Utilization of Articulatory Movements Observed by Palatography in Prosthetic Treatment

本研究的目的是评估上颌缺损术后，利用腭造影术改良腭形的上颌假体对言语障碍的改善。采用“包括牙齿的腭图”检查假体的腭轮廓，并进行修改，以显示正确的舌-腭和牙齿接触。将覆盖上颌牙齿上颚和咬合面的黑色乙烯基座制成的人工腭涂以白色海藻酸盐粉末，置入受试者口腔内。在发完测试音后，用润湿粉末的方法来显示舌头接触区域。图像处理系统对每个受试者的5个相同声音样本进行平均处理。测试声音是不发声的爆破音、发声的爆破音和拍打音。通过发音测试评估上颌义齿植入前（BT）和植入后受试者的语音变化：(1)声学语音发音测试；(2)用鼻测量仪（型号6200-2）根据鼻平衡评分、阈值、时间历史进行测量；(3)用声谱仪（声谱图）分析声纹。研究对象为10例正常无牙成人和5例上颌手术缺损患者。根据缺陷的程度，他们被分为三组：I类；内硬板（二）。ClassII;含软板（一块）。ClassIII;远达软腭后缘（二）。实验结果如下：1.实验结果表明：1 .英语发音测试得分低，英语发音测试得分高。英语一、二年级学生的嗅觉平衡分数较高，而英语一、二年级学生的嗅觉平衡分数较高。与正常受试者相当接近。ⅱ类得分高于ⅰ、ⅱ、ⅲ类。AT组声像图异常减少。i、II类，II类稍有改善。

The purpose of this study was to evaluate speech disorder improvement by the maxillary prostheses of which palatal shape were modified utilizing the palatography in the patients with maxillary defect after surgery.The palatal contour of the prostheses were examined using "Palatography including teeth" and modified so as to show proper tongue-to-palate and teeth contact. The artificial palates made of black vinyl seat covering the palate and occlusal surfaces of maxillary teeth were coated with white alginate powder and inserted into the mouths of the subjects. After pronunciation of test sound, the tongue contact areas were demonstrated by wetting of powder. Each subject's five samples of same sound were averaged by the image processor system. The test sounds were voiceless plosive, voiced plosive and flapped sounds.Changes in speech of subjects before (BT) and after insertion of the maxillary prostheses (AT) were evaluated by the articulation tests : (1) The acoustical speech articulation test ; (2) the nasality measured by Nasometer (Model 6200-2) with reference to the nasalance scores, threshold, time history ; (3) voice print analyzed by a sound spectrograph (sonagram).The subjects were ten normal dentulous adults and five patients with maxillary defect by operation. They were classified into three groups according to the extent of the defect : Class I ; within hard plate (two). ClassII ; including soft plate (one). ClassIII ; reaching as far as posterior border of soft palate (two).The results were as follows :1. The articulation test score were low in BT., but became higher in AT..2. The nasalance scores of classI, II in BT. were high, but that in AT. were fairly close to that of normal subjects. In classIII, the scores were higher than that in classI, II.3. Abnomality of the sonagram decreased in AT. of classI, II, but in classIII, it showed a little improvement.