Effect of Professional Denture Cleaning on Surface Roughness of Silicone or Acrylic Soft Relining Materials.

The aim of this study was to investigate the effects of combining mechanical (ultrasonic) and chemical cleaning (using denture cleaners) on the surface roughness of silicone or acrylic soft relining materials. The silicone soft relining material with the lowest Shore A hardness and a acrylic soft relining material routinely used in Japan were selected. Four groups were established based on type of treatment: immersion in water (W); ultrasonic cleaning in tap water (U); ultrasonic cleaning in a hypochlorous acid denture cleanser (HU); or ultrasonic cleaning in an acidic denture cleanser (AU). Following the tests, surface roughness was determined as the arithmetic mean height of the surface (Sa) and maximum height (Sz). Data were analyzed using the Kruskal-Wallis test followed by Bonferroni correction for a multiple comparison. No significant difference was observed in the Sa or Sz of the silicone soft relining material between the 4 groups. Significant differences were observed in the Sa of the acrylic soft relining material between Groups W and HU (p=0.008) and between Groups W and AU (p=0.008), but no significant differences in the Sz among the 4 groups. Combining U with AU or U with HU yielded no increase in the surface roughness of the silicon soft relining material. The surface roughness of the acrylic soft relining material showed an increase, however, with the combination treatments used.

Comparison of Adhesive Resistance to Chewing Gum among Denture Base Acrylic Resin, Cobalt-Chromium Alloy, and Zirconia.

The purpose of this study was to compare the adhesiveness of chewing gum to acrylic resin, cobalt-chromium alloy, and zirconia. Test specimens were fabricated using acrylic resin (resin), cobalt-chromium alloy (Co-Cr), and Ceria stabilized tetragonal zirconia polycrystal-based nanostructured zirconia/alumina composite (zirconia). Specimens of each material were attached to the upper and lower terminals of a digital force gauge. The operator masticated chewing gum, wiped off any saliva, and placed the gum on the lower specimen. The gum was compressed to a thickness of 1 mm between the upper and lower specimens. Thereafter, traction was applied to the upper specimen at a cross-head speed of 100 mm/min under 3 different conditions (dry, wet with distilled water, and wet with artificial saliva) to determine the maximum adhesive strength of the chewing gum. The statistical analysis was performed using the Bonferroni test after a one-way analysis of variance (α=0.05). Under dry conditions, adhesive force was 14.8±6.8 N for resin, 14.0±4.8 N for Co-Cr, and 4.3±2.3 N for zirconia. Significant differences were noted between resin and zirconia, and between Co-Cr and zirconia. When distilled water was applied to the specimen surface, the adhesive strength was 16.8±1.7 N for resin, 8.3±2.1 N for Co-Cr, and 2.7±0.8 N for zirconia. Significant differences were noted between resin and Co-Cr, resin and zirconia, and Co-Cr and zirconia. When artificial saliva was applied to the specimen surface, the adhesive force was 18.5±2.8 N for resin, 5.3±0.8 N for Co-Cr, and 3.0±1.7 N for zirconia. Significant differences were noted between resin and Co-Cr, and resin and zirconia. Chewing gum adhered less strongly to zirconia than to acrylic resin or cobalt-chromium alloy.

Effect of luting system with acidic primers on the durability of bonds with Ti-15Mo-5Zr-3Al titanium alloy and its component metals.

This study evaluated the effect of luting system with acidic primers on the durability of bonds with Ti-15Mo-5Zr-3Al titanium alloy (Ti-15Mo-5Zr-3Al) and its component metals. Adherend metals were Ti-15Mo-5Zr-3Al, Ti, Mo, Zr, and Al. Four primers were evaluated as adhesion promoters: Alloy Primer (ALP), Estenia Opaque Primer (EOP), M. L. Primer (MLP), and Super Bond liquid (SBL). An acrylic resin was used as the luting material. Pre- and post-thermocycling shear bond strength was determined to evaluate the bonding durability, and the results were compared using non-parametric statistical analyses (n=11/group). The post-thermocycling bond strength in MPa (median) associated with ALP, EOP, MLP, and SBL were 18.8, 19.8, 4.1, and 0.8, respectively, for Ti-15Mo-5Zr-3Al. The results showed that two primers containing 10-methacryloyloxydecyl dihydrogen phosphate (MDP) were effective for the durability of bonding of Ti-15Mo-5Zr-3Al to the resin. MDP enhanced the bonding durability of the resin bonded to either Ti, Zr, or Al.

