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Oliver S, Keyser MMB, Jhingree S, Bocklage C, Lathrop H, Giduz N, Moss K, Blakey G, White R, Turvey T, Mielke J, Zajac D, Jacox LA. Impacts of anterior-posterior jaw disproportions on speech of dentofacial disharmony patients. Eur J Orthod 2023; 45:1-10. [PMID: 36308520 PMCID: PMC9912703 DOI: 10.1093/ejo/cjac057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND/OBJECTIVES Articulation problems impact communication, development, and quality of life, and are diagnosed in 73-87% of patients with Class II Dentofacial Disharmony (DFD). We evaluated whether differences exist in stop (/t/ or/k/), fricative (/s/ or/ʃ/), and affricate (/tʃ/) consonant sounds of Class II DFD subjects, and whether extent of malocclusion correlates with severity of speech distortion. We hypothesized that Class II patients display milder distortions than Class III and anterior open bite (AOB), as Class II patients can posture into a Class I occlusion. MATERIALS/METHODS Audio and orthodontic records were collected from DFD patients (N = 53-Class II, 102-Class III, 72-Controls) who were pursuing orthodontics and orthognathic surgery. A speech pathologist perceptually scored speech. Acoustic differences in recordings were measured using Spectral Moment Analysis. RESULTS When Class II subjects were compared to controls, significant differences were found for the centroid frequency (M1) of the /s/ sound and the spectral spread (M2) of /t/, /tʃ/, and /s/ sounds, with pairwise significance for controls relative to Class II AOB and all Class II subjects. Class II AOB subjects had higher M1 and M2 values than patients with Class II closed bites and Class I controls for most sounds. When comparing across anterior-posterior (AP) groups, differences exist between controls, Class II and III DFD subjects for M1 of /t/, /tʃ/, and/ʃ/ and M2 for /t/, /tʃ/, /s/, and /ʃ/ sounds. Using linear regression, correlations between Class II and III severity and spectral measures were found for /t/ and /tʃ/ sounds. CONCLUSIONS/IMPLICATIONS Class II and III patients have a higher prevalence of qualitative distortions and spectral changes in consonants compared to controls, but Class II spectral shifts are smaller and affect fewer sounds than in Class III and AOB cohorts. Linear correlations between AP discrepancy and spectral change suggest causation and that treatment may improve articulation problems.
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Affiliation(s)
- Steven Oliver
- Division of Craniofacial and Surgical Care, Orthodontics Group, Adams School of Dentistry, University of North Carolina, Chapel Hill, NC, USA
| | - Mary Morgan Bitler Keyser
- Division of Craniofacial and Surgical Care, Orthodontics Group, Adams School of Dentistry, University of North Carolina, Chapel Hill, NC, USA
| | - Samantha Jhingree
- Division of Craniofacial and Surgical Care, Orthodontics Group, Adams School of Dentistry, University of North Carolina, Chapel Hill, NC, USA
| | - Clare Bocklage
- Division of Craniofacial and Surgical Care, Orthodontics Group, Adams School of Dentistry, University of North Carolina, Chapel Hill, NC, USA
| | - Hillary Lathrop
- Division of Craniofacial and Surgical Care, Orthodontics Group, Adams School of Dentistry, University of North Carolina, Chapel Hill, NC, USA
| | - Natalie Giduz
- Division of Craniofacial and Surgical Care, Orthodontics Group, Adams School of Dentistry, University of North Carolina, Chapel Hill, NC, USA
| | - Kevin Moss
- Division of Oral and Craniofacial Health Sciences, Adams School of Dentistry, University of North Carolina, Chapel Hill, NC, USA
| | - George Blakey
- Division of Craniofacial and Surgical Care, Oral Surgery Group, Adams School of Dentistry, University of North Carolina, Chapel Hill, NC, USA
| | - Raymond White
- Division of Craniofacial and Surgical Care, Oral Surgery Group, Adams School of Dentistry, University of North Carolina, Chapel Hill, NC, USA
| | - Timothy Turvey
- Division of Craniofacial and Surgical Care, Oral Surgery Group, Adams School of Dentistry, University of North Carolina, Chapel Hill, NC, USA
| | - Jeff Mielke
- North Carolina State University, English Department, Tompkins Hall, Raleigh, NC, USA
| | - David Zajac
- Division of Craniofacial and Surgical Care, Speech Pathology Group, Adams School of Dentistry, University of North Carolina, Chapel Hill, NC, USA
| | - Laura Anne Jacox
- Division of Craniofacial and Surgical Care, Orthodontics Group, Adams School of Dentistry, University of North Carolina, Chapel Hill, NC, USA
- Division of Oral and Craniofacial Health Sciences, Adams School of Dentistry, University of North Carolina, Chapel Hill, NC, USA
- UNC Adams School of Dentistry, 385 S Columbia St, Chapel Hill, NC 27599, USA
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Jhingree S, Xie Y, Bocklage C, Giduz N, Moss K, Zajac D, Jacox LA. Validating Spectral Moment Analysis as a Quantitative Measure of Speech Distortions in Speakers With Class III Malocclusions. Perspect ASHA Spec Interest Groups 2022; 7:728-740. [PMID: 35875421 PMCID: PMC9302712 DOI: 10.1044/2022_persp-21-00315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
