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Evidence-based Dentistry Mar 2024Electronic search was conducted up to September 2021 in three electronic databases including Scopus, Web of Science, and EMBASE. Only studies in English language were...
DATA SOURCES
Electronic search was conducted up to September 2021 in three electronic databases including Scopus, Web of Science, and EMBASE. Only studies in English language were selected.
STUDY SELECTION
Prospective and retrospective studies including cohort, cross-sectional, randomized control trials, and qualitative studies were included. Both the inclusion and exclusion criteria were reported. The search in the databases and the selection of the studies were performed independently by two reviewers. The included studies assessed the effects of clear aligner therapy on the speech difficulty.
DATA EXTRACTION AND SYNTHESIS
Data extraction was performed independently by two reviewers. The data from the relevant studies were extracted into a customized Template. The systematic review was carried out and reported based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) reporting guidelines. Details regarding the authors, year of publication, sample size, included participants, age, groups, outcome assessment, results, and inferences were extracted from the selected studies. The quality of the selected studies was assessed based on the relevant guidelines from Cochrane Handbook for Systematic Reviews. The criteria examined sequence generation, allocation concealment, blinding, outcome data, selective reporting, and other sources of bias. Non-randomized studies were assessed using the ROBINS-I tool (Risk of Bias in Non-randomized studies). The strength of evidence was assessed by the evidence grading system developed by the GRADE collaboration as described in the Cochrane Handbook for Systematic Reviews of Interventions.
RESULTS
The search identified 283 results. 269 articles were excluded based on their title and abstract after evaluation against the inclusion criteria. 14 articles were assessed in full text. Finally, 7 papers were included in the qualitative analysis. The included studies were 5 cohort studies and 2 randomized clinical studies. 332 patients were examined in the included studies. There were 195 females and 137 males. 191 patients were treated using clear aligner therapy (CAT) while 122 patients were treated using labial fixed appliances and 19 patients were treated using lingual orthodontic treatment. Out of the 191 patients who were treated using CAT, 179 patients were treated using Invisalign (Santa Clara, CA, USA) while 12 patients were treated using Smile Align (Mumbai, India). All seven selected studies examined speech dysfunction. The speech difficulty was assessed through two tools - semiobjective assessment by speech pathologists and professionals and subjective evaluations by the patients themselves through a patient questionnaire that assess the effects of aligners on speech. The risk of bias assessment revealed that two studies had moderate risk of bias while five articles had serious risk of bias. Meta-analysis was not performed due to the high heterogeneity of the included studies. The level of evidence was assessed as low due to the methodological insufficiencies and risk of bias in the included studies. The results showed that both CAT and fixed appliances (FA) resulted in speech difficulties in terms of clarity and delivery of speech that include speech alteration, slurring of words, lisping, and nasality. Some patients who were treated using CAT reported impairment in the lingual space that affected their speech. Lingual FA resulted in more speech difficulty when compared to labial FA and CAT. Aligners caused errors in the articulation of /s/,/z/,/zh/,/sh/,/th/,/ch/. Acoustic analysis revealed /s/ sound appeared most affected. Aligners had an effect on speech while reading, with patients slowing down to their speed to better articulate. The above-mentioned speech difficulties were transient. The included patients normalized their speech within 7-14 days from start of treatment while few patients took 30-60 days to recover.
CONCLUSIONS
Although the likelihood of speech difficulties would be high with CAT, the current evidence states that speech difficulties shown with CAT are similar to those found with FA. However, the patients who were treated using CAT adapt quickly and speech recovers within a few weeks. Time to recovery varied greatly, ranging from a week to two months in certain cases.
Topics: Male; Female; Humans; Retrospective Studies; Speech; Prospective Studies; Cross-Sectional Studies; Speech Disorders; Orthodontic Appliances, Removable
PubMed: 38225369
DOI: 10.1038/s41432-024-00969-w -
Journal of Alzheimer's Disease : JAD 2024Dementia is a general term for several progressive neurodegenerative disorders including Alzheimer's disease. Timely and accurate detection is crucial for early...
BACKGROUND
Dementia is a general term for several progressive neurodegenerative disorders including Alzheimer's disease. Timely and accurate detection is crucial for early intervention. Advancements in artificial intelligence present significant potential for using machine learning to aid in early detection.
