Abstract
This article describes prosthetic procedure to improve occlusion and esthetics of a cleft palate patient with reference to speech articulation. A method was designed to determine the mandibular positions during speech in which three phenomena: (1) path of the mandibular movements (MKG), (2) spectrogram of voice, and (3) voice sound were simultaneously recorded on the same frame of 16mm motion picture films. The voice spectrogram was analyzed by Speech Spectrographic Display (S. S. D). The method was applied to predict acceptable occlusal vertical dimension (O. V. D) for a cleft palate patient before prosthetic treatment.
The O. V. D of the patient was gradually increased by setting resin blocks on the occlusal surface of the mandible. At various O. V. D, the mandibular positions during pronunciation of /s/, /1/, /m/ were observed. The suitable range of O. V. D was estimated from these observations. Within this range, the maxillary overlay denture for diagnosis was prepared. The presence of the denture, /m/ position maintained a constant level and proper amount of interocclusal space existed during speech so that the O. V. D was assumed to be suitable. Then, at the same level of O. V. D, the Konuskronen telescope denture was constructed.
The palatal contour of the denture was examined using "Palatography including lingual and occlusal surfaces of teeth" and modified so as to show proper tongue-to-palate and teeth contact. In consequence, at the tenth month follow-up visit, satisfactory results in appearance and function were observed.