PURPOSE This study examined the relationship between judged speech sound distortions and spectral moment metrics in speakers with Class III malocclusion. METHODS A quantitative online survey was distributed to 30 speech specialists (clinicians and/or students) and 100 lay listeners to judge the clarity of the sounds /s/, /ʃ/, /t/ and /k/ using a visual analog scale (VAS) from recordings of 11 Class III (underbite) Dentofacial Disharmony (DFD) patients and eight Class I controls. Patients and controls were grouped according to high, moderate, and low /s/-/ʃ/ first spectral moment differences. A linear mixed model was used to analyze the data. RESULTS VAS scale ratings increased as a function of decreasing spectral contrast for both groups of listeners. VAS ratings of speech specialists were more homogenous than lay listeners, and speech specialists rated distortions as less severe than lay listeners. CONCLUSIONS Recordings of Class III DFD patients with low /s/-/ʃ/ first spectral moment differences were scored by listeners as having increased VAS scale ratings, indicative of more significant perceived speech-sound distortions. Spectral moment analysis appears to be a promising approach for characterizing speech of DFD patients and other craniofacial disorders.
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Affiliation(s)
- Samantha Jhingree
- Orthodontics, Division of Craniofacial and Surgical Care, Adams School of Dentistry, University of North Carolina, 201 Brauer Hall, CB 7450, 25799-7450, USA
- Division of Oral and Craniofacial Health Sciences, Adams School of Dentistry, University of North Carolina, CB #7455, Chapel Hill, NC 27599, USA
| | - Yushan Xie
- Orthodontics, Division of Craniofacial and Surgical Care, Adams School of Dentistry, University of North Carolina, 201 Brauer Hall, CB 7450, 25799-7450, USA
| | - Clare Bocklage
- Orthodontics, Division of Craniofacial and Surgical Care, Adams School of Dentistry, University of North Carolina, 201 Brauer Hall, CB 7450, 25799-7450, USA
- Division of Oral and Craniofacial Health Sciences, Adams School of Dentistry, University of North Carolina, CB #7455, Chapel Hill, NC 27599, USA
| | - Natalie Giduz
- UNC School of Social Work, Tate-Turner-Kuralt Building, 325 Pittsboro Street, CB #3550, Chapel Hill, NC 27599-3550 USA
| | - Kevin Moss
- Division of Oral and Craniofacial Health Sciences, Adams School of Dentistry, University of North Carolina, CB #7455, Chapel Hill, NC 27599, USA
| | - David Zajac
- Division of Craniofacial and Surgical Care, Craniofacial Center, Adams School of Dentistry, University of North Carolina, 270 Brauer Hall, CB#270, Chapel Hill, NC 25799-7450, USA
| | - Laura Anne Jacox
- Orthodontics, Division of Craniofacial and Surgical Care, Adams School of Dentistry, University of North Carolina, 201 Brauer Hall, CB 7450, 25799-7450, USA
- Division of Oral and Craniofacial Health Sciences, Adams School of Dentistry, University of North Carolina, CB #7455, Chapel Hill, NC 27599, USA
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Keyser MMB, Lathrop H, Jhingree S, Giduz N, Bocklage C, Couldwell S, Oliver S, Moss K, Frazier-Bowers S, Phillips C, Turvey T, Blakey G, White R, White RP, McMichael DL, Zajac D, Mielke J, Jacox LA. Impacts of Skeletal Anterior Open Bite Malocclusion on Speech. FACE (Thousand Oaks) 2022; 3:339-349. [PMID: 35903399 PMCID: PMC9328410 DOI: 10.1177/27325016221082229] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
INTRODUCTION Articulation problems are seen in 80-90% of dentofacial deformity (DFD) subjects compared with 5% of the general population, impacting communication and quality of life, but the causal link is unclear. We hypothesize there are both qualitative (perceptual) and quantitative (spectral) differences in properties of stop (/t/ or /k/), fricative (/s/ or /∫/), and affricate (/t∫/) consonant sounds and that severity of anterior open bite (AOB) jaw disharmonies correlates with degree of speech abnormality. METHODS To test our hypotheses, surgical orthodontic records and audio recordings were collected from DFD patients (n=39 AOB, 62 controls). A speech pathologist evaluated subjects and recordings were analyzed using spectral moment analysis (SMA) to measure sound frequency distortions. RESULTS Perceptually, there is a higher prevalence of auditory and visual speech distortions in AOB DFD patients when compared to controls. Quantitatively, a significant (p<0.01) increase in the centroid frequency (M1) was seen in the /k/, /t/, /t∫/, and /s/ sounds of AOB subjects compared to the controls. Using linear regression, correlations between AOB skeletal severity and spectral distortion were found for /k/ and /t/ sounds. CONCLUSIONS A higher prevalence of qualitative distortion and significant quantitative spectral distortions in consonant sounds were seen in AOB patients compared to controls. Additionally, severity of skeletal AOB is correlated with degree of distortion for consonant sounds. These findings provide insight into how the surgical and/or orthodontic treatment of AOB may impact speech.