Spindle Cell Variant of Ameloblastic Carcinoma: Another Example in a Japanese Male.

Spindle cell variant of ameloblastic carcinoma (SpCAC) is a rare subtype of ameloblastic carcinoma. Herein, we describe an additional case of SpCAC of the mandible of a 76-year-old Japanese male. We discuss diagnostic problems we encountered in this case, focusing on unusual expression of myogenic/myoepithelial markers, such as smooth muscle actin and calponin.

Usefulness of myofascial flap without skin in contemporary oral and maxillofacial reconstruction.

PURPOSE: Pedicle myofascial graft should be considered in contemporary oral and maxillofacial reconstruction for the following reasons: 1) the pedicle myofascial unit is reliable and easily handled; 2) on the grafted myofascia in the oral cavity, the mucosa regenerates naturally with regard to suppleness and surface characteristics; and 3) vascularized myofascial coverage of tissues or materials is useful in some clinical situations. The purpose of this retrospective study was to evaluate the usefulness of this graft material. PATIENTS AND METHODS: Using myofascial flaps from the pectoralis major muscle in 15 patients and from the platysma muscle in 11 patients, several types of reconstructive procedures were conducted in the Department of Oral and Maxillofacial Surgery, Wakayama Medical University. RESULTS: Myofascial tissue was used to cover the surgical defect and for regeneration of oral mucosa (24 patients), to prevent exposure of the mandibular reconstruction plate (4 patients), for prevention of wound breakdown and secondary infection in the oral cavity (2 patients), for vascularized coverage of free grafted autologous bone (2 patients), and for protection of large vessels after radical neck dissection (9 patients). Although partial flap necrosis or wound dehiscence was noticed in 3 patients with a platysma-myofascial graft, the healing process of all patients was favorable and required no additional operations. This procedure is most suitable for the reconstruction of small to medium-sized soft tissue defects in the oral cavity, because it induces the formation of nearly normal mucosa through epithelial regeneration without clear scar formation. CONCLUSIONS: Myofascial flap is a useful option in certain oral and maxillofacial reconstruction cases in which mucosal regeneration and/or vascularized soft tissue coverage are required.

Effect of mechanical and chemical cleaning on surface roughness of silicone soft relining material.

PURPOSE: This study aims to investigate the effect of mechanical and chemical cleaning on the surface roughness of silicone soft relining materials. METHODS: We selected silicone soft relining materials with the highest (Soft) and lowest (Supersoft) Shore A hardness. In the abrasion test, specimens were cleaned 50,000 times using a kitchen sponge (Sponge), a soft (Soft brush) or hard (Hard brush) denture brush, or stored in water (No cleaning). In the immersion test, specimens were immersed in either water (Water), neutral peroxide denture cleanser (Neutral), alkaline peroxide denture cleanser (Alkaline), or hypochlorite denture cleanser (Hypochlorite) for 1440 h. Surface roughness of the arithmetic mean height of the surface (Sa) and maximum height (Sz) were measured before and after the tests. Data were analyzed using the Kruskal-Wallis and Mann-Whitney U tests. RESULTS: In the abrasion test, significant differences were observed for Sa and Sz with Soft relining materials, but not for No cleaning and Sponge. In the immersion test, significant differences were observed for Sa and Sz with Soft relining materials, but not between Water and Neutral or Water and Alkaline. Significant differences were observed with Supersoft, except between Water and Neutral or Water and Alkaline for Sa and between Water and Neutral for Sz. CONCLUSIONS: Mechanical cleaning using a sponge did not increase the surface roughness of the material with a high Shore A hardness. Furthermore, neutral peroxide denture cleanser did not increase the roughness of materials with high and low Shore A hardness.

Comparison of adhesiveness of chewing gum to hard and soft denture base materials.

