ABSTRACT
Speech production in different oral rehabilitation modalities
In order to study the speech production of subjects submitted to different oral
rehabilitation modalities, and to verify whether the modality type used would interfere in
speech production, 36 elderly (average age = 68 years), both gender, were evaluated after
the Research Ethics Committee’s approval. The sample was divided into 3 groups: group A,
composed by 13 subjects with natural teeth, at least up to second premolar; group B, with 13
edentate subjects using maxillary and mandibular conventional denture; and group C, with
10 edentate subjects using maxillary conventional denture and mandibular implant-supported
prosthesis. Exclusion criteria were medical history of neurological diseases, head and neck
oncologic disease, psychiatric disease; laryngeal surgery; alcoholism; users of any drugs
whose side effects could cause xerostomia; craniofacial malformation, malocclusion, and
velopharyngeal dysfunction; hearing disorders or hearing aid users and cognitive alteration.
A dentist evaluated the prosthesis stability. Recorded speech samples were obtained
through spontaneous speech, vocable and sentences repetition, and counting of numbers.
The analysis was executed by 5 speech pathologists. They were guided to perform a general
impression of the spontaneous speech, identifying articulation, labial movements, and saliva
control alterations. Besides that, they had to identify the frequency of phonemes alterations
through the vocable and phrase repetition sample, and to detect the phonemes alterations
types such as: articulation point changes, tongue projection, lisp or mandibular deviation, in
the vocable and phrase repetition as well as in the counting of numbers. Analysis of the
alterations frequency involved the calculation of Percentage of Correct Consonants (PCC), to
verify the agreement among the observers, besides the comparison among groups, and
between the association of alteration presence or absence, in the spontaneous speech, and
the prosthesis stability. Acoustic analysis of the phoneme /s/ was also performed, through
digital record of the speech. For that, a sentence-vehicle (“Digo ____ aqui”) reading or
repetition was used, where Portuguese language key-words were inserted (“sapo”, “suco”,
“siga”). Duration and frequency parameters of the phoneme /s/ were considered and
compared among groups. Also, the alteration presence or absence in the /s/ production was
compared to the duration and frequency of this phoneme. The results showed that, in
spontaneous speech, there was a large speech alteration in group C. However, the
alterations types were found in few occurrences, but in all of the studied groups. Speech
alterations presence was identified in the vocable and phrase repetition as well as in the
counting of numbers. A smaller Percentage of Correct Consonants value was observed for
the linguodental phonemes, in groups B and C, therefore with a larger alteration occurrence,
followed by the alveolar phonemes. There was a prevalence of occurrences without
alterations in group A, contrarily to groups B and C, in the two speech samples studied, with
the lisp and tongue projection being the most occurred alteration types. The comparison
among groups, in relation to alteration frequency, showed no significant differences in the
vocable and phrase repetition and counting of numbers. Dental evaluation showed that the
majority of group B subjects had an unsatisfactory mandibular prosthesis, but an association
could not be observed between speech alteration and unsatisfactory maxillary and
mandibular prosthesis. There were no significant statistical differences in duration and
frequency of the phoneme /s/ among groups. Comparison between alteration presence or
absence in /s/ production and duration and frequency showed no significant statistical
differences. In conclusion, despite the small sample, it appears that prosthesis type as well
as stability does not interfere in speech production.
keywords: Speech. Speech acoustics. Dental prosthesis.