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Affiliation(s)
- Mary Morgan Bitler Keyser
- Division of Craniofacial and Surgical Care, Orthodontics Group, Adams School of Dentistry, University of North Carolina, 270 Brauer Hall, CB#270, Chapel Hill, NC 25799-7450, USA
| | - Hillary Lathrop
- Division of Craniofacial and Surgical Care, Orthodontics Group, Adams School of Dentistry, University of North Carolina, 270 Brauer Hall, CB#270, Chapel Hill, NC 25799-7450, USA
| | - Samantha Jhingree
- Division of Craniofacial and Surgical Care, Orthodontics Group, Adams School of Dentistry, University of North Carolina, 270 Brauer Hall, CB#270, Chapel Hill, NC 25799-7450, USA
| | - Natalie Giduz
- Division of Craniofacial and Surgical Care, Orthodontics Group, Adams School of Dentistry, University of North Carolina, 270 Brauer Hall, CB#270, Chapel Hill, NC 25799-7450, USA
| | - Clare Bocklage
- Division of Craniofacial and Surgical Care, Orthodontics Group, Adams School of Dentistry, University of North Carolina, 270 Brauer Hall, CB#270, Chapel Hill, NC 25799-7450, USA
| | - Sandrine Couldwell
- Division of Craniofacial and Surgical Care, Oral Surgery Group, Adams School of Dentistry, University of North Carolina, 270 Brauer Hall, CB#270, Chapel Hill, NC 25799-7450, USA
| | - Steven Oliver
- Division of Craniofacial and Surgical Care, Orthodontics Group, Adams School of Dentistry, University of North Carolina, 270 Brauer Hall, CB#270, Chapel Hill, NC 25799-7450, USA
| | - Kevin Moss
- Division of Oral and Craniofacial Health Sciences, Adams School of Dentistry, University of North Carolina, 270 Brauer Hall, CB#270, Chapel Hill, NC 25799-7450, USA
| | - Sylvia Frazier-Bowers
- Division of Craniofacial and Surgical Care, Orthodontics Group, Adams School of Dentistry, University of North Carolina, 270 Brauer Hall, CB#270, Chapel Hill, NC 25799-7450, USA
| | - Ceib Phillips
- Division of Oral and Craniofacial Health Sciences, Adams School of Dentistry, University of North Carolina, 270 Brauer Hall, CB#270, Chapel Hill, NC 25799-7450, USA
| | - Timothy Turvey
- Division of Craniofacial and Surgical Care, Oral Surgery Group, Adams School of Dentistry, University of North Carolina, 270 Brauer Hall, CB#270, Chapel Hill, NC 25799-7450, USA
| | - George Blakey
- Division of Craniofacial and Surgical Care, Oral Surgery Group, Adams School of Dentistry, University of North Carolina, 270 Brauer Hall, CB#270, Chapel Hill, NC 25799-7450, USA
| | - Ray White
- Division of Craniofacial and Surgical Care, Oral Surgery Group, Adams School of Dentistry, University of North Carolina, 270 Brauer Hall, CB#270, Chapel Hill, NC 25799-7450, USA
| | | | | | - David Zajac
- Division of Craniofacial and Surgical Care, Speech Pathology Group, Adams School of Dentistry, University of North Carolina, 270 Brauer Hall, CB#270, Chapel Hill, NC 25799-7450, USA
| | - Jeff Mielke
- North Carolina State University, English Department, Tompkins Hall, Raleigh, NC, 27695, USA
| | - Laura Anne Jacox
- Division of Craniofacial and Surgical Care, Orthodontics Group, Adams School of Dentistry, University of North Carolina, 270 Brauer Hall, CB#270, Chapel Hill, NC 25799-7450, USA
- Division of Oral and Craniofacial Health Sciences, Adams School of Dentistry, University of North Carolina, 270 Brauer Hall, CB#270, Chapel Hill, NC 25799-7450, USA
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Lathrop-Marshall H, Keyser MMB, Jhingree S, Giduz N, Bocklage C, Couldwell S, Edwards H, Glesener T, Moss K, Frazier-Bowers S, Phillips C, Turvey T, Blakey G, White R, Mielke J, Zajac D, Jacox LA. Orthognathic speech pathology: impacts of Class III malocclusion on speech. Eur J Orthod 2022; 44:340-351. [PMID: 34562076 PMCID: PMC9127721 DOI: 10.1093/ejo/cjab067] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
