Orthognathic Speech Pathology: Phonetic Contrasts of Patients With Dental Discrepancies Pre- and Post-Treatment Analyses

Malocclusion Clinical Trial

— OSP  

Official title:

Orthognathic Speech Pathology: Phonetic Contrasts of Patients With Dentofacial Discrepancies With Pre- and Post-Treatment Analyses

Clinical Trial Details — Status: Recruiting

Administrative data

• NCT number: NCT04117360
• Other study ID #: 19-1196
• Status: Recruiting
• Start date: September 11, 2019
• Est. completion date: December 2026

Study information

• Verified date: February 2024
• Source: University of North Carolina, Chapel Hill
• Contact: Laura A Jacox, PhD, DMD, MS
• Phone: 847- 702-0988
• Email: ljacox[@]ad.unc.edu
• Is FDA regulated: No
• Study type: Observational

Clinical Trial Summary

The investigators are studying how speech is effected by jaw and tooth position in jaw surgery patients. Eighty percent of our jaw surgery patients have speech pathologies, compared to five percent of the general population, but speech pathologists do not understand why. The investigators hypothesize that open bites and underbites prevent most patients from being able to pronounce words normally and surgical correction will lead to improvement in speech. Patients will be audio recorded speaking and patients' tongue gestures ultrasound recorded before and after their jaw surgeries to observe what changes occur in their speech and tongue movements.

Description:

Purpose: The investigators are studying how phoneme distortion is effected by jaw disproportions in dentofacial disharmony (DFD) patients and whether speech improves after orthognathic surgery and orthodontic treatment. Spectral moment and tongue gestural analysis are being used to mechanistically determine how jaw position effects speech. The investigators hypothesize that skeletal open and underbites contribute to phoneme distortion and tongue gestural changes that improve following surgical correction of jaw position. All DFD patients are already seeking treatment from orthodontics and oral surgery. The study will observe how their speech changes before and after treatment. There is no randomization or intervention involved.

Aim 1: Qualify the prevalence of auditory and visual speech distortions in the DFD population. Aim 2: Quantitatively evaluate the first spectral moment (kHz) of four articulating consonant sounds (/t/, /k/, /s/, and /?/ pronounced "sh"). Quantify and analyze the changes in speech distortions for orthognathic patients pre and post-operation. Aim 3: Evaluate tongue posture during speech with patients from Aim 2 pre and post-operation.

Participants:

Participants: Patients of the UNC dentofacial disharmony (DFD) clinic who have undergone orthognathic surgery for correction of jaw disharmonies.

Procedures (methods):

Patients will be recorded pronouncing a series of words highlighting a range of phonetic contrasts including --/s-sh/ and t-k/. words each presented on a screen using PowerPoint, 3 times each with carrier phrases). Recordings include an acoustic feed, a profile video of the jaws plus lips, and ultrasound imaging of the tongue relative to the palate and jaws. Research staff will score audio recordings according to their spectral moments and ultrasound recordings according to tongue movement and associate findings with degree of dental discrepancy. Prospective recordings will be collected at three timepoints: 1-3 months prior to jaw surgery, 3-8 months and 9-15 months post-operation for 60 overbite, 60 openbite and 60 underbite DFD patients. These time points were selected to co-occur with patients' surgical check-ups to ensure reliable data collection while minimizing confounding factors such as severe facial swelling and splint placement which occur immediately after surgery.

Recruitment information / eligibility

• Status: Recruiting
• Enrollment: 180
• Est. completion date: December 2026
• Est. primary completion date: December 2026
• Accepts healthy volunteers: No
• Gender: All
• Age group: 15 Years to 40 Years

Eligibility

Inclusion Criteria:

• Jaw surgery patient at UNC with a skeletal open bite, underbite or overjet greater than 5mm.

• Age 15-40 years

Exclusion Criteria:

• Hearing loss

• Learned English as a second language

• Significant regional accent, as characterized by a speech pathologist

• Developmental delay, performing several grade levels below age bracket

• history of craniofacial disorder

• genetic syndrome associated with known craniofacial presentation

• history of craniofacial trauma

• history of prior craniofacial surgery (excluding extractions and dental procedures)

• Jaw surgery without fixed orthodontic appliances

Related Conditions & MeSH terms

• Dentofacial Abnormalities
• Dentofacial Anomalies, Including Malocclusion
• Dentofacial Deformities
• Dentofacial Disharmony
• Malocclusion
• Malocclusion in Children
• Skeletal Malformation
• Skeletal Malocclusion
• Speech Disorders
• Speech Sound Disorder

Intervention

Other:
• Orthognathic surgery and Orthodontics
This study is observational. All subjects identified to participate will be undergoing orthognathic jaw surgery and orthodontic treatment.

Locations

Country	Name	City	State
United States	University of North Carolina	Chapel Hill	North Carolina

Sponsors (2)

Lead Sponsor	Collaborator
University of North Carolina, Chapel Hill	North Carolina State University

Country where clinical trial is conducted

United States, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Change in Speech Distortion Phonemes over Time	Audio recordings of consonant phonemes will be quantitatively analyzed using spectral moment analysis yielding mean values.	pre-operation through 9-15 months post-operation
Primary	Change in Quantitative Tongue Gestures over Time	Ultrasound analysis of tongue posture to quantitatively describe tongue position during speech.	pre-operation through 9-15 months post-operation