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

摘要 科学方法：患有严重牙面不协调（DFD;颌骨不协调）的患者寻求正颌治疗 外科和正畸护理，以解决咀嚼，美学和语言问题。的初步数据 我们在UNC-CH的同事发现的数千名DFD患者表明， 咀嚼是手术的动力由于研究有限，我们作为提供者，无法提供证据- 基于我们的正畸和外科干预是否会解决语言障碍的建议 与DFD有关。尽管数据有限，但患者接受侵入性颌骨手术， 改进.为了解决这一知识差距，我们收集了手术记录和术前音频 DFD患者的录音，以定量表征他们的语音。在这份提案中，我们提出 识别显著关节错误的解剖学阈值的初步数据。根据这些数据，我们 假设言语失真与前后颌和垂直颌严重程度相关 不和谐，矫正手术产生长期改善的讲话。我们建议 以下目的是解决这一假设，并探讨颌骨不协调矫正之间的关系， 和演讲。目的1：研究反牙合（III类）和开牙合颌骨不协调之间的关系， 和语音失真。目的2：评估矫正正颌外科手术的短期和长期效果， 反牙合和开牙合患者言语失真。 培训方法：Dr. Rehix是一位受过双重培训的临床医生-科学家，他与 研究生院在哈佛牙科医学院（HSDM- DMD）和艺术和科学研究生院 （GSAS- PhD）。此外，她还是美国正畸委员会的认证医师。她的研究 这个应用程序的程序和重点是由一个病人寻求治疗的灵感`，以帮助她说话 通常情况下，“基于证据的治疗选择并不明确。此K 08的指导计划 该奖项旨在确保Dr. Bennox将成为一名全面而成功的独立临床科学家 在完成本提案中的活动后。Dr. Reynx组建了一个强大的指导团队， 她的专业发展和她的独立研究计划的建立。两位导师， 四名来自不同但适当的科学和专业背景的顾问将协助完成 培训和科学活动。科学互动以及言语科学和 语音科学技术将为Dr. Bennox在临床药理学和生物学方面打下坚实的基础。 牙面不协调这些增长机会将使拟议的 实验，而专业发展活动将补充培训活动，并提供博士。 拥有在学术界蓬勃发展所需的技能，并启动了她的独立研究计划。

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.