INTRODUCTION Patients with dentofacial disharmonies (DFDs) seek orthodontic care and orthognathic surgery to address issues with mastication, esthetics, and speech. Speech distortions are seen 18 times more frequently in Class III DFD patients than the general population, with unclear causality. We hypothesize there are significant differences in spectral properties of stop (/t/ or /k/), fricative (/s/ or /ʃ/), and affricate (/tʃ/) consonants and that severity of Class III disharmony correlates with the degree of speech abnormality. METHODS To understand how jaw disharmonies influence speech, orthodontic records and audio recordings were collected from Class III surgical candidates and reference subjects (n = 102 Class III, 62 controls). A speech pathologist evaluated subjects and recordings were quantitatively analysed by Spectral Moment Analysis for frequency distortions. RESULTS A majority of Class III subjects exhibit speech distortions. A significant increase in the centroid frequency (M1) and spectral spread (M2) was seen in several consonants of Class III subjects compared to controls. Using regression analysis, correlations between Class III skeletal severity (assessed by cephalometric measures) and spectral distortion were found for /t/ and /k/ phones. CONCLUSIONS Class III DFD patients have a higher prevalence of articulation errors and significant spectral distortions in consonants relative to controls. This is the first demonstration that severity of malocclusion is quantitatively correlated with the degree of speech distortion for consonants, suggesting causation. These findings offer insight into the complex relationship between craniofacial structures and speech distortions.
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Affiliation(s)
- Hillary Lathrop-Marshall
- Division of Craniofacial and Surgical Care, Orthodontics, Adams School of Dentistry, University of North Carolina, Chapel Hill, USA
| | - Mary Morgan B Keyser
- Division of Craniofacial and Surgical Care, Orthodontics, Adams School of Dentistry, University of North Carolina, Chapel Hill, USA
| | - Samantha Jhingree
- Division of Craniofacial and Surgical Care, Orthodontics, Adams School of Dentistry, University of North Carolina, Chapel Hill, USA
| | - Natalie Giduz
- Division of Craniofacial and Surgical Care, Orthodontics, Adams School of Dentistry, University of North Carolina, Chapel Hill, USA
| | - Clare Bocklage
- Division of Craniofacial and Surgical Care, Orthodontics, Adams School of Dentistry, University of North Carolina, Chapel Hill, USA
| | - Sandrine Couldwell
- Division of Craniofacial and Surgical Care, Oral Surgery, Adams School of Dentistry, University of North Carolina, Chapel Hill, USA
| | - Haley Edwards
- Division of Craniofacial and Surgical Care, Orthodontics, Adams School of Dentistry, University of North Carolina, Chapel Hill, USA
| | - Tim Glesener
- Division of Craniofacial and Surgical Care, Orthodontics, Adams School of Dentistry, University of North Carolina, Chapel Hill, USA
| | - Kevin Moss
- Division of Oral and Craniofacial Health Sciences, Adams School of Dentistry, University of North Carolina, Chapel Hill, USA
| | - Sylvia Frazier-Bowers
- Division of Craniofacial and Surgical Care, Orthodontics, Adams School of Dentistry, University of North Carolina, Chapel Hill, USA
| | - Ceib Phillips
- Division of Oral and Craniofacial Health Sciences, Adams School of Dentistry, University of North Carolina, Chapel Hill, USA
| | - Timothy Turvey
- Division of Craniofacial and Surgical Care, Oral Surgery, Adams School of Dentistry, University of North Carolina, Chapel Hill, USA
| | - George Blakey
- Division of Craniofacial and Surgical Care, Oral Surgery, Adams School of Dentistry, University of North Carolina, Chapel Hill, USA
| | - Ray White
- Division of Craniofacial and Surgical Care, Oral Surgery, Adams School of Dentistry, University of North Carolina, Chapel Hill, USA
| | - Jeff Mielke
- Department of English, North Carolina State University, Raleigh, USA
| | - David Zajac
- Division of Craniofacial and Surgical Care, Craniofacial Center, Adams School of Dentistry, University of North Carolina, Chapel Hill, USA
| | - Laura A Jacox
- Division of Craniofacial and Surgical Care, Orthodontics, Adams School of Dentistry, University of North Carolina, Chapel Hill, USA
- Division of Oral and Craniofacial Health Sciences, Adams School of Dentistry, University of North Carolina, Chapel Hill, USA