OBJECTIVE
Summarize the state-of-the-art machine learning-based approaches for dementia prediction, focusing on non-invasive methods, as the burden on the patients is lower. Specifically, the analysis of gait and speech performance can offer insights into cognitive health through clinically cost-effective screening methods.
METHODS
A systematic literature review was conducted following the PRISMA protocol (Preferred Reporting Items for Systematic Reviews and Meta-Analyses). The search was performed on three electronic databases (Scopus, Web of Science, and PubMed) to identify the relevant studies published between 2017 to 2022. A total of 40 papers were selected for review.
RESULTS
The most common machine learning methods employed were support vector machine followed by deep learning. Studies suggested the use of multimodal approaches as they can provide comprehensive and better prediction performance. Deep learning application in gait studies is still in the early stages as few studies have applied it. Moreover, including features of whole body movement contribute to better classification accuracy. Regarding speech studies, the combination of different parameters (acoustic, linguistic, cognitive testing) produced better results.
CONCLUSIONS
The review highlights the potential of machine learning, particularly non-invasive approaches, in the early prediction of dementia. The comparable prediction accuracies of manual and automatic speech analysis indicate an imminent fully automated approach for dementia detection.
Topics: Humans; Machine Learning; Dementia; Speech; Gait Analysis
PubMed: 38848181
DOI: 10.3233/JAD-231459 -
Journal of Stroke and Cerebrovascular... Sep 2023Acquired episodic stuttering in adulthood represents a rare condition, which has been infrequently described in the literature.
BACKGROUND
Acquired episodic stuttering in adulthood represents a rare condition, which has been infrequently described in the literature.
CASE PRESENTATION
We describe the case of a 62-year-old male who presented to the emergency room with three episodes of new-onset brief isolated stuttering with no other speech impairment or associated focal neurologic deficits. His brain magnetic resonance imaging was notable for the presence of a small acute ischemic stroke involving the left precuneus cortex.
SYSTEMATIC LITERATURE REVIEW
We performed a systematic literature review to evaluate the association between stroke and acquired neurogenic stuttering. The evidence published to this date suggests that the underlying pathophysiology of acquired stutter does not localize to an isolated or focal region. The development of stuttering secondary to strokes may be the result of a disruption at any level in a cortico-striato-cortical integrative pathway mediating speech execution.
CONCLUSION
Here we aimed to emphasize the importance of carefully evaluating new-onset recurrent episodic stuttering to rule out an underlying stroke or another neurogenic etiology. We provide a comprehensive review of acquired stuttering, its differential diagnosis, and its evaluation.
Topics: Male; Humans; Middle Aged; Stuttering; Ischemic Stroke; Brain; Speech; Stroke
PubMed: 37516023
DOI: 10.1016/j.jstrokecerebrovasdis.2023.107271 -
The Journal of Craniofacial Surgery Jun 2024This study aims to compare flaps at different sites in treating soft tissue defects after oral cancer surgery and improving patients' quality of life (QoL). Databases... (Comparative Study)
Comparative Study
This study aims to compare flaps at different sites in treating soft tissue defects after oral cancer surgery and improving patients' quality of life (QoL). Databases were searched until September 2023. The extracted data included the scores of chewing, swallowing, speech, mood, and appearance based on the University of Washington QoL questionnaire, version 4. Two types of free flaps and 2 types of pedicled tissue flaps were included. The free flaps were the forearm free flap (FFF) and anterolateral thigh flap, and the pedicled tissue flaps were the submental artery island flap and pectoralis major myocutaneous flap (PMMF). Compared with FFF, there was no significant difference in the scores of chewing, swallowing, speech, and mood among anterolateral thigh, submental artery island flap, and PMMF, and PMMF generally had a higher score than FFF only in terms of appearance, with statistical significance. There is no significant difference in chewing, swallowing, speech, and mood between flaps from different sites in repairing postoperative soft tissue defects of oral cancer. Therefore, the widely used FFF may be the preferred choice considering the QoL of patients after oral cancer surgery.
Topics: Humans; Quality of Life; Mouth Neoplasms; Free Tissue Flaps; Surgical Flaps; Plastic Surgery Procedures; Mastication; Deglutition; Speech
PubMed: 38363300
DOI: 10.1097/SCS.0000000000010031