ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM
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Title Patients with Lingual Orthodontic Brackets Experience Speech Difficulties of Longer Duration when Compared to Patients with Labial Brackets
Clinical Question In patients undergoing orthodontic treatment, do patients with lingual orthodontic brackets experience speech difficulties of a longer duration in comparison to patients with labial orthodontic brackets?
Clinical Bottom Line In patients undergoing orthodontic treatment, patients with lingual orthodontic brackets experience speech difficulties of longer duration when compared to patients with labial orthodontic brackets. This is supported by a randomized controlled trial and prospective longitudinal clinical study including patients with labial and lingual orthodontic brackets, where there was a statistically significant difference in the duration of speech difficulties after orthodontic bracket placement for the patients with lingual brackets. These findings are applicable to dentists and orthodontists because they can help educate orthodontic patients on expectations during treatment.
Best Evidence (you may view more info by clicking on the PubMed ID link)
PubMed ID Author / Year Patient Group Study type
(level of evidence)
#1) 23075062Khattab/201317 patients with labial brackets and 17 patients with lingual bracketsRandomized Controlled Trial
Key resultsAfter auditive analysis of spectrographs, the lingual bracket group experienced statistically significant speech difficulties immediately after bracket placement (P < 0.001), 1 month after placement (P < 0.001), and 3 months after placement (P = 0.003). The labial bracket group experienced statistically significant speech difficulties immediately after bracket placement (P < 0.001), but no statistically significant speech difficulties were found 1 month and 3 months after bracket placement.
#2) 25540661Rai/201412 patients with labial brackets and 12 patients with lingual bracketsProspective Longitudinal Clinical Study
Key resultsAfter spectrographic assessment of the ā€œsā€ sound in patients with lingual and labial orthodontic brackets, there was no statistical significance between the speech performance of labial and lingual bracket groups before bracket placement and within 24 hours after bracket placement. There was a statistically significant difference in speech performance between lingual and labial bracket groups 1 week after placement (P = 0.0002) and 1 month after placement (P = 0.0153), with the lingual bracket group being more affected than the labial bracket group.
Evidence Search ("tongue"[MeSH Terms] OR "tongue"[All Fields] OR "lingual"[All Fields]) AND ("lip"[MeSH Terms] OR "lip"[All Fields] OR "labial"[All Fields]) AND ("orthodontic brackets"[MeSH Terms] OR ("orthodontic"[All Fields] AND "brackets"[All Fields]) OR "orthodontic brackets"[All Fields] OR ("orthodontic"[All Fields] AND "bracket"[All Fields]) OR "orthodontic bracket"[All Fields]) AND ("speech"[MeSH Terms] OR "speech"[All Fields])
Comments on
The Evidence
Validity: In the randomized controlled trial, the investigators followed specific criteria to choose the final participants of the study. The mean age of participants was 21.25 years and all had class 1 malocclusion. They also had no previous orthodontic treatment and no previous speech disorders. The groups had adequate follow-up and compliance. In the prospective longitudinal clinical study, the groups were similar at the start with a mean age of about 23 years and minimum to moderate crowding. They also had no previous speech disorders. The groups had adequate follow-up and compliance. Perspective: These studies provide strong evidence for the comparison of speech difficulties with lingual and labial orthodontic brackets. However, the patient groups had a small number of participants. Also, more studies could be done comparing the speech of patients with different systems or designs of lingual brackets.
Applicability These studies used two different lingual bracket systems (Stealth and STb) and the participants also spoke two different languages (Arabic and Kannada). The type of lingual bracket used and the language spoken by patients could limit the applicability of these results. Patients should be educated on what to expect during treatment with lingual orthodontic brackets. Further studies could include using contemporary lingual brackets and the vowel and consonant sounds of the English language in order to provide more applicable data.
Specialty/Discipline (General Dentistry) (Orthodontics)
Keywords Lingual Orthodontic Brackets, Labial Orthodontic Brackets, Speech Performance, Speech Difficulties
ID# 3145
Date of submission: 03/15/2017spacer
E-mail selfk@livemail.uthscsa.edu
Author Kristen Self
Co-author(s)
Co-author(s) e-mail
Faculty mentor/Co-author Ravikumar Anthony, BDS, MDS, MS
Faculty mentor/Co-author e-mail AnthonyR@uthscsa.edu
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