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Jacox LA, Tang N, Li Y, Bocklage C, Graves C, Coats S, Miao M, Glesener T, Kwon J, Giduz N, Lin FC, Martinez J, Ko CC. Orthodontic loading activates cell-specific autophagy in a force-dependent manner. Am J Orthod Dentofacial Orthop 2022; 161:423-436.e1. [PMID: 35039202 DOI: 10.1016/j.ajodo.2020.09.034] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 09/01/2020] [Accepted: 09/01/2020] [Indexed: 01/07/2023]
Abstract
INTRODUCTION Orthodontic tooth movement (OTM) relies on bone remodeling and controlled aseptic inflammation. Autophagy, a conserved homeostatic pathway, has been shown to play a role in bone turnover. We hypothesize that autophagy participates in regulating bone remodeling during OTM in a force-dependent and cell type-specific manner. METHODS A split-mouth design was used to load molars with 1 of 3 force levels (15, 30, or 45 g of force) in mice carrying a green fluorescent protein-LC3 transgene to detect cellular autophagy. Fluorescent microscopy and quantitative polymerase chain reaction analyses were used to evaluate autophagy activation and its correlation with force level. Cell type-specific antibodies were used to identify cells with green fluorescent protein-positive puncta (autophagosomes) in periodontal tissues. RESULTS Autophagic activity increased shortly after loading with moderate force and was associated with the expression of bone turnover, inflammatory, and autophagy markers. Different load levels resulted in altered degrees of autophagic activation, gene expression, and osteoclast recruitment. Autophagy was specifically induced by loading in macrophages and osteoclasts found in the periodontal ligament and alveolar bone. Data suggest autophagy participates in regulating bone turnover during OTM. CONCLUSIONS Autophagy is induced in macrophage lineage cells by orthodontic loading in a force-dependent manner and plays a role during OTM, possibly through modulation of osteoclast bone resorption. Exploring the roles of autophagy in OTM is medically relevant, given that autophagy is associated with oral and systemic inflammatory conditions.
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Affiliation(s)
- Laura Anne Jacox
- Division of Craniofacial and Surgical Care, and Division of Oral and Craniofacial Health Sciences, Adams School of Dentistry, University of North Carolina, Chapel Hill, NC
| | - Na Tang
- Division of Oral and Craniofacial Health Sciences, Adams School of Dentistry, University of North Carolina, Chapel Hill, NC Department of Oral Medicine, Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, Chengdu, Sichuan, China
| | - Yina Li
- Division of Craniofacial and Surgical Care, Adams School of Dentistry, University of North Carolina, Chapel Hill, NC
| | - Clare Bocklage
- Division of Craniofacial and Surgical Care, and Division of Oral and Craniofacial Health Sciences, Adams School of Dentistry, University of North Carolina, Chapel Hill, NC
| | - Christina Graves
- Division of Oral and Craniofacial Health Sciences, Adams School of Dentistry, University of North Carolina, Chapel Hill, NC
| | | | - Michael Miao
- Curriculum in Oral and Craniofacial Biomedicine, Adams School of Dentistry, University of North Carolina, Chapel Hill, NC
| | - Tim Glesener
- Division of Oral and Craniofacial Health Sciences, Adams School of Dentistry, University of North Carolina, Chapel Hill, NC
| | - Jane Kwon
- Division of Craniofacial and Surgical Care, and Division of Oral and Craniofacial Health Sciences, Adams School of Dentistry, University of North Carolina, Chapel Hill, NC
| | - Natalie Giduz
- Division of Craniofacial and Surgical Care, Adams School of Dentistry, University of North Carolina, Chapel Hill, NC
| | - Feng-Chang Lin
- Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC
| | - Jennifer Martinez
- National Institutes of Health, Bethesda, Md National Institute of Environmental Health Sciences, Research Triangle Park, Durham, NC
| | - Ching-Chang Ko
- Division of Orthodontics, College of Dentistry, The Ohio State University, Columbus, Ohio.
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