Comparison of speech performance in labial and lingual orthodontic patients: A prospective study

Ambesh Kumar Rai, Joe E. Rozario, Sanjay V. Ganeshkar


Background: The intensity and duration of speech diffi culty inherently associated with lingual therapy is a signifi cant issue of concern in orthodontics. This study was designed to evaluate and
to compare the duration of changes in speech between labial and lingual orthodontics.
Materials and Methods: A prospective longitudinal clinical study was designed to assess speech of 24 patients undergoing labial or lingual orthodontic treatment. An objective spectrographic evaluation of/s/sound was done using software PRAAT version 5.0.47, a semiobjective auditive evaluation of articulation was done by four speech pathologists and a subjective assessment of speech was done by four laypersons. The tests were performed before (T1), within 24 h (T2), after 1 week (T3) and after 1 month (T4) of the start of therapy. The Mann-Whitney U-test for independent samples was used to assess the signifi cance difference between the labial and lingual appliances. A speech alteration with P < 0.05 was considered to be signifi cant.
Results: The objective method showed a signifi cant difference to be present between the two groups for the/s/sound in the middle position (P < 0.001) at T3. The semiobjective assessment showed worst speech performance in the lingual group to be present at T3 for vowels and blends
(P < 0.01) and at T3 and T4 for alveolar and palatal consonants (P < 0.01). The subjective assessment also showed a signifi cant difference between the two groups at T3 (P < 0.01) and T4 (P < 0.05).
Conclusion: Both appliance systems caused a comparable speech diffi culty immediately after bonding (T2). Although the speech recovered within a week in the labial group (T3), the lingual group continued to experience discomfort even after a month (T4).
Key Words: Articulation, labial orthodontics, lingual orthodontics, spectrography, speech

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