事在UNC-CH产生的数千名DFD患者表明，语音问题超过了受损 咀嚼功能是手术的动机。由于研究有限，我们作为提供者无法提供证据 - 关于我们的正畸和手术干预措施是否会解决语音障碍的基于建议 与DFD相关。尽管数据有限，但患者接受了侵入性下颌手术，以期言语 改进。为了解决知识的差距，我们收集了手术记录和术前音频 DFD患者的记录以定量为特征。在此提案中，我们提出 初步数据确定了重大关节误差的解剖阈值。基于这些数据，我们 假设语音扭曲与前后和垂直下巴的严重程度相关 不和谐和矫正手术可以长期改善语音。我们建议 以下目的是解决这一假设并探索颌骨不和谐校正之间的关系 和演讲。目的1：检查咬咬（III级）和开放咬合下巴不和谐之间的关系， 和语音失真。目标2：评估纠正矫正手术对短期和长期影响对 咬咬和开放咬伤的患者的语音失真。 培训方法：Jacox博士是一位双训练的临床医生，他同时完成了牙科学校 哈佛大学牙科医学学院（HSDM-DMD）和艺术与科学研究生院 （GSAS-PHD）。此外，她是美国正畸委员会的认证外交官。她的研究 该应用程序的计划和重点是受到寻求治疗的患者的启发。 通常'，因此尚不清楚基于证据的治疗选择。该K08的指导计划 奖项旨在确保Jacox博士将成为一个全面且成功的独立临床医生科学家 在完成此提案中的活动之后。 Jacox博士组建了一个强大的指导团队来指导 她的专业发展和建立她的独立研究计划。两个联合官和 来自不同但适当的科学和专业背景的四名顾问将有助于完成 培训和科学活动。科学互动以及语音科学和 言语科学技术将增加雅各斯博士在临床正畸和生物学方面的强大基础 牙本质不和谐。这些增长机会将成功完成拟议的 实验，而专业发展活动将补充培训活动并为博士提供。 Jacox具有在学术界蓬勃发展并启动其独立研究计划所必需的技能。