Outcomes of Prosthodontic Management Essay

Speech is the coordinated function of the vocal pamphlet includes respiratory, phonatory, resonatory and articulatory systems. Hindrance to whatsoever of these systems results in bringing disorders. Cleft mouth and palate (CLP) is one such congenital disorder leading to destination disorder. The abnormal diction of these individuals with sally lip and palate can be analyzed interms of acoustical, perceptual and physiological measurements. The actors line of individuals with cleft palate is earlier characterized by abnormalities in nasal resonance.This is a direct result of unoperated cleft / fistula and or velopharyngeal dysfunction. The individuals with velopharyngeal dysfunction cannot either adequately or systematically close the velopharyngeal port during speech leading to nasal escape of unplumbed energy. In addition, there may be articulatory errors, including compensatory articulations and reduced spokesperson quality resulting in poor speech intelligibility (McW illiams, Morris & Shelton, 1990 Kuehn & Moller, 2000 Kummer, 2001 Peterson-Falzone, Hardin-Jones & Karnell, 2001 Bzoch, 2004).Nasal resonance increases and is perceived as hypernasality if the durations of the velopharyngeal opening and termination movements in relation to the opening and closing of the oral cavity become prolonged. Many investigators puddle showed that certain measure measures reflecting the movements of speech articulators ar related to the degree of oral-nasal resonance imbalance in individuals with cleft palate with or without cleft lip (Warren et al. , 1985 Jones, 2000 Dotevall et al. 2001, 2002 Ha et al. , 2004). Jones (2000) opined that profligate perceived nasalization could result from a mistiming of velopharyngeal movements, relative to component onset and offset. Few studies (Ha, Sim, Zhi, & Kuehn, 2003 Ha, David, & Kuehn, 2010) concluded that individuals with cleft palate exhibit weeklong acoustic nasalization than normal speakers and also lay me asures of their speech ar positively correlated with the perceived hypernasality.Hence they concluded that acoustic measures of temporal characteristics of speech can provide supplementary diagnostic information in relation to the degree of hypernasality. Hoopes, (1970) demonstrated that speed of velar movement during speech was slower for individuals with cleft palate than normal subjects. Forner (1983) observed some trouble with normal rate and range of movement and interarticulatory timing based on the results of significantly longer than normal speech segment durations.The rehabilitation of individuals innate(p) with cleft lip and palate and related craniofacial anomalies require coordination of plastic surgery, prosthetic intervention and behavioral therapy. A multidisciplinary approach is essential to achieve optimal results. To permit development of normal speech patterns, habilitation of these individuals should be considered surgically or prosthetically as first as pos sible (Riski, 1979 Dorf & Curtin, 1982 Witzel et al. , 1984).Definitive prosthodontic discourse is usually one of the final therapies instituted and it must attempt to alleviate any anatomical and functional deficiencies that may remain after the gamut of other intervention is essentially completed. The concept of victimization speech prosthesis was introduced as early as 1860 in treating velopharyngeal dysfunction in clients with cleft lip and palate (Mc Grath and Anderson 1991) and has since been adopted by others (Leeper et al. 1996).The use of speech bulb obturator in the interposition of hypernasality became less popular in the 19th century, but was revived in the 20th century. This was partly due to the development of techniques that permitted direct visualization of the velopharyngeal instrument and advances in the surgical procedures. A prosthetic device palatal get hold can be suggested for the persons in whom adequate tissue is present but poor control of coordinatio n and timing of velopharyngeal (VP) movements are observed.The palatal swindle aims to countermand the soft palate in a posterior and superior way of life through the use of acrylic additions on the back of a dental appliance. It is used to prosthetically create a normal VP layover for speech development until the surgical repair can be performed. Hence this can do for the better velopharyngeal closure by improving the oral nasal coupling. The velopharyngeal closure dynamics can be studied using acoustic abbreviation of the speech, along with the perceptual evaluation.Acoustic analysis offers the opportunity to observe the speech patterns resulting from simultaneous and sequential interactions of phonation, resonation and articulation as these occur in certain time speech production. Spectrographic data have been used ofttimes to study cleft palate speech (Horii, 1980). McGrath and Anderson (1990) reported a check of the outcome guidance of 200 individuals with cleft pala te and gear up that 95% were able to eliminate both hypernasality and nasal emission distortions in speech through prosthetic management.Jian Ningyi & Guilan (2002) investigated the effect of a temporary obturator to treat VPD and found that velopharyngeal closure can be greatly improved by using a temporary oral prosthesis and speech training. Most of these studies have used obturator or speech bulb in individuals with cleft palate, and in truth few studies included speech training along with the prosthetic management and shows positive results. There are dearths of studies using palatal lift in persons with submucous cleft palate along with the speech therapy.The present study is a part of the longitudinal study which is aimed to determine the effect of palatal lift prosthesis on temporal parameters of speech and correlating with the physiological findings. The aims of the study are three fold. First, is to compare the temporal parameters of nasalization and nasalence values wit h the normal subjects. Second, is to investigate the temporal parameters of nasalization and nasalance values without prosthesis, with prosthesis and after undergoing 10 sessions of speech therapy. Third, is to investigate the velopharyngeal closure with and without prosthesis using nasoendoscopy.