PURPOSE: The purpose of this study was to compare the adhesiveness of chewing gum to hard and soft denture base materials to investigate food retention associated with the basal surface of the denture. METHODS: Test specimens were fabricated using acrylic resin[Re], cobalt-chromium alloy[Co], zirconia[Zr], silicone soft relining material[SS], and acrylic soft relining material[AS]. Samples were set on a top-and-bottom pair lifting platform equipped with a digital force gauge. The experimenter chewed 3.0 g of chewing gum for 5 min. After surface saliva was wiped off, the chewing gum was placed on the lower test fragment and compressed until the distance between the upper and lower test fragments decreased to 1 mm. The upper test fragment was pulled at a crosshead speed of 100 mm/min. Adhesiveness was measured under dry conditions, and under wet conditions with inter-positioned artificial saliva. RESULTS: Under dry conditions, the adhesive strength was 17.04 ±â€¯1.99 N for Re, 12.88 ±â€¯2.20 N for Co, 3.80 ±â€¯1.03 N for Zr, 5.76 ±â€¯1.41 N for SS, and 12.54 ±â€¯2.44 N for AS. Under wet conditions, the adhesive strength was 5.26 ±â€¯1.64 N for Re, 0.96 ±â€¯0.21 N for Co, 3.32 ±â€¯0.40 N for Zr, 5.20 ±â€¯1.35 N for SS, and 6.78 ±â€¯1.97 N for AS. CONCLUSIONS: Among the hard denture base materials, zirconia recorded low adhesiveness and Re recorded high adhesiveness under both wet and dry conditions. The adhesiveness of Co was low under wet conditions but high under dry conditions. Among the soft denture base materials, SS under dry conditions recorded lower adhesiveness than that of AS. The adhesiveness of SS was low under both wet and dry conditions.

Influence of chewing on expression level of human beta-defensin 2 and secretory immunoglobulin A in the epithelium.

PURPOSE: This study aimed to clarify the influence of chewing on human ß-defensin 2 (hBD-2) and secretory immunoglobulin A (SIgA) expression levels. METHODS: We included 15 healthy males with no missing teeth (mean age, 25.5±2.5years). Subjects were instructed to chew a piece of gum for 30min. Saliva and skin-extraction samples were collected before and after chewing for 15 and 30min. hBD-2 and SIgA concentrations in the samples were determined using enzyme-linked immunosorbent assay (ELISA). hBD-2 and SIgA expression levels before and after chewing were analyzed using the Mann-Whitney U test, following the Friedman test. The significance level was 0.05. RESULTS: The hBD-2 level in skin-extraction samples was significantly different before (99.4±17.3pg/mL) and after chewing for 30min (142±23.0pg/mL). The SIgA level in skin-extraction samples was also significantly different before (2.39±0.25µg/mL) and after chewing for 30min (3.61±0.33µg/mL). No significant difference was noted in either hBD-2 or SIgA secretion rate in saliva between before and after chewing. CONCLUSIONS: Chewing gum for 30min increased hBD-2 and SIgA expression levels in skin. Moreover, chewing gum could influence the secretion pattern of these two biomolecules on skin, but not in saliva.

Surface morphology of silicone soft relining material after mechanical and chemical cleaning.

PURPOSE: The objective was to investigate the influence of chemical and mechanical cleaning on the surface morphology of a silicone soft relining material. METHODS: Three plate-shaped specimens were prepared for each group (Control, Hard and Soft) by laminating a 1.5-mm-thick silicone soft relining material. The Control group specimens were stored in water, and the Hard and Soft group specimens were cleaned with hard and soft bristle denture brushes, respectively. Abrasion testing with a toothbrush and immersion testing with an enzyme-containing peroxide denture cleanser were performed, simulating a period of approximately 4 months. The arithmetic mean roughness (Sa) and maximum height of the cross-section (Sz) were measured before and after abrasion and immersion testing. RESULTS: Sa was 4.9±0.9, 22.1±4.2 and 44.2±4.0µm in the Control, Soft and Hard groups, respectively. Sz was 257.5±31.7, 392.0±23.8 and 452.2±41.9µm in the Control, Soft and Hard groups, respectively. After abrasion testing, Sa and Sz differed significantly between the Soft and Control groups and between the Hard and Control groups. Sa was 2.2±1.2µm before and after immersion, and Sz was 142.1±81.4µm before and after immersion. No significant difference was noted in either Sa or Sz in the Control specimens before or after immersion. CONCLUSIONS: Surfaces cleaned using a soft bristle brush were less likely to roughen than those cleaned with a hard bristle brush under the conditions of this study. Additionally, chemical cleaning using the enzyme+neutral peroxide denture cleanser did not roughen the surface of the silicone soft relining material.

Nickel-associated delayed multiple white matter lesions after stent-assisted coil embolization of intracranial unruptured aneurysm.

