臺灣博碩士論文加值系統

研究目的：
牙科方面的治療往往都是期望能讓病人提升生活品質、改善咀嚼功能、美觀、發音、提升自我形象、以及增進口腔健康等等。然而在發音這個部分，還是一直是牙醫師最常忽略的部分。對於牙齒喪失而配戴局部可撤式義齒的病患而言，於臨床上偶爾會發現舒適度、咀嚼功能上都相當理想，但是在發音上卻出現了問題。
學者們提出了腭板厚度對發音的影響，認為厚度是有直接的相關，然而卻很少有提出腭板的形狀對於發音的影響。因此本研究將探討不同的上顎主連接體對於語音清晰度的影響，同時對於舒適度也做一併的探討。
研究方法：
本研究的語音清晰度是以知覺的方法，分析二十位正常人在分別配戴4種不同上顎主連接體的語音清晰度及舒適度。依受試者的口內模型製作四種上顎主連接體，分別為：腭板、U型腭主連接體、單腭帶、以及前後腭帶。語音材料為單音節詞的評量表。評分者為三名聽力正常人，利用項目辨識法評分。而舒適度則以未配戴為10當作標準給分，再進一步比較舒適度的優劣。語音清晰度以配對t檢定，舒適度則以無母數配對t檢定做為統計方法。
結果：
本研究發現語音清晰度分數未配戴者為99.66分，腭板為99.50分，前後腭帶99.42分，U型腭主連接體99.52分，單腭帶為99.44分，正常人配戴不同的上顎主連接體雖然會對發音有些微的改變，但並不會造成語音清晰度的差異。而在舒適度方面，單腭帶為7.625分，U型腭主連接7.26分，前後腭帶6.565分，腭板6.215分，單腭帶及U型腭主連接體顯著的比前後腭帶、腭板還要舒服。
結論：
使用不同上顎主連接體並不會造成語音清晰度的差異，但可以發現在塞音三構音上卻有較易錯誤的情形。而在舒適度方面，以單腭帶和U型腭主連接體較好，因為U型腭主連接體有強度上不足的考量，因此在缺牙區適合的情形下，選擇使用單腭帶可以讓病患感覺較舒適。

The purpose of the dental treatment is going to improve quality of life, chewing ability, esthetic, phonation, self-image, and oral healthy of the patients. However, the dentists always neglect the phonation influences of the dentures. Dentists often give a denture which is comfort and good chewing, but there are still some problems on phonation.
Scholars proposed many approaches to influences of the thickness about the palatal plate with phonation. However there are few relative studies about the influences of shape of the palatal plate and phonation. So this study is going to investigate the effect of speech intelligibility with different upper major connectors. Besides, the comfort of major connectors is going to be discussed.
Twenty normal persons are wearing four types of upper major connector for measuring perceptual judgement of speech intelligibility and comfort. The four types of major connector (palatal plate, U-shaped major connector, single palatal strap, anterior-posterior palatal strap) are made after upper arch impression. The speech material is single word chart. Perceptual judgements from item identification method are done by 3 persons without any hearing disability. The comfort of major connectors is also measured. The score of comfort ranged from 0 to 10 is compared with control group(without any major connector) which is scored 10.
The score of speech intelligibility of control group is 99.66, the palatal plate group is 99.50, the anterior-posterior palatal strap group is 99.42, the U-shaped major connector group is 99.52, and the single palatal strap group is 99.44. There are no significant differences of the speech intelligibility among different upper major connectors. The comfort score of single palatal strap is 7.625, the U-shaped major connector is 7.26, the anterior-poster palatal strap is 6.565, and the palatal plate is 6.215. Single palatal strap and U-shaped major connector have better comfort than anterior-posterior palatal strap and palatal plate.

中文摘要………………………………………………….…….i
Abstract………………………………………………………..iii
致謝
第一章 緒論
第一節 研究背景…………………………………………………1
第二節 研究目的與動機………………………………………..2
第三節 研究架構………………………………………………..3
第四節 研究問題………………………………………………..4
第二章 文獻回顧
第一節 牙科補綴物與語音的關係……………………………..5
第二節 語音清晰度的概念……………………………………..10
第三節 影響語音清晰度測量的變項…………………………..12
第四節 語音清晰度的測量……………………………………..18
第三章 方法
第一節 語音樣本的採集………………………………………..27
第二節 舒適度評估……………………………………………..31
第三節 語音清晰度的測量……………………………………32

第四章 結果
第一節 知覺測量……………………………………………..34
第二節 舒適度評估…………………………………………..35
第五章 討論
第一節 主要發現……………………………………………..36
第二節 上顎主連接體對語音清晰度的影響………………..37
第三節 配戴上顎主連接體較常發生的構音錯誤…………..38
第四節 上顎主連接體對舒適度的影響…………………….40
第六章 結論與未來展望
第一節 結論…………………………………………………..41
第二節 未來展望……………………………………………..42
參考文獻………………………………………43
附表……………………………………………53
附圖……………………………………………60
表次
表3-1：二十名受測者基本資料…..…………………….53
表3-2：本研究之語音量表……...…………………….54
表4-1：二十名受試者配戴各個主連接體之語音清晰度得分…...55
表4-2：實驗組與控制組的差異與配對t檢定結果……..…..56
表4-3：不同主連接體所產生的語音對比錯語計................57
表4-4：二十位受試者對於不同上顎主連體的評分….…......58
表4-5：各組之間舒適度的平均分數差及無母數配對t定………...59
圖次
圖1-1 影響語音清晰度的架構表 …………………………………60
圖3-1 藻膠印模材圖片…………………………………………….61
圖3-2 自動調拌機圖片……………………………………………61
圖3-3 硬石膏……..…………………………………………….62
圖3-4 石膏真空調拌機………………….……………………….62
圖3-5 四種不同主連接體……………….…………………………63
圖3-6 四種主連接體試戴於口內……………………………………64
圖3-7 本研究所使用之麥克風……………………………………...65
圖3-8 本研究所使用之數位錄音機………………………………..65
圖5-1 塞音三構音(雙唇/齒槽/軟腭)口內構造相關位置………….66

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