Metal-induced encephalopathy after stent-assisted coil embolization is extremely rare. The present report describes two patients who presented with symptomatic intracranial parenchymal edematous lesions after stent-assisted coil embolization. A 64-year-old woman underwent stent-assisted coil embolization for a left internal carotid artery aneurysm; 21 days after the procedure she presented with right hand weakness and MRI revealed multifocal white matter lesions. Another woman aged 52 years underwent stent-assisted coil embolization for right vertebral artery aneurysm; 18 days after the procedure she presented with left-sided sensory disturbance and MRI demonstrated multiple white matter lesions. Treatment in both cases resulted in improvement of these lesions after steroid pulse therapy, and the patients had no associated morbidity 4 months after the procedures. Clinicians should monitor for neurologic symptoms and postoperative delayed radiologic parenchymal edematous changes associated with the metal allergic reaction after nitinol stent-assisted coil embolization.

Evaluation of participants' perception and taste thresholds with a zirconia palatal plate.

PURPOSE: Zirconia and cobalt-chromium can withstand a similar degree of loading. Therefore, using a zirconia base for removable dentures could allow the thickness of the palatal area to be reduced similarly to metal base dentures. We hypothesized that zirconia palatal plate for removable dentures provides a high level of participants' perception without influencing taste thresholds. The purpose of this study was to evaluate the participants' perception and taste thresholds of zirconia palatal plate. METHODS: Palatal plates fabricated using acrylic resin, zirconia, and cobalt-chromium alloy were inserted into healthy individuals. Taste thresholds were investigated using the whole-mouth gustatory test, and participants' perception was evaluated using the 100-mm visual analog scale to assess the ease of pronunciation, ease of swallowing, sensation of temperature, metallic taste, sensation of foreign body, subjective sensory about weight, adhesiveness of chewing gum, and general satisfaction. RESULTS: For the taste thresholds, no significant differences were noted in sweet, salty, sour, bitter, or umami tastes among participants wearing no plate, or the resin, zirconia, and metal plates. Speech was easier and foreign body sensation was lower with the zirconia plate than with the resin plate. Evaluation of the adhesiveness of chewing gum showed that chewing gum does not readily adhere to the zirconia plate in comparison with the metal plate. The comprehensive participants' perception of the zirconia plate was evaluated as being superior to the resin plate. CONCLUSIONS: A zirconia palatal plate provides a high level of participants' perception without influencing taste thresholds.

Expression of caveolin-1 and its correlation with cisplatin sensitivity in oral squamous cell carcinoma.

PURPOSE: Cisplatin (CDDP) is widely used for chemotherapy of oral squamous cell carcinoma (OSCC). However, the mechanism of resistance to CDDP is unclear. Recently, caveolin-1 was identified as being associated with both metastasis and multidrug resistance. In the present study, we showed that caveolin-1 expression is significantly related to chemosensitivity in OSCC. METHODS: We established a CDDP-resistant cell line, H-1R, from the parental OSCC cell line, H-1. Caveolin-1 expression was determined by reverse transcriptase-polymerase chain reaction (RT-PCR) in both cell lines. We analyzed expression of caveolin-1 in 30 OSCC biopsy specimens and investigated the relationship between expression of caveolin-1 and patients' clinicopathological parameters and chemotherapeutic responses. RESULTS: The 3-(3,4-dimethyl-thiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay indicated that H-1R has a ten-times greater resistance to CDDP than H-1 has. The level of caveolin-1 expression in H-1R was significantly decreased in comparison with that in H-1 by real-time RT-PCR analysis. Positive caveolin-1 immunostaining correlated positively with a complete response (16/20, 80.0%). However, negative immunostaining was found in 6/7 (85.7%) cases with no response. Positive immunohistochemical staining of caveolin-1 correlated positively with chemosensitivity to CDDP-based combination chemotherapy (P=0.02). CONCLUSIONS: These results suggest that overexpression of the caveolin-1 gene may provide novel diagnostic markers associated with CDDP sensitivity in OSCC.

Establishment and gene analysis of a cisplatin-resistant cell line, Sa-3R, derived from oral squamous cell carcinoma.

Cisplatin (CDDP) is widely used for chemotherapy of many malignancies, especially of oral squamous cell carcinoma (SCC). However, because the mechanism of resistance to CDDP is unclear, we established a CDDP-resistant cell line, Sa-3R, from a CDDP-sensitive cell line, Sa-3, which was derived from moderately differentiated SCC of the lower gingiva. The 3-(3,4-dimethyl-thiazol-2-yl) 2,5-diphenyltetrazolium bromide assay indicated that Sa-3R has 7.5-fold greater resistance to CDDP than Sa-3. Comparing gene expression levels in the cell lines using an in-house cDNA microarray, which represented 2,201 oral disease origin genes, many differentially expressed genes were identified. The ATP-binding cassette transporter genes (MDR-1, MRP-1, and MRP-2), and FANCONI, GRP58, FLJ12089, and SPINT-2 were up-regulated, whereas FOSL1, MRPS27, and PGK-1 were down-regulated. These results were confirmed by semiquantitative reverse transcriptase-polymerase chain reaction. The Sa-3/Sa-3R cell lines could be useful to identify the candidates responsible for the mechanism of CDDP-resistance and the up- or down-regulated genes identified by the gene expression profiles in the Sa-3R cell line may be, in part, associated with the mechanism.

Establishment and characterization of a cisplatin-resistant oral squamous cell carcinoma cell line, H-1R.

Cisplatin (CDDP) is a widely used potent chemotherapeutic agent for many malignancies. However, the mechanism of resistance to CDDP remains unclear. To investigate the molecular mechanism, we established a CDDP-resistant cell line (H-1R) from a CDDP-sensitive cell line (H-1) which was derived from moderately differentiated squamous cell carcinoma of the lower gingiva. The 3-(3,4-dimethyl-thiazol-2-yl) 2,5-diphenyltetrazolium bromide (MTT) assay indicated that H-1R had a 10-fold greater resistance to CDDP than H-1. When we compared gene expression levels in the cell lines using an in-house cDNA microarray, which represented 2,201 genes originating from normal oral tissue, primary oral cancer, and oral cancer cell lines, 12 genes showing elevated mRNA expression in H-1R compared with H-1 were identified. Among them, the up-regulated expression of ATP-binding cassette transporter genes (MDR1, MRP1, and MRP2), CD55, and PGK1 and down-regulated expression of Caveolin 1 were further confirmed by semiquantitative reverse transcriptase-polymerase chain reaction (PCR) or real-time PCR. Our results suggest that H-1 and H-1R cell lines could be useful for elucidating the candidate genes responsible for CDDP resistance, including the genes found in this study.

Longitudinal investigation of soft palate and nasopharyngeal airway relations in different rotation types.

The relationship between the soft palate and the nasopharyngeal airway in different mandibular growth rotation models was investigated. A total of 72 lateral cephalograms were obtained three years longitudinally from 24 individuals. The subjects had a mean age of 10.7 +/- 1.2 years and showed a normal (n = 8), posterior (n = 8), and anterior (n = 8) mandibular rotation pattern. Linear and angular measurements of the soft palate and nasopharyngeal airway were recorded by using PORDIOS computer program and were examined by means of descriptive statistics and paired t-tests. A linear increase in the soft palate length (SPL) was observed in all groups, with the posterior mandibular rotation group showing the largest increase within the observation period (28.56 +/- 4.83 to 34.98 +/- 2.87; P < .01). According to the paired t-test, palatal plane (ANS-PNS)/soft palate tip (SPT) angle showed a statistically significant decrease in the posterior rotation group (P < .01). The ratio between SPL and superior nasopharyngeal space (SPS) did not show a statistically significant difference among the groups. Although various amounts of soft palate and nasopharyngeal airway growth occurred in the different mandibular rotation types, the ratio between SPL and SPS (SPL/SPS), which plays an indispensable role in velopharyngeal functions, did not show a statistically significant difference in the groups. This assured velopharyngeal closure throughout the active growth period.

Serine- and mannose-modified liposomal contrast agent for computed tomography: evaluation of the enhancement in rabbit liver VX-2 tumor model.

Kupffer cell imaging is a powerful tool for the detection of liver cancer. This diagnostic procedure depends on the faculty of the reticuloendothelial system (RES) which takes up foreign bodies, including small particles. The current study aimed to develop a novel RES targeting liposomal contrast agent that functionalized with serine or mannose, the moiety specifically binding to a corresponding receptor on phagocytic cells. Liposomes loaded with non-ionic X-ray contrast media, Iohexol, were prepared by supercritical carbon dioxide reverse-phase evaporation method and were intravenously injected to healthy rabbits in order to evaluate the liver parenchymal enhancement in X-ray computed tomography (CT). From 10 to 40 min after injection, the mean enhancement value of the liver parenchyma approached 45 and 34 Hounsfield units (HU) when serine-modified iodinated liposomal contrast agent (ILCA) and mannose-modified ILCA were applied, respectively. The tumor-to-liver contrast values were also evaluated after the administration of the prepared ILCA to rabbits with VX-2 carcinoma. For serine-modified ILCA, tumor-to-liver contrast was 82 HU at 1 min and >24 HU at 10-40 min; for mannose-modified ILCA, the values were 58 HU at 0.5 min and >21 HU at 10-40 min. These vales estimated from the region of intrest and the imaging figures of liver indicate the potential of ILCA for clinical use.

Synthesis of a novel ester analog of nucleic acids bearing a serine backbone.

A novel analog of nucleic acids bearing an optically active serine ester backbone, serine-based nucleobase-linked polyester (SNE), was synthesized. Monomers containing a thymine base were synthesized from L- and D-serines. Furthermore, reaction conditions were thoroughly examined for the ester bond formation by using a new phosphonium-type condensing reagent on a solid support without racemization. The release of the dimer from the resin was also investigated using a new type of linker, which could be cleaved under neutral conditions.

Prediction of deterioration of velopharyngeal function associated with maxillary advancement using electromyography of levator veli palatini muscle.

OBJECTIVE: The purpose of the present study was to examine the possibility that postoperative velopharyngeal function following maxillary advancement could be predicted using preoperative electromyography of the levator veli palatini. DESIGN: Levator muscle electromyography was recorded preoperatively during speech and blowing. Levator activity was expressed as a percentage relative to the maximum value observed throughout the experiment. Postoperative velopharyngeal function was evaluated by means of perceptual judgment and nasoendoscopy. PARTICIPANTS: The subjects were four patients with repaired cleft palates who underwent maxillary advancement, two by osteotomy and two by distraction osteogenesis. None of the subjects presented with preoperative hypernasality, and nasoendoscopy demonstrated complete velopharyngeal closure in all subjects prior to maxillary advancement. RESULTS: Preoperative levator activity for speech of two subjects was similar to that for normal speakers (< 60% of total range), and postoperative nasality and nasoendoscopic findings revealed no detectible changes. For the other two subjects, levator activity for speech exceeded 60% of the total range, similar to that of speakers with velopharyngeal incompetence. These subjects showed increased hypernasality and deteriorated velopharyngeal closure following maxillary advancement. CONCLUSION: The deterioration of velopharyngeal function associated with maxillary advancement was demonstrated for subjects whose levator activity was at higher levels during speech in comparison with maximal activity observed during blowing, regardless of the amount of maxillary advancement. Preoperative levator muscle electromyography could be a predictor in identifying patients at higher risk of postsurgical deterioration of velopharyngeal function.

Effect of a speech prosthesis on electromyographic activity levels of the levator veli palatini muscle activity during syllable repetition.

OBJECTIVES: To examine whether repeated production of a syllable effects levator veli palatini muscle activity for speakers with velopharyngeal incompetence and whether the effect can be changed by a speech prosthesis. DESIGN: Repeated-measures analysis; each subject produced the speech sample /pu/ more than 200 times in each of 2 experimental conditions. SETTING: Graduate dental school in Japan. PARTICIPANTS: Four patients with operated cleft palate with a speech prosthesis. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Electromyographic traces were highband-pass filtered at 30 Hz, rectified, and smoothed with a time constant of 30 ms. Electromyographic traces were made of each production in 2 conditions: (1) without the prosthesis and (2) with the prosthesis. The regression slope of the linear regressor line, when smoothed levator activity was the criterion variable and the number of productions was the explanatory variable, was calculated in each condition. RESULTS: The mean value of levator activity was significantly smaller with the prosthesis in than without it (P<.10, t test). With the prosthesis, the regression slope was significant for all 4 subjects, whereas it was insignificant without the prosthesis for 3 of 4 subjects (P<.10, t test). Absolute values of the regression slope were significantly smaller with the prosthesis than without it for all subjects (P<.10, t test). Comparison of the regression slopes for the 2 conditions identified a significant difference in slopes between the 2 conditions (P<.10, t test). CONCLUSION: In operated cleft palate patients with velopharyngeal incompetence, a speech prosthesis can stabilize both temporal changes in levator muscle activity and connected speech, such